After a standard 75 g carbohydrate dose for an oral glucose tolerance test, the patient vomits 90 minutes after ingestion. The best course of action is to:

• A. give the patient orange juice and continue the test
• B. start the test over immediately with a 50 g carbohydrate dose
• C. draw blood for glucose and discontinue the test
• D. place the patient in a recumbent position, reassure him and continue the test.

Answer: (C)

Vomiting during an oral glucose tolerance test means the glucose dose may not be properly absorbed, so the test results beyond that point cannot be interpreted reliably. The appropriate action is to stop the test and obtain a blood glucose measurement at the time of the event to document the current level. Continuing or reloading the test would violate the protocol and could lead to unreliable results or safety concerns. Plan a repeat OGTT on a different day when the patient can tolerate the glucose load.