Rbs Ogtt Final Present

RBS AND OGTT
Objectives
◉ Define Random Blood Sugar (RBS) and
OGTT.
◉ Enumerate the steps in RBS determination
and OGTT.
◉ Differentiate RBS and Postprandial blood
sugar determination.
◉ Illustrate the normal glucose tolerance curve.
Question 1
Define RBS and OGTT.
What is their use in
medical diagnostics?
RANDOM BLOOD SUGAR
○ Also known as
■ Random Blood Glucose Test
■ Capillary Blood Glucose.
○ Taken from a non-fasting patient
○ Test may be carried out at any time of
the day, thus termed, ‘random’.
USES OF RANDOM BLOOD SUGAR
TEST
○ used to diagnose Diabetes and is also

considered as a monitoring treatment
▪ If sugar level: >200 mg/dL
○ Tool used in monitoring Hypoglycemia and

Hyperglycemia.
Advantage Disadvantage
• Fast • Unspecific (False
• Least expensive Positive Results)
ORAL GLUCOSE TOLERANCE
TEST (OGTT)
◉ Also known as Glucose Tolerance Test

◉ A glucose tolerance test measures how well
your body’s cells are able to absorb glucose.
USES OF ORAL GLUCOSE
TOLERANCE TEST
▪ Performed if the RBS result is

abnormally high.
▪ Used in the diagnosis of:

➢ Diabetes Mellitus Type II
➢ Gestational Diabets (GDM)
RBS OGTT
Blood glucose Measures the ability of

measurement at any the body to utilize
Definition time of the day glucose with a needed
fasting of 8-14 hours.
Normal less than 126 mg/dl less than 140 mg/dl

range
RBS OGTT
1. Diagnose diabetes 1. Diagnose diabetes
Medical 2. Determines if 2. Gestational diabetes
diagnostic hypoglycemic or
hyperglycemic
Quick test
Advantage
Not expensive
not highly specific time-consuming as it
Disadvantage requires multiple
blood testing
Normal Diabetic
RBS <160 mg/dL > 200 mg/dL
FBS 70- 110 >126 mg/dL

mg/dL
Blood Sugar 65-70 HYPO HYPER
Level mg/dL <60 mg/dL >75 mg/dL
Question 2
What are the different steps
involved in doing RBS determination
and OGTT.
How are the patients prepared before
the specimens are collected?
RBS PATIENT PREPARATION
No special procedure or preparation

needed before testing
RBS PROCEDURE
1. Clean fingertip using alcohol.

2. Use a lancet to puncture the skin and obtain a
blood sample.
3. A drop of blood is placed onto a paper strip of a
glucometer to determine the blood sugar level
RBS VIA GLUCOMETER
OGTT PATIENT PREPARATION
• Patient should be ambulatory

• Continue with a normal diet days before the test.
• If there are medications being taken, consult it with
the doctor.
• Fasting for 8-14 hours is required.
• No smoking or drinking of alcohol prior to testing
OGTT PROCEDURE
Question 3
Differentiate between RBS and
postprandial blood sugar
determination.
What is a better indicator of your
blood sugar level?
Why?
POST PRANDIAL BLOOD SUGAR
DETERMINATION
◉ Post – “after”
■ Refers to blood sugar level after a meal.
■ Must be taken two hours after

beginning of a meal since glucose
concentration begins to rise 10 minutes
after start of the meal.
■ Normal range is at 140 mg/dL
WHICH IS A BETTER INDICATOR OF
BLOOD GLUCOSE LEVEL?
RBS Test PPG Determination
On the spot blood sugar testing It serves as a test to see if
that can have results that vary blood sugar is controlled
greatly from the next
Screening test for Diabetes Check and monitors DM and
Mellitus glycemic control
NV: 70 – 120 mg/dL NV: 140 mg/dL

POST PRANDIAL BLOOD SUGAR
DETERMINATION
◉ Hemoglobin A1C, also called glycated hemoglobin
◉ When glucose comes in contact with hemoglobin A, it is
said to by glycated.
◉ The attached glucose remains throughout the lifespan of
RBC,
◉ Thus making it possible to measure the blood glucose
levels for the past weeks.
◉ This makes it useful for evaluating the effectiveness of the
patients diet and treatment regimen
Question number 4
Illustrate the normal glucose
tolerance curve. Explain the
different points on the curve
andrelate them to the different
aspects of glucose metabolism.
Question 5
What is a “prolonged” OGTT
curve? What diseases/conditions
can bring about this type of
curve?
Question 5
What diseases/conditions
can bring about this type
of curve?
Destroyed/
Malfunctioning
Pancreatic Beta Cells
Diabetes Mellitus I
-There is a Decrease Insulin
decreased insulin
production due to
Increase Blood Glucose
malfunctioning Beta
cells
Destroyed/
Downregulated
Receptor
Diabetes Mellitus II
-Insulin resistance Insulin Resistance
due to genetic or
lifestyle factors such
as obesity and
Increased blood
sedimentary glucose concentration
lifestyle
Anti Insulin
Effect
Gestational
Diabetes Increased Blood
-pregnancy Glucose
related hormones
can block the Impaired glucose
effects of insulin tolerance
Question 6
What is a “flat or inverted” OGTT
curve? What diseases/conditions can
bring about this type of curve?
“Flat” oral glucose
tolerance test
This is an OGTT the peak of which has been defined

variously as less than 40 mg, 25 mg, or 20 mg/100 ml
above the FBG value. The most commonly used
definition is 25 mg/100 ml (1.38 mmol/L). The condition
most frequently associated with a flat OGTT is small
intestinal carbohydrate malabsorption due to sprue or
celiac disease, with a lesser number of cases seen in
myxedema and some cases reported in pituitary
insufficiency.
FLAT OGGT CURVE
INVERTED OGTT CURVE
◉ It is a reverse curve
◉ The blood sugar decreases further upon
intake of glucose
Diseases/conditions can
bring about flat or
inverted curve
MALABSORPTION
◉ Is a condition caused
by the decreased
ability to digest
and/or absorb
nutrients from the
food.
◉ Decreased
absorption of glucose
in the body
ADDISON’S DISEASE
◉ Addison’s disease is a disorder in which the adrenal glands – which

sit on top of the kidneys – do not produce enough of the hormones
cortisol and aldosterone.
◉ Cortisol helps the body respond to stress, including the stress of

illness, injury, or surgery. It also helps maintain blood pressure, heart
function, the immune system, and blood glucose (sugar) levels.
◉ Aldosterone affects the balance of sodium and potassium in the

blood, which in turn controls the amount of fluid the kidneys
remove as urine, which affects blood volume and blood pressure.
HYPOTHYROIDISM
◉ Also called underactive thyroid disease,

is a common disorder. With
hypothyroidism, the thyroid gland does
not make enough thyroid hormone.
◉ In hypothyroidism, flat curve is
contributed by decreased and delayed
glucose absorption in intestinal tract
Question 7
Which test is highly sensitive
and diagnostic for diabetes
mellitus. Why?
Glucose Tolerance Test
• The most sensitive test for detecting borderline
diabetes mellitus
• Glucose tolerance means ability of the body to utilize
glucose in the circulation.
• It is a valuable diagnostic aid in the diagnosis of
diabetes mellitus, insulin resistance, impaired beta-cell
function and sometimes reactive hypoglycemia and
acromegaly.

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RBS AND OGTT

○ used to diagnose Diabetes and is also

○ Tool used in monitoring Hypoglycemia and

◉ Also known as Glucose Tolerance Test

▪ Performed if the RBS result is

▪ Used in the diagnosis of:

Blood glucose Measures the ability of

Normal less than 126 mg/dl less than 140 mg/dl

RBS <160 mg/dL > 200 mg/dL

FBS 70- 110 >126 mg/dL

No special procedure or preparation

1. Clean fingertip using alcohol.

• Patient should be ambulatory

■ Must be taken two hours after

NV: 70 – 120 mg/dL NV: 140 mg/dL

This is an OGTT the peak of which has been defined

◉ Addison’s disease is a disorder in which the adrenal glands – which

◉ Cortisol helps the body respond to stress, including the stress of

◉ Aldosterone affects the balance of sodium and potassium in the

◉ Also called underactive thyroid disease,

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