Oral Glucose Tolerance Testing (OGTT) at ambulatory clinics

We perform OGTT in our draw stations and obtain the fasting results before administering the glucose drink.  We use glucose meters to screen the patient, if they are above the threshold, the phlebotomist sends the fasting sample to the main lab and has the patient wait for the result.  From our policy:

3. If the laboratory result is below the threshold, continue to beverage administration.  If the laboratory result is above threshold, call the ordering provider and obtain their decision whether to proceed with the test or cancel it.  Some providers may choose to diagnose based on one elevated fasting value or they may require two or more thresholds be met or exceeded.  
• Note: If the provider cannot be reached, discontinue the test with the following comment: “Per Asante policy, Dextrose Beverage will not be administered to patients with a fasting glucose >92 mg/dL (gestational) or >125 mg/dL (non-gestational) unless notified otherwise.”

Sources:
American Diabetes Association, Diagnosis and Classification of Diabetes Mellitus, Diabetes Care, 35(Suppl 1): S64–S71, doi: 10.2337/dc12-s064, 2012

WHO and IDF Technical Advisory Group, Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: report of a WHO/IDF consultation, World Health Organization, 2006

Thank you Danielle, I have the ADA 2025 Diagnosis and Classification of Diabetes: Standards of Care and will look for the statement to not administer the glucose drink. The problem I'm encountering is that our clinics use a commercial reference lab and they do not send it to our main hospital lab. So they do not get the results for the fasting glucose level. They just draw the fasting specimen and then proceed with giving the patient the drink and draw the post specimens. The commercial reference lab procedure doesn't state any cutoff for the fasting level and it just states to draw the fasting level and then give the drink.