Using Ice Cream for Diagnosis of Diabetes Mellitus and Impaired Glucose Tolerance: An Alternative to the Oral Glucose Tolerance Test

Chanprasertpinyo, Wandee; Bhirommuang, Nattapimon; Surawattanawiset, Titiporn; Tangsermwong, Thanwarin; Phanachet, Pariya; Sriphrapradang, Chutintorn

doi:10.1016/j.amjms.2017.08.007

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Several studies have explored substituting a glucose drink with food, e.g. ice cream, a muffin and beverage, or a specially designed breakfast 24 , 25 , 26 . These studies all demonstrated significant correlation between the results from the standard OGTT glucose load and tests using food.…”

Section: Discussionmentioning

confidence: 99%

Barriers to completing oral glucose tolerance testing in women at risk of gestational diabetes

et al. 2020

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Aim Complications of gestational diabetes (GDM) can be mitigated if the diagnosis is recognized. However, some atrisk women do not complete antenatal diagnostic oral glucose tolerance testing (OGTT). We aimed to understand reasons contributing to non-completion, particularly to identify modifiable factors. Methods Some 1906 women attending a tertiary UK obstetrics centre (2018-2019) were invited for OGTT based on risk-factor assessment. Demographic information, test results and reasons for non-completion were collected from the medical record. Logistic regression was used to analyse factors associated with non-completion. Results Some 242 women (12.3%) did not complete at least one OGTT, of whom 32.2% (n = 78) never completed testing. In adjusted analysis, any non-completion was associated with younger maternal age [≤ 30 years; odds ratio (OR) 2.3, 95% confidence interval (CI) 1.6-3.4; P < 0.001], Black African ethnicity (OR 2.7, 95% CI 1.2-5.5; P = 0.011), lower socioeconomic status (OR 0.9, 95% CI 0.8-1.0; P = 0.021) and higher parity (≥ 2; OR 1.8, 95% CI 1.1-2.8; P = 0.013). Non-completion was more likely if testing indications included BMI ≥ 30 kg/m 2 (OR 1.7, 95% CI 1.1-2.4; P = 0.009) or family history of diabetes (OR 2.2, 95% CI 1.5-3.3; P < 0.001) and less likely if the indication was an ultrasound finding (OR 0.4, 95% CI 0.2-0.9; P = 0.035). We identified a common overlapping cluster of reasons for non-completion, including inability to tolerate test protocol (21%), social/mental health issues (22%), and difficulty keeping track of multiple antenatal appointments (15%). Conclusions There is a need to investigate methods of testing that are easier for high-risk groups to schedule and tolerate, with fuller explanation of test indications and additional support for vulnerable groups.

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Section: Discussionmentioning

confidence: 99%

Barriers to completing oral glucose tolerance testing in women at risk of gestational diabetes

et al. 2020

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“…In this review, we analyzed the results from 13 studies, five of them conducted in pregnant women, that compared the efficacy of an MMTT in screening or diagnosing DM and GDM. Half of the studies not performed in the context of GDM showed a strong or very strong correlation between the 2-h glucose values of both tests [ 14 , 37 , 38 , 39 ] and low percentages of missed or misdiagnosed cases [ 37 , 40 , 41 , 42 ], which may indicate that the MMTT could serve as an alternative to the OGTT. As for GDM, the results showed that a high number of women screened positive for GDM using the MMTT without having that condition, as proven by the low percentage of PPV and sensitivity [ 45 , 50 , 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…The differences in both quantity and nutritional values of the food items administered in the diverse MMTT can influence the metabolic responses of the participants [ 29 , 30 ]. Besides, some of the studies included herein compared the MMTT to a 75 g [ 14 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 46 ] or 100 g glucose load [ 45 , 47 , 50 ], while others compared it to a GCT [ 47 , 50 ], and one study used capillary glucose values [ 44 ] instead of blood glucose. A few of the studies included were performed more than twenty years ago; thus, some of the methodologies may be outdated (i.e., Roberts et al [ 46 ] assessed IGT in pregnant women using the WHO criteria from 1980, which are currently outdated).…”

Section: Discussionmentioning

confidence: 99%

“…In a cross-over study conducted by Chanprasertpinyo et al [ 37 ], the authors assessed the effectiveness of using ice cream (described in Table 2 ) as an alternative to the 75 g oral glucose solution to diagnose diabetes and IGT in 104 healthy participants with no previous history of diabetes. The 2-h plasma glucose values were lower after the ice cream test compared with the OGTT (97.52 ± 40.71 mg/dL and 110 ± 55.53 mg/dL, respectively), but without statistical significance ( Table 1 ).…”

Section: Mixed Meal Tolerance Test As a Methods To Screen Glucose Dis...mentioning

confidence: 99%

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Metabolic Effects of an Oral Glucose Tolerance Test Compared to the Mixed Meal Tolerance Tests: A Narrative Review

2022

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The oral glucose tolerance test (OGTT) is recommended for assessing abnormalities in glucose homeostasis. Recognised as the gold standard test for diagnosing diabetes, the OGTT provides useful information about glucose tolerance. However, it does not replicate the process of absorption and digestion of complex foods, such as that which occurs with a mixed meal tolerance test (MMTT), an alternative that is still not well explored in the diagnosis of metabolic alterations. The MMTT could be an asset in detecting glucose homeostasis disorders, including diabetes since it has more similarities to the common dietary pattern, allowing early detection of subtle changes in metabolic homeostasis in response to combined nutrients. This alternative has the advantage of being more tolerable and pleasant to patients since it induces a more gradual increase in blood glucose, thus reducing the risk of rebound hypoglycemia and other related complications. The present article reviewed the clinical data available regarding the possibility of screening or diagnosing altered glucose homeostasis, including type 2 diabetes mellitus, with the MMTT.

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“…There have been solutions put forward in order to increase the compliance with screening for OGTT. There have been several publications about substituting glucose with food, such as ice-cream or muffin and these have all found correlations of food, with the standard OGTT with glucose load [ 36 , 37 ]. The intravenous OGTT has been used as an alternative in women experiencing nausea, but this approach has not been validated as well [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

The Frequency of Acceptance of Oral Glucose Tolerance Test in Turkish Pregnant Women: a single tertiary center results

Sezer¹

2021

North Clin Istanbul

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Objective: It is thought that there is not enough data about the frequency of acceptance of oral glucose tolerance test (OGTT) in Turkish pregnant women. The aim of this study was to investigate the frequency of acceptance of OGTT among participants in our single tertiary center. Methods: The data of non-diabetic 344 pregnant women seen at the Obstetrics Clinic of our hospital between September 2016 and September 2017 were obtained from the hospital records. Women who did not have regular follow-up during pregnancy were excluded. One of the two or one-step approaches was used in the diagnosis of gestational diabetes mellitus (GDM) depending on the choice of the physician following the patient. Results: There were 223 subjects eligible for the study. One hundred seventy-seven pregnant women (79.4%) accepted to do OGTT. We determined that 46 women (20.6%) did not complete at least one OGTT, of whom 74% (n=34) never completed the recommended screening test in this cohort. The overall frequency of GDM was approximately 15.2% (n=34). OGTT acceptability was higher among pregnant women with university graduates (p=0.02). Adverse pregnancy outcomes were similar between the accepted and rejected groups. Among the reasons for OGTT rejection, the media had a significant influence (n=35). Conclusion: Our results show that a significant percentage of patients refused to do OGTT. Therefore the actual frequency of pregnant women with GDM could not be determined. One way to increase compliance may be recommending only the one-step test for pregnant women in countries with a high rejection rate of OGTT.

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Using Ice Cream for Diagnosis of Diabetes Mellitus and Impaired Glucose Tolerance: An Alternative to the Oral Glucose Tolerance Test

Cited by 4 publications

References 22 publications

Barriers to completing oral glucose tolerance testing in women at risk of gestational diabetes

Barriers to completing oral glucose tolerance testing in women at risk of gestational diabetes

Metabolic Effects of an Oral Glucose Tolerance Test Compared to the Mixed Meal Tolerance Tests: A Narrative Review

The Frequency of Acceptance of Oral Glucose Tolerance Test in Turkish Pregnant Women: a single tertiary center results

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