A glucose tolerance test with the prior administration of triamcinolone (8 mg. at eleven and at one hour preceding glucose) was performed in two groups, (1) a control group of 163 normal individuals having no diabetic antecedents; and (2) a group of 301 “clinically prediabetic” patients so classified on obstetrical grounds orbecause both parents were diabetic, with a previously normal glucose tolerance test.
Abnormal triamcinolone curves were found in 1.8 per cent of the control group, an additional 1.8 per cent were “suspicious,” contrasting with 80 per cent abnormal and 11.6 per cent “suspicious” curves in the clinically prediabetic group. A comparison of this test with the standard glucose tolerance, the tolbutamide or the glucose-cortisone test, reveals that the triamcinolone test had a higher correlation with the clinical findings; also, the disadvantages attributed to the glucose-cortisone test did not occur.
In fifty-five subjects, with two diabetic parents, and who had a previous normal glucose tolerance test, 67.2 per cent showed abnormalities when tested by a triamcinolone glucose tolerance test (54.5 per cent abnormals and 12.7 per cent suspicious). This result contrasted with an incidence of 1.6 per cent abnormal tests and an additional 1.6 per cent suspicious tests in a control group matched for age and sex.It is suggested that the triamcinolone provocative test be further employed in the search for diabetic tendencies in suspicious or likely subjects. DIABETES 16:57-60, January, 1967.
In 152 consecutively observed mothers who had delivered malformed infants intheir last pregnancy, 10 per cent had abnormal standard glucose tolerance tests and 45 per cent abnormal triamcinolone glucose tolerance tests. These findings are in contrast to a 3.3 per cent prevalence of abnormal triamcinolone glucose tolerance tests in a controlled group selected for absence of findings suggesting diabetes. The observation suggests that a relation exists between carbohydrate disturbance and the delivery of malformed infants.
a) From 67 to 87 per cent of the abnormal triamcinolone glucose tolerance curves are improved after treatment with small doses of hypoglycemic drugs.(b) As the weight reducing diet normalized only 6.6 per cent of the abnormal triamcinolone curves, it is possible to conclude that weight reduction alone is not enough to normalize this test.(c) The incidence of obstetrical complications (macrosomias, miscarriages, stillbirths, habitual abortion, and congenital malformations) in women with an abnormal triamcinolone test decreases remarkably or disappears after normalization of this test. DIABETES 75: 726-29, October, 1966.
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