Self-administered oral glucose tolerance test with capillary glucose measurements for the screening of diabetes mellitus in high-risk adults: a feasibility study

Abstract

IntroductionEarly diagnosis of prediabetes based on blood sampling for the oral glucose tolerance test (OGTT) is crucial for intervention but multiple barriers hinder its uptake. This study aimed to assess the feasibility and precision of a self-administered capillary OGTT for type-2 diabetes mellitus (T2DM) in high-risk individuals.Research design and methodsParticipants with history of gestational diabetes or prediabetes were recruited in primary care. Due to their prediabetic status and previous diagnosis of gestational diabetes mellitus, a proportion of participants had previous experience doing OGTT. They self-administered the capillary OGTT and concurrently their venous glucose samples were obtained. They filled a questionnaire to collect their demographic information, views of their capillary OGTT, and their preferred site of the test.ResultsAmong 30 participants enrolled in this feasibility study, 93.3% of them felt confident of performing the capillary OGTT themselves, and 70.0% preferred the test at home. Older, less educated participants found it less acceptable. Mean capillary glucose values were significantly higher than venous glucose values, with mean difference at 0.31 mmol/L (95% CI 0.13 to 0.49) at fasting, and 0.47 mmol/L (95% CI 0.12 to 0.92) 2 hours post-OGTT. Capillary and venous glucose measurements were correlated for fasting (r=0.95; p<0.001) and 2-hour-post-OGTT (r=0.95;p<0.001). The Fleiss-Kappa Score (0.79, p<0.0001) indicated fair agreement between the two methods. The capillary OGTT had excellent sensitivity (94.1%) and negative predictive value (NPV=91.7%) in identifying prediabetes or T2DM status, vis-a-vis to venous glucose samples.ConclusionSelf-administered capillary OGTT is feasible and acceptable, especially among younger adults, with excellent sensitivity and NPV compared with plasma-based OGTT.

S-allyl cysteine and Taurine attenuate diabetic nephropathy in rats via the inhibition of oxidative stress and recovering histopathological changes

“…Due to its ease of application, it is the physiological test that is most frequently used for rodents to firstly examine their glucose homeostasis. When a bolus of glucose is administered, the OGTT monitors alterations in blood glucose values over a two-hour period (Nelson, 1988; Tan et al ., 2021).…”

Light stimulation of mitochondria reduces blood glucose levels

“…Participants fasted overnight, consuming only water for at least 10 h prior to the OGTT. An initial finger prick capillary blood glucose level was measured using a blood glucose monitor (Kinetik Wellbeing, UK), which has demonstrable sensitivity [22]. Subsequently, participants consumed 75 g glucose in water (total volume of 150 mL), within 2 min.…”

Pregnancy as an opportunity to prevent type 2 diabetes mellitus: FIGO Best Practice Advice

“…The rate of adherence to postpartum follow‐up is improved when proactive systems are in place, in addition to routine care. Providing an option for home blood sample collection for completing the OGTT has been shown to increase the rate of follow‐up 24,66,67 . Moreover, evidence suggests that sending reminders to patients to return for follow‐up by telephone, e‐mail, or SMS increased the odds of a postpartum visit three‐fold compared with no reminders 68 .…”

“…Providing an option for home blood sample collection for completing the OGTT has been shown to increase the rate of follow‐up. 24 , 66 , 67 Moreover, evidence suggests that sending reminders to patients to return for follow‐up by telephone, e‐mail, or SMS increased the odds of a postpartum visit three‐fold compared with no reminders. 68 However, a personalized approach, such as making telephone calls in lieu of emails or letters, has been shown to improve screening rates and enhance patient commitment.…”