The Rapid Intravenous Glucose Tolerance Test in Obstetrical Patients with a Family History of Diabetes

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Abstract
The index of tolerance of the rapid intravenous glucose tolerance test (GTT) was based on the slope k of the logarithmic fall in venous glucose concentration during the first hour following the intravenous injection of 25 gm of glucose. The mean values and lower ranges of k were determined in 116 healthy, nondiabetic women without family or obstetrical histories suggesting diabetes, in order to provide standards for the application of the test in the screening of diabetes suspects. An enhanced response to the rapid intravenous GTT occurs during pregnancy in normal controls, in contrast to the unchanged or impaired responses reported with other tolerance tests. This distinguishing feature is of importance in the evaluation of the obstetrical patient. Application of the rapid intravenous GTT to ninety-seven apparently well, obstetrical patients with normal gestational histories but with a family history of diabetes resulted in a 31% incidence of low responses. In 70 of these patients with diabetes in their close relatives, the incidence of impaired tolerance was 36%. Subsequent retesting indicated a tendency for improvement of low k values in the early postpartum period and for deterioration of normal responses during a subsequent pregnancy and with the passage of time. As a screening procedure for individuals susceptible to diabetes, the rapid intravenous GTT yields a high incidence of positive responses, is not adversely affected by the pregnant state and conveniently presents the tolerance test data in terms of a single numerical index.

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