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impaired glucose tolerance

Etiology: - artificial sweeteners can alter the gut microbiome leading to absorption of more calories & glucose intolerance [5] Epidemiology: 1) 25% of obese children [2] 2) 21% of obese adolescents [2] Laboratory: 1) fasting plasma glucose 110-126 mg/dL. 2) two hour glucose on glucose tolerance testing 140-200 mg/dL * case presentation [6] with fasting plasma glucose of 94 mg/dL, HgbA1c of 6.1% & two hour glucose on glucose tolerance testing 177 mg/dL (no additional testing needed) Management: 1) see prediabetes 2) acarbose reduces the risk of diabetes [4] 3) metformin reduces the risk of diabetes [4]

Related

diabetes mellitus type 2 (insulin-resistant) glucose (dextrose, D-glucose) glucose challenge (tolerance) test insulin resistance

General

impaired glycemic control

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  2. Journal Watch 22(8):61, 2002 Sinba R et al N Engl J Med 346:802, 2002 Rocchini AP N Engl J Med 346:854, 2002
  3. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  4. Prescriber's Letter 10(9):49 2003
  5. Suez J et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 2014 Oct 9; 514:181 PMID: 25231862
  6. NEJM Knowledge+ Question of the Week. July 30, 2019 https://knowledgeplus.nejm.org/question-of-week/868/