GTT Innovations

I found a patient in the antenatal ward who had been admitted for an oral glucose tolerance test by our Assistant Professor. Her fasting plasma sugar was 112 mg%. I asked him why she was hospitalized, since we have an excellent laboratory where the personnel are well trained to do this work. He said he thought it would be better this way. I had a bad feeling about the whole thing. So I decided to check everything rather than trust that all would be well and move on. "How much glucose have you given to this patient?" I asked the house officer. "Seventy five grams" she said. "The protocol is to give a 100 grams load. Why have you deviated from the protocol?" She looked at others for support, but did not answer my question. I asked the Registrar the same question, who had no answer too. I checked how many blood samples had been drawn. The fasting, 1 hour and 2 hours samples had been drawn. "Now what do we do?" I asked. The Associate Professor, three Assistant Professors and all residents did not have answer. I do not blame them, because I could not think of anything other than abandoning the test and performing it correctly the next day. I think God must have received a distress signal from the patient's guardian angel. I suddenly had an unexplained urge to pick up the patient's glucose pack and see how much glucose was left behind. It was a 100 g pack, and weighed much more than 25 g. I opened it and looked inside. There was more than half glucose left behind. "How much glucose did you take?" I asked the patient. "Up to this mark the doctor made on the box" she said, pointing out the mark for me to see. The mark was at 2 cm distance from the top of the box, which was 6 cm tall. The house officer had no explanation for the placement of the mark there. Then suddenly the solution popped up in my head. "Let us look at the fasting and 2 hour samples' results. It will be like a 50 g glucose load test. Do not collect the 3 hour sample. If it shows abnormality, we will investigate her further." God has saved many a situation that man (or woman) had created in our hospital, for which no human solution was possible. This was one of them.