120-min Values Research Articles

Long-term therapy with CFTR modulators consistently improves glucose metabolism in adolescents and adults with cystic fibrosis

BackgroundImpaired glycemic control and the subsequent development of Cystic fibrosis Related Diabetes (CFRD) are prevalent complications, affecting up to 50 % of adults with cystic fibrosis (CF). CFTR modulator (CFTRm) therapies improve pulmonary functions, reduce exacerbation rates, increase survival in people with CF (pwCF) and appear to have a positive effect on extrapulmonary manifestations, such as nutritional state, improvements in upper respiratory symptoms, and quality of life. Initial findings indicate that CFTRm may have a positive impact on short-term glycemic control; however, long-term effects remain uncertain at present. MethodsIn this retrospective study, data were collected and analyzed on 15 pwCF, ages 13–37 years, started on CFTRm therapy. Oral Glucose Tolerance Test (OGTT) results were compared pre- and post-CFTRm therapy. ResultsThe 120-min OGTT value decreased from 159.7 mg/dL to 130.4 mg/dL post-CFTRm (p = 0.047). The average time elapsed between the two OGTTs was 49.87 months (ranging 9–157 months, median 38 months). Glycemic status improved in six pwCF (two CFRD to normal (NGT)/indeterminate (INDET) glucose tolerance; two impaired glucose tolerance (IGT) to INDET; two INDET to NGT) and worsened in one (IGT to CFRD). Six pwCF and NGT remained stable with no changes in glycemic status throughout the follow-up period. ConclusionsCFTRm therapy may decelerate the glycemic control deterioration in pwCF over an extended period. These findings indicate the need for periodic OGTTs following the initiation of CFTRm therapy to appropriately adjust insulin requirements and prevent hypoglycemia. Further larger cohorts are required to authenticate and substantiate these findings.

47-OR: Association of Early Pregnancy Triglycerides and HbA1c in a UK Multiethnic Cohort

Introduction: Role and ethnic variations of early pregnancy triglycerides and HbA1c on birthweight in women without gestational diabetes (GDM) is not clear. Aim: To explore the association of early pregnancy HbA1c and triglycerides in multi-ethnic women at risk of developing GDM Methods: PRiDE study, designed to address the role of B vitamins on incident GDM, recruited 4746 women (12.5 weeks of gestation) from 10 centres across UK, who fulfilled NICE criteria for GDM screening (OGTT at 26.5 weeks). Intergrowth centiles were used to assess LGA. Multiple regression analyses were used to explore the effects of early pregnancy triglycerides and HbA1c, adjusted for key covariates. Additional model included 0- and 120-min glucose values at OGTT. Results: 3782 did not have GDM (74% Whites; 10.1% South Asians). 81.3% were nulliparous. Mean age: 30.3 ± 5.2; BMI: 30.6 ± 7.1. Mean birthweight: 3417.1 ± 590.0 (at 39.1 ± 1.7 weeks). Early pregnancy plasma triglyceride but not HbA1c was independently associated with birthweight, macrosomia and LGA. Addition of OGTT glucose values reduced the effect size for macrosomia and LGA. No ethnic specific interactions were observed. Conclusion: In women who are at high risk but did not develop GDM, early pregnancy triglyceride but not HbA1c levels was independently associated with birthweight. These effects were independent of ethnicity and partially mediated through plasma glucose levels at OGTT. Disclosure Y.Ghebremichael-weldeselassie: None. N.Sukumar: None. P.Saravanan: Other Relationship; Novo Nordisk, Research Support; Novo Nordisk, Amgen Inc., Abbott. Funding Medical Research Council, UK (MR/J000094/1)

InVivo Evaluation of 6 Analogs of 11C-ER176 as Candidate 18F-Labeled Radioligands for 18-kDa Translocator Protein.

Because of its excellent ratio of specific to nondisplaceable uptake, the radioligand 11C-ER176 can successfully image 18-kDa translocator protein (TSPO), a biomarker of inflammation, in the human brain and accurately quantify target density in homozygous low-affinity binders. Our laboratory sought to develop an 18F-labeled TSPO PET radioligand based on ER176 with the potential for broader distribution. This study used generic 11C labeling and invivo performance in the monkey brain to select the most promising among 6 fluorine-containing analogs of ER176 for subsequent labeling with longer-lived 18F. Methods: Six fluorine-containing analogs of ER176-3 fluoro and 3 trifluoromethyl isomers-were synthesized and labeled by 11C methylation at the secondary amide group of the respective N-desmethyl precursor. PET imaging of the monkey brain was performed at baseline and after blockade by N-butan-2-yl-1-(2-chlorophenyl)-N-methylisoquinoline-3-carboxamide (PK11195). Uptake was quantified using radiometabolite-corrected arterial input function. The 6 candidate radioligands were ranked for performance on the basis of 2 invivo criteria: the ratio of specific to nondisplaceable uptake (i.e., nondisplaceable binding potential [BPND]) and the time stability of total distribution volume (VT), an indirect measure of lack of radiometabolite accumulation in the brain. Results: Total TSPO binding was quantified as VT corrected for plasma free fraction (VT/fP) using Logan graphical analysis for all 6 radioligands. VT/fP was generally high at baseline (222 ± 178 mL·cm-3) and decreased by 70%-90% after preblocking with PK11195. BPND calculated using the Lassen plot was 9.6 ± 3.8; the o-fluoro radioligand exhibited the highest BPND (12.1), followed by the m-trifluoromethyl (11.7) and m-fluoro (8.1) radioligands. For all 6 radioligands, VT reached 90% of the terminal 120-min values by 70 min and remained relatively stable thereafter, with excellent identifiability (SEs < 5%), suggesting that no significant radiometabolites accumulated in the brain. Conclusion: All 6 radioligands had good BPND and good time stability of VT Among them, the o-fluoro, m-trifluoromethyl, and m-fluoro compounds were the 3 best candidates for development as radioligands with an 18F label.

Neurolytic celiac plexus block enhances skeletal muscle insulin signaling and attenuates insulin resistance in GK rats.

Non-insulin-dependent diabetes mellitus (NIDDM) is associated with chronic inflammatory activity and disrupted insulin signaling, leading to insulin resistance (IR). The present study investigated the benefits of neurolytic celiac plexus block (NCPB) on IR in a rat NIDDM model. Goto-Kakizaki rats fed a high-fat, high-glucose diet to induce signs of NIDDM were randomly divided into NCPB and control groups; these received daily bilateral 0.5% lidocaine or 0.9% saline injections into the celiac plexus, respectively. Following 14 and 28 daily injections, rats were subject to oral glucose tolerance tests (OGTTs) or sacrificed for the analysis of serum free fatty acids (FFAs), serum inflammatory cytokines and skeletal muscle insulin signaling. Compared with controls, rats in the NCPB group demonstrated significantly (P<0.05) lower baseline, 60-min and 120-min OGTT values, lower 120-min serum insulin, lower IR [higher insulin sensitivity index (ISI1) and lower ISI2) and lower serum FFAs, tumor necrosis factor-α, interleukin (IL)-1β and IL-6. Conversely, NCPB rats exhibited higher basal and insulin-stimulated skeletal muscle glucose uptake and higher skeletal muscle insulin receptor substrate-1 (IRS-1) and glucose transporter type 4 expression. There were no differences between the groups in insulin receptor β (Rβ) or Akt expression; however Rβ-Y1162/Y1163 and Akt-S473 phosphorylation levels were higher and IRS-1-S307 phosphorylation were lower in NCPB rats than in the controls. These results indicate that NCPB improved insulin signaling and reduced IR, possibly by inhibiting inflammatory cytokine release.

Evaluation of a Self-Administered Oral Glucose Tolerance Test

OBJECTIVETo assess the feasibility of using a disposable, self-administered, capillary blood sampling oral glucose tolerance test (OGTT) device in a community setting.RESEARCH DESIGN AND METHODSEighteen healthy and 12 type 2 diabetic volunteers underwent six 75-g OGTTs using a prototype device in the following three settings: unaided at home (twice); unaided but observed in clinic (twice); and performed by a nurse with simultaneous laboratory glucose assays of 0- and 120-min venous plasma samples (twice). The device displayed no results. A detachable data recorder returned to the clinic provided plasma-equivalent 0- and 120-min glucose values and key parameters, including test date, start and end times, and time taken to consume the glucose drink.RESULTSThe device was universally popular with participants and was perceived as easy to use, and the ability to test at home was well liked. Device failures meant that 0- and 120-min glucose values were obtained for only 141 (78%) of the 180 OGTTs performed, independent of setting. Device glucose measurements showed a mean bias compared with laboratory-measured values of +0.9 at 5.0 mmol/L increasing to +4.4 at 15.0 mmol/L. Paired device glucose values were equally reproducible across settings, with repeat testing showing no training effect regardless of setting order.CONCLUSIONSSelf-administered OGTTs can be performed successfully by untrained individuals in a community setting. With improved device reliability and appropriate calibration, this novel technology could be used in routine practice to screen people who might need a formal OGTT to confirm the presence of impaired glucose tolerance or diabetes.

Postprandial hyperglycemia and insulin response are affected by sea buckthorn (Hippophaë rhamnoides ssp. turkestanica) berry and its ethanol-soluble metabolites

Repeated postprandial hyperglycemia and subsequent mild, late hypoglycemia as well as high postprandial insulin response lead to metabolic events that may eventually develop into type 2 diabetes. The aim of this study was to assess how sea buckthorn berries as well as two sea buckthorn extraction residues modulate the postprandial metabolism after a high-glucose meal. Ten healthy normal-weight male volunteers consumed four study breakfasts, one control (A) and three sea buckthorn meals on four distinct study days. All the meals contained yoghurt and glucose (50 g). The sea buckthorn ingredients used were dried and crushed whole berries (meal B1), supercritical fluid (SF)-carbon dioxide (CO(2))-extracted oil-free berries (meal B2) or ethanol-extracted SF-CO(2)-extraction residue (meal B3). Blood samples for glucose, insulin and tumor necrosis factor-α analyses were collected before and during the 6-h study period. Meal B1 suppressed the postprandial peak insulin response when compared with meal A (Δconcentration of 30-min peak value--21.8 mU/l, P=0.039), and stabilized postprandial hyperglycemia and subsequent hypoglycemia (Δconcentration of 30-min peak value--120-min value -30.4 mU/l, P=0.036). Furthermore, meal B2 resulted in a more stable insulin response than the control meal (Δconcentration of 30-min peak value--120-min value -25.9 mU/l, P=0.037). Removal of the CO(2)-soluble oil component from the berries did not show a significant change in the studied postprandial effects of the berries. The EtOH soluble components, again showed advantageous properties in both insulin and glucose responses.

Glucose and Insulin Measurements from the Oral Glucose Tolerance Test and Mortality Prediction

To verify what information from oral glucose tolerance tests (OGTTs) independently predicts mortality. A total of 1,401 initially nondiabetic participants from the Baltimore Longitudinal Study of Aging aged 17-95 years underwent one or more OGTTs (median 2, range 1-8), with insulin and glucose measurements taken every 20 min over the course of 2 h included in this study. Proportional hazards using the longitudinally collected data and Bayesian model averaging were used to examine the association of OGTT measurements individually and grouped with mortality, adjusting for covariates. Participants were followed for a median 20.3 years (range 0.5-40). The first-hour OGTT glucose and insulin levels increased only modestly with age, whereas levels during the second hour increased 4% per decade. Individually, 100- and 120-min glucose measures and fasting and 100-min insulin levels were all independent predictors of mortality. When all measures were considered together, only higher 120-min glucose was a significant independent risk factor for mortality. The steeper rise with age of the OGTT 2-h glucose values and the prognostic primacy of the 120-min glucose value for mortality is consistent with previous reports and suggests the value of using the OGTT in clinical practice.

Intraoperative radiation enhances decline of pancreatic exocrine function after pancreatic head resection.

Intraoperative radiation therapy has been introduced to improve survival rates after resection of biliopancreatic cancer. Early and late effects of intraoperative radiation on the exocrine and endocrine functions of the residual pancreas were examined in 54 patients with pancreatic head resection. Of the 54 patients, 20 underwent intraoperative radiation (A group) and the other 34 did not (B group). Fasting blood sugar level, a 120-min value of the 75-g oral glucose tolerance test, N-benzol-L-tyrosyl-p-aminobenzoic acid (BT-PABA) excretion value (a pancreatic exocrine function test), and amount of postoperative pancreatic juice drainage were compared between groups A and B at preoperative and early and late postoperative times. Fasting blood sugar level and a 120-min value of the 75-g oral glucose tolerance test (OGTT) showed no change at the early (<2 months) postoperative period of the two groups. At the late (>6 months) postoperative period, fasting blood sugar showed no alteration, while the 75-g OGTT 120-min value increased compared to the preoperative level in both groups. In the group A, the 75-g OGTT 120-min value at the late postoperative period was significantly higher than those at the preoperative and early postoperative periods (289.4 +/- 104.9 vs 193.0 +/- 58.2 mg/dl, P = 0.0198 and 289.4 +/- 104.9 vs 184.4 +/- 104.9 mg/dl, P = 0.0285). Preoperative BT-PABA excretion value was not different between the two groups. It decreased at the early postoperative period and returned to the preoperative level at the late postoperative period in both the groups. The decline of BT-PABA in group A was 23 +/- 21%, which was significantly larger than 11 +/- 24% in group B. The total amount of postoperative pancreatic juice drainage from postoperative days (POD) 4-13 in group A was about half as much as that in group B (720.8 +/- 916.4 vs 1433.8 +/- 962.1 ml, P = 0.0128). Univariate and multivariate regression analysis of factors concerning the decline of BT-PABA values at the early postoperative period showed that intraoperative radiation was a significant independent determinant. In conclusion, these results suggest that intraoperative radiation causes significant deterioration of pancreatic exocrine function at the early postoperative period. Intraoperative radiation for resectable periampullary carcinoma should be reappraised based on the decline of the pancreatic exocrine function as well as the improvement of the survival curve.

Glucagon in the Treatment of Acute Asthma in Children

Glucagon has a bronchodilator effect by stimulating cyclic AMP production through activation of its own receptor. The purpose of this study was to determine if bronchodilation can be induced by glucagon in acute asthma in children. Twenty patients with acute asthma (mean age 9.9 ± 2.1 years) were treated with 1 mg of subcutaneous glucagon, and 20 patients with acute asthma (mean age 10.7 ± 2.1 years) received 400 μg of metered-dose salbutamol. Respiratory function tests were performed (FVC, FEVl, PEFR, FEF25-75) before treatment and 30 and 120 min after treatment. The test results were compared with the basal values within each group and between the two groups. When the 30-min and 120-min posttreatment respiratory function test values were compared with the basal values, a significant improvement was found in the glucagon and salbutamol groups (p 0....

Effects of Treatment with Pentoxifylline on the Cardiovascular Manifestations of Group B Streptococcal Sepsis in the Piglet1

Pentoxifylline (PTXF) is a methylxanthine derivative which modifies leukocyte function and inhibits tumor necrosis factor (TNF)-alpha release. As TNF-alpha is considered a proximal mediator in the cascade leading to septic shock, we evaluated the ability of PTXF to attenuate the cardiovascular manifestations of sepsis secondary to an infusion of group B beta-hemolytic streptococci (GBS). Fifteen anesthetized, mechanically ventilated piglets (weight, 2815 +/- 552 g) were randomly assigned to a treatment group which received a continuous infusion of PTXF (5 mg/kg/h) beginning 30 min after GBS (7.5 x 10(8) colony-forming units/kg/min) administration was started or to a control group which received GBS plus saline as placebo. Comparison of the hemodynamic measurements and arterial blood gases over the first 120 min of bacterial infusion for treatment and control groups revealed the following statistically significant differences (120-min values presented): cardiac output was significantly higher in the PTXF group (0.159 +/- 0.035 versus 0.09 +/- 0.026 L/kg/min; p < 0.05) as was stroke volume (0.54 +/- 0.11 versus 0.27 +/- 0.126 mL/kg/beat; p < 0.01). Pulmonary and systemic vascular resistances remained lower in the PTXF-treated animals (167 +/- 45 versus 233 +/- 69 mm Hg/L/kg/min; p < 0.03) and (427 +/- 162 versus 828 +/- 426 mm Hg/L/kg/min; p < 0.03, respectively). Median survival time was significantly longer in the PTXF group (180 versus 120 min; p < 0.05). In an additional group of animals, PTXF administration before GBS infusion revealed no attenuation in the rise of TNF-alpha, accompanying sepsis. These data demonstrate that treatment with PTXF may ameliorate some of the deleterious hemodynamic manifestations of GBS sepsis and result in improved survival in a young animal model without significantly modifying plasma TNF-alpha levels.

Effect of an Interleukin-1 Receptor Antagonist on the Hemodynamic Manifestations of Group B Streptococcal Sepsis

IL-1 is purported to be a proximal mediator in the cascade leading to septic shock. To characterize its hemodynamic effects and to ascertain whether its blockade would ameliorate the deleterious consequences of sepsis, an IL-1 receptor antagonist (IL-1ra) was administered to 16 anesthetized, mechanically ventilated piglets that received a continuous infusion of group B streptococci (GBS) (7.5 x 10(7) colony-forming units/kg/min). Systemic (Psa), pulmonary artery (Ppa), and wedge (Pwp) pressures and cardiac output were measured pre-GBS and every 30 min during GBS infusion. After 15 min of bacterial infusion the control group received normal saline, whereas the treatment group received a bolus of IL-1ra (40 mg/kg) followed by a continuous infusion of IL-1ra (60 micrograms/kg/min). In comparing IL-1ra-treated animals with controls from the 15-min GBS baseline to the succeeding septic study period (45-120 min), the following treatment effects were noted (120-min values shown): mean Psa remained elevated in treatment compared with control animals (12.7 +/- 2.5 versus 9 +/- 3.5 kPa; p < 0.001) as did CO (0.21 +/- 0.07 versus 0.13 +/- 0.08 L/min/kg; p < 0.001). Pwp decreased in the treatment compared to the control group over the study period (1 +/- 0.3 versus 1.6 +/- 0.7 kPa; p < 0.02). Mean Ppa and mean Pra were not different between groups over time. Median length of survival was significantly longer (p = 0.04) in treated (226 min) compared with control animals (150 min). These data suggest that IL-1 plays an important role in GBS sepsis and septic shock, and that IL-1ra may in part ameliorate the cardiovascular alterations associated with GBS sepsis in the neonate.

The effect of glyburide on beta-cell sensitivity to glucose-dependent insulinotropic polypeptide.

To assess whether treatment with glyburide alters beta-cell sensitivity to GIP in NIDDM patients. We studied 5 untreated NIDDM patients in a meal study (Ensure, 240 ml/M2) and a 2-h hyperglycemic glucose clamp study (glucose 5.4 mM above fasting). From 60 to 120 min of the clamp, GIP was infused in a primed continuous manner at a rate of 2 pmol.kg-1 x min-1. Subjects then were treated with glyburide. After they had been on a stable dose of medication for 1 mo, the meal study and glucose clamp studies were repeated. In response to treatment, a decrease in fasting glucose and an increase in weight was observed (12.8 +/- 1.8 vs. 8.5 +/- 0.8 mM and 74.3 +/- 6.3 vs. 76.1 +/- 6.3 kg, respectively, P < 0.05). In response to the meal study, the AUC for glucose was less, for insulin was increased, and for GIP was unchanged after treatment (16.9 +/- 2.1 vs. 12.6 +/- 6.9 mM, P < 0.05; 161 +/- 47 vs. 242 +/- 60 pM, P < 0.05; and 199 +/- 22 vs. 219 +/- 18 pM, respectively). During the hyperglycemic clamp, steady-state glucose and 90- to 120-min GIP values were equivalent before and after treatment (18.0 +/- 1.3 vs. 18.3 +/- 1.3 mM and 302 +/- 59 vs. 298 +/- 37 pM, respectively). The 90-120 min insulin responses to the hyperglycemic clamp were greater after therapy (123 +/- 37 vs. 283 +/- 80 pM, P < 0.05) reflecting increased beta-cell responses to GIP. We conclude that glyburide enhances beta-cell sensitivity to GIP.

Oral glucose tolerance test in healthy pregnant Nigerian women.

Oral glucose tolerance tests (OGTTs) with 75 g glucose were performed in 20 healthy pregnant Nigerian women in each trimester of pregnancy and the puerperium; 34 nonpregnant control subjects matched for age and parity were also studied. The blood glucose levels from fasting to 60 min were lower in pregnant subjects, but the 90- and 120-min values were higher. The highest blood glucose values were observed in the first trimester with an apparent improvement in glucose tolerance in the second and third trimesters. This observation is strikingly different from the established pattern of OGTT in pregnant Caucasian women. With pooled data from OGTT results in the three trimesters for the 20 pregnant women (60 OGTTs), a statistically derived criterion (based on mean + 2SD approximated to the nearest 5) for the interpretation of OGTT in pregnant Nigerian women was devised. This criterion defines the upper limits of normal for venous whole-blood glucose in pregnant Nigerian women during an OGTT with a 75-g glucose load as follows: fasting, 90; 30 min, 135; 60 min, 150; 90 min, 145; and 120 min, 125 mg/dl. These values are lower than those recommended for pregnant women by the National Diabetes Data Group (O'Sullivan and Mahan criteria) and the World Health Organization. The results from this study underscore the need for caution regarding uncritical application of data from one racial or ethnic group to others.

Cardioinhibitory effect of atrial peptide in conscious rats

The hemodynamic and renal excretory responses to 150-min atriopeptin II (AP II) infusion (330 ng X kg-1 X min-1) were assessed in five chronically instrumented rats with (FR protocol) and without (NR protocol) replaced urinary fluid losses. The observed changes were compared with those obtained by vehicle in the same rats. The hypotension seen with AP II infusion (120-min value: -27 +/- 2%, FR and NR responses combined) was due solely to a decreased cardiac output (CO; 120-min combined value: -34 +/- 3%). Total peripheral resistance remained unchanged or slightly elevated. A drop in stroke volume plus a later-developing (by 75-90 min) decrease in heart rate contributed to the CO decline. This latter bradycardic component, the opposite response to that typically produced reflexly by hypotension, was reversed by atropine sulfate treatment at 120 min and may thus be neural in origin. The finding of similar hemodynamic changes in the FR and NR rats and the lack of a significant effect of AP II on hematocrit suggest that volume depletion or a plasma extravasation were not contributors to the cardioinhibitory effect of the peptide.

Chronic effects of gastroduodenal surgery on glucose and insulin response to oral glucose tolerance test in a population study.

Oral glucose tolerance test (OGTT) results were compared between 4,667 middle-aged males attending a preventive medical screening and intervention program in Malmö and the subjects in this sample who reported a history of previous operation for gastric or duodenal ulcer (n = 158, or 3.4%). 76% of the operated subjects were smokers in comparison with 50% in the general cohort of males of the same age. The glucose and insulin responses in the OGTT in both the smoking and non-smoking operated cases showed higher early peak values and a subsequent rapid drop of the levels with lower 120-min values of both glucose and insulin compared to the average screening cohort. This type of response to an oral glucose load had previously been well known in the acute and immediate postoperative stages of gastric and duodenal resection, but it had not been shown before that it seems to be a permanent effect and may chronically influence the results of OGTTs in the population. Gastro-duodenal surgery should be included among the factors which may significantly affect the chronic results and thereby also the clinical interpretation of the OGTTs in the population.

Effect of Dietary Fiber on Complications of Gastric Surgery: Prevention of Postprandial Hypoglycemia by Pectin

The dumping syndrome is a very troublesome problem to some patients after gastric surgery. Gel-forming carbohydrates have recently been used to modify glucose absorption. The addition of 14.5 g of pectin to a 50-g oral glucose load prevented the occurrence of hypoglycemic symptoms and maintained the blood glucose levels above control values by 64% at 90 min (P less than 0.002) and 46% at 120 min (P less than 0.01) in postgastric surgery patients whose 120-min values after 50 g of glucose alone had fallen below 50 mg per 100 ml (2.8 mmoles per liter). Breath H2 production, used as an index of bacterial fermentation of glucose, was abolished or reduced by pectin in all 5 cases in which this had previously occurred. A trial of 10 g of pectin per day prevented recurrent postprandial hypoglycemic attacks in the most severely affected individual. Pectin and perhaps other unabsorbable polysaccharides are likely to prove useful in the treatment of abnormal carbohydrate absorption after gastric surgery.

Oral glucose tolerance test in 100 normal children.

Oral glucose tolerance tests (OGTTs) were conducted in 100 normal, non-obese children aged 4 to 15 years with a negative family history for diabetes. Glucose was administered in a 20% solution (1.75 g/kg body weight), and blood glucose levels were determined by the o-toluidine technique (capillary microglycemia in whole blood). The following results were obtained: fasting: 79±26 mg/100 ml ( $$\bar x$$ ±2 SD); 30 min: 121±54 mg/100 ml; 60 min: 103 ± 42 mg/100 ml; 90 min: 98±36 mg/100 ml; 120 min: 90±36 mg/100 ml. Individually, 70 children showed peak blood glucose at 30 min (sub-group A), 19 at 60 min (sub-group B); 5 at 90 min (sub-group C), and 6 showed flat curves (sub-group D). The $$\bar x$$ +2 SD values of some of these sub-groups slightly exceeded that of the whole 100-children group. This suggests that normal curves pertaining to these sub-groups might be considered pathologic if referred to the statistical values of the whole groups. Out of the 100 children, 4 showed one value above $$\bar x$$ +2 SD, and 3 showed two values above that limit. At 120 min, however, none of the individual or group values were above $$\bar x$$ ±2 SD (126 mg/100 ml), which supports other authors’ criteria regarding the importance of the 120-min value in this test. On the basis of the present findings, normal OGTT’s were defined as those in which all values except for one, which must not be the 120-min value, fall within the $$\bar x$$ ±2 SD range calculated for the whole group. Normal children may present two values, except for the 120-min value, slightly above $$\bar x$$ +2 SD, although we consider retesting advisable in such cases.