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Diabetes Mellitus:- Part 3 – Glucose after 2 hours of meal (postprandial glucose level)

October 25, 2022Chemical pathologyLab Tests

Glucose after 2 hours (Postprandial glucose)

Sample for blood glucose

  1. The test is done on the serum of patients or oxalate blood.
    • When the test is done on the serum, the serum should be separated within 30 minutes of collection.
  2. The serum can be stored at 25° C for 8 hours and 72 hours at 4 °C.
  3. Oxalate blood can also be used. Preservative sodium fluoride may be added.
    • The plasma can be stored at 25 °C for 24 hours (with preservative sodium fluoride).

Precautions

  1. In the case of fluoride as a preservative, a decrease of 9 mg/dL is seen during the first 2 hours.
  2. The whole blood glucose level is 90% of the plasma glucose.

Pathophysiology of glucose

  1. Carbohydrate metabolism and interaction between carbohydrates, fats, and proteins. This interaction is important for our body to control glucose levels.
    Diabetes mellitus and insulin action

    Diabetes mellitus and insulin action

    Carbohydrate metabolism

    Diabetes mellitus and insulin action

    Glucose level is regulated by insulin and glucagon

    Glucose level is regulated by insulin and glucagon

Definition of 2 hours of glucose level (postprandial glucose) :

  1. It will give the body glucose tolerance 2 hours after the meal.
  2. Meal acts as a glucose challenge for body metabolism.
  3. Insulin is secreted in response to increased glucose levels due to food intake.
  4. Blood glucose will be normal within 2 hours.
  5. In diabetic patients, glucose levels will remain elevated.
Post prandial glucose (2 hours glucose)

Postprandial glucose (2 hours glucose)

Interpretation of postprandial or 2 hours of glucose:

  1. Postprandial glucose level is a screening test for DM.
  2. If glucose level is >140 mg/dL and <200 mg/dL, then GTT (glucose tolerance test) is advised.
  3. If level after 2 hours = >200 mg/dL,  diabetes mellitus is confirmed.
  4. Advise HbA1c for further evaluation.
Glucose postprandial (2 hours)

Glucose postprandial (2 hours)

Normal 2 hours (postprandial) glucose level:

Source 1

  • <120 mg/dL
    • To convert into SI unit x 0.0555 = mmol/L

Source 2

  1. 0 to 50 years = < 140 mg/dl (<7.7 mmol/L)
    1. And some believes <120 mg/dl ( < 6.66 mmol/L).
  2. For people age 50 and younger = < 140 mg/dL (7.8 mmol/L).
  3. For people ages 50 – 60 = <150 mg/dL (8.3 mmol/L).
  4. For people aged 60 and older = <160 mg/dL (8.9 mmol/L)

2 hours glucose (postprandial)level:

  1. Normal = <140 mg/dL.
  2. Impaired glucose tolerance (IGT) = 140 to 199 mg/dL
  3. Diabetes mellitus = ≥200 mg/dL

The latest criteria for Diabetes Mellitus:

  1. The level of 200 mg/dl or
    1. Above 200 mg/dl after 75 grams of glucose overload or
  2. Two casual glucose readings of 200 mg/dl or above are labeled as Diabetic patients.
    • This test is not recommended because of the many factors influencing the result.
Diagnosis Fasting glucose level Random glucose level 2-hour glucose level (in OGTT) HbA1c 
Prediabetics 100 to 125 mg/dL 140 to 199 mg/dL 140 to 199 mg/dL 5.7 to 6.4%
Diabetes mellitus > 126 mg/dL >200 mg/dL >200 mg/dL >6.5%
  • Please, for more details on Glucose, see in Glucose fasting level.

Questions and answers:

Question 1: What is a stimulus for the insulin release.
Show answer
Food, when entering the stomach, will lead to the stimulus of the pancreas and secrete insulin.
Question 2: What is the level of HbA1c for the diabetic patients.
Show answer
It is usually >6.5%.

Possible References Used
Go Back to Chemical pathology

Comments

Alan Damer Reply
August 12, 2020

is OGTT 145mg/dl after one hour is considered pre-diabetics

Pls advise

Tks

Dr. Riaz Reply
August 12, 2020

After one hour is normal. If you want to be sure please get check HbA1c.
https://www.labpedia.net/diabetes-mellitus-part-4-glucose-tolerance-test-g-t-t-oral-glucose-tolerance-test-ogtt-gestational-diabetes-mellitus/
See this link as well.

Dr. Riaz Reply
August 16, 2020

Your Glucose level is within normal range. Please advise HbA1c.

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