The Clinical Value of the Glucogram and a New Approach to the Intravenous Glucose Tolerance Test

Abstract

The analysis of 197 glucograms is presented and the authors discuss some new points of clinical importance in the appraisal of the diabetic state. The suggestion is also made that when the sulphonylurea test is done, it should follow sequentially an intravenous glucose tolerance test. Further, it was found that in assessing the result of an intravenous glucose tolerance test it is of importance to take into account the blood sampling method, and whether the patient is ambulant or confined to bed. A simplified intravenous glucose tolerance test is suggested which requires 3 blood samples only, takes less than an hour to perform and derives the K-value from a simple table. The Correlation of the various tests and their clinical interpretation is discussed.Die Arbeit beschäftigt sich mit der Analyse von 197 Glucogrammen. Anhand dieses Materials werden einige neue Gesichtspunkte für die Diabetes-Diagnose diskutiert. Unter anderem wird vorgeschlagen, daß der Sulfonylharnstoff-Test immer anschließend an einen intravenösen Glucosebelastungstest gemacht wird, und, daß bei der Beurteilung cies intravenösen Glucosebelastungstests sowohl die Art der Blutprobe, als auch der Unterschied zwischen ambulanter oder stationärer Untersuchung berücksichtigt werden muß. Eine vereinfachte Methode dieses Tests, die nur drei Blutproben verlangt und in einer Stunde beendigt ist, und in der man den K-Wert von einer Tabelle abliest, ist erstmalig beschrieben. Die Beziehung der verschiedenen Tests zueinander und ihre klinische Interpretation wird ausführlich besprochen. SulphonylureaTolbutamide, and sometimes chlorpropamide were given. These were supplied in readily injectable form, either 10 or 20 m/ ampoules. Of tolbutamide 1.0 g was given, of chlorpropamide 0.5 g, but the injectable form of the latter drug is only available by special request from the manufacturers. No adverse effects were seen as a result of these injections. Glucose analysisMost of our glucograms were recorded with the use of the HOFFMAN ferricyanide reaction (8) and our manifold has been Z. klin. Chem. / 4. Jahrg. 1966 / Heft 5 32 Brought to you by | provisional account Unauthenticated Download Date | 7/18/15 9:20 AM

Continuous Monitoring of Blood Sugar in the Investigation of Glucose Homeostasis

“…They devised a doublelumen catheter (Weller et al, 1960), through one lumen of which blood could be sampled, after it had been anticoagulated by heparin pumped down the other lumen. However, most early workers found it easier either to heparinise the patient or to add anticoagulants after the blood had been sampled (Kawerau and Surtees, 1966). Nonetheless, the method was never widely adopted, due to Paper read at Southern England and South Wales Regional Mcctiog, London, March, 1969. difficulties in sampling; and Professor Butterfield and his colleagues concluded in 1964: 'The precautions needed to prevent blood clotting in the AutoAnalyzer were arduous ... and we recommend frequent sampling rather than continuous monitoring whenever possible' (Butterfield et al, 1964).…”