الفهرس 
Diagnosis of diabetes mellitus
Matrial and methodsOnly 14 pages are availabe for public view
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Abstract
-The aim of this work is to evaluate the intravenoU8
glucose tolerance test and double sample test in diabetic
patients with chronic renal failure.
We performed the two tests by using the G1ucocheck
apparatus on three groups of patients, the first group was
twenty diabetic patients with chronic renal failure, the
secpnd group was ten diabetic non uremic patients and the
third group was ten uremic non diabetic patients.
In the diabetic patients with chronic renal failure
we found inprovement in carbohydrate tolerance mean kg
( 0.69 + 0.11 ) than in diabetic non uremic patients mean
kg ( 0.58 ± 0.05 ) ( P < 0.001 i.
The cause of this improvement is not clearly established
but decreased caloric intake, impaired hepatic
glycogenolysis and prolongation of the half-life of insulin
are thought to be involved.
We a180 found low fasting blood glucose in the diabetic
uremic patients mean fasting -( 121..3 ± 17.87 mg/dl )
than in diabetic non uremic patients mean fasting
( 155.6 + 20.4 mg/dl ) ( P < 0.001 ).
So blood sugar levels are easier to control in
diabetics with progressive renal insufficiency whose
insulin requirements often decreased.
On comparing the results obtained with the intravenous
glucose tolerance test and double sample test, we
found that: with the intravenous glucose tolerance test
all the diabetic uremic patients were diagnosed diabetica,
but with the double sample test only 50% of cases were
diagnosed diabetics, 30% were diagnosed impaired glucose
tolerance and 20% were diagnosed non diabetics.
So we found that intravenous glucose tolerance test
is more sensetive in diagnosing diabetes mellitus than
double sample test especially in diabetic uremic patients
because the intravenous glucose tolerance test avoids the
absorption from the gastrointestinal tract which is markedly
affected with uremia and repeated nausea and vomiting.
Also with intravenous route we avoid the involvement
of insulin releasing gut hormones.
With the intravenous glucose tolerance test in
uremic non diabetic patients we found impairment in glucose
tolerance in 70% of cases mean kg ( 0.98 ± 0.12 ) but
with the double sample test all these case8/were diagnosed
normal with normal fasting and 2 hour blood
glucose level.