Use of Glucose Meters to Establish a Cutpoint for Nonperformance of an Oral Glucose Tolerance Test

Although the use of the oral glucose tolerance test (OGTT) for the routine diagnosis of diabetes mellitus is discouraged in recent practice standards, physicians continue to order the OGTT, sometimes as an initial screening test for diabetes mellitus. Measuring a fasting glucose level before administration of the oral glucose solution in an OGTT can be performed and the result used to discontinue the OGTT in many patients with diabetes mellitus. In a hospital setting, a rapid plasma glucose value can be obtained relatively easily in the central laboratory. However, in a community setting with many practice locations, alternative methods for obtaining a rapid glucose screen must be used. We report the results of a program involving the use of capillary blood glucose meters to screen patients before an OGTT. We also established a cutoff value for the capillary glucose test above which an OGTT should not be performed.