Question

[John66]

Could any one tell me why it is that in the uk you have to have a bg reading of 110 to have a oral glucose tolerance test, but in the usa it is only a bg reading 100.

[kimbo]

COST probably,I asked about an antibody test after reading about them on this site as I am being treated as t2 but was told i could be slow onset t1.
I was told they tend not to do them in the uk as they are too expensive !!

[Harold]

Where did you hear this at?

[kimbo]

Hi,
If you are asking about the antibody test it was the diabetic specialist nurse,so i went to the doctors ,one didnt know what i was talking about and the other said to ask the consultant at the diabetic clinic as he didnt know how to go about it if they are available,so i will see what the consultant says in july.I assume time will tell which type i am,but i just thought it would be an advantage to know sooner rather than later.If they tested all urine samples for sugar at the hospital labs my d would have been picked up at the onset,but they dont,they only checked mine for infection as i was having discomfort , i now know it was due to diabetes.

Kim

[Harold]

Hi,
If you are asking about the antibody test
No, I know about the antibody test and over here thay always do a c-peptide first, a whole lot cheaper. The c-peptide test indicates insulin levels since it is made along with insulin in the body. So unless ones c-peptides are significantly low they won't do an antibody test. As for your doctors acting ignorant it should not come as a suprise. They are told what they can and can not do by non-medical people. Try asking for a c-peptide first.

What I was asking about was John's reference to the bg level required to get a GTT done. A FBG (fasting blood glucose) over 110mg/dL (6.1mmol/L) or a RBG (random blood glucose) over 126mg/dL (7.0mmol/L) I thought was the criteria, but hey things change and maybe he had a reference. :whistling

[John66]

This is from the American diabetic association web site.

Q: How does the FPG test define diabetes and pre-diabetes?


A: Normal fasting blood glucose is below 100 mg/dl. A person with pre-diabetes has a fasting blood glucose level between 100 and 125 mg/dl. If the blood glucose level rises to 126 mg/dl or above, a person has diabetes.

Now in the UK they say that you are not pre-diabetic until you have a FBG reading of 6.1 or 110mg/dl. so they will not give you a OGGT test until you do.
And as you can see pre-diabetic in the US it is between 100 and 125 mg/dl.

[Harold]

The ADA does not set standards for the medical profession. So what is the ADA? From MedicineNet "The American Diabetes Association is the nation's leading nonprofit health organization providing diabetes research, information and advocacy." (http://www.medterms.com/script/main/art.asp?articlekey=8397) A lot of what the ADA has recomended has been incorporated over the years to our benefit.

To get back to your question, only in the last several years has the medical profession in the U.S. recognized the need to diagnose and treat Prediabetes. Along with realizing that people develope full blown diabetes with out displaying symptoms for years. So not only may a doctor call for a GTT with a FPG between 100 and 110, but they may even have one done if an FPG falls between 70 and a 100. A person with risk factors or displaying symptoms maybe asked to do a GTT regardles of their FPG. As to why the U.K. has not lowered the bar yet I can think of two most likely reasons. One they are waiting to see what affect lowering the bar has on the progression of diabetes and what it cost over the long term compared to what they are currently doing. The second would be can the health system support lowering the bar without raising taxes or going broke. In other words it depends a lot on who is paying for it.

REF;
WebMD (http://my.webmd.com/content/article/59/66836?z=1667_50910_6504_00_24)
EndocrineWeb (http://www.endocrineweb.com/diabetes/diagnosis.html)