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Abstract
Global diabetes prevalence is increasing every year. Glucose control is the most important aspect of diabetes management, and numerous studies on diabetes treatment have shown the importance of glucose reduction in the prevention of diabetic complications. Glucose control may be influenced by three components of glycemia (a "triad"): fasting hyperglycemia, postprandial hyperglycemia, and HbA1c. Which of these components most influences glucose control is still under debate. However, there are sufficient data to demonstrate the importance of postprandial glucose control in the prevention of cardiovascular complications. A few pivotal studies have been performed on the association of fasting or postprandial hyperglycemia with overall glucose control. These studies suggest that different components of glycemia have variable effects according to degree of glucose control. Also, glycemic variability is emphasized as a new component in glucose control. More studies should be performed to find better ways of controlling postprandial hyperglycemia for the prevention of cardiovascular complications of diabetes.
Figures and Tables
Fig. 1
Relative contributions of postprandial (□) and fasting (▪) hyperglycemia (%) to overall diurnal hyperglycemia over quintiles of HbA1c.
Adapted from Monnier et al. Diabetes Care 2003;26:881-5 [6].
Fig. 2
Twenty-four hour recordings of continuous glucose motoring system in five groups of patients with type 2 diabetes.
Curve 1: A1C < 6.5%; curve 2: 6.5-7%; curve 3: 7-8%; curve 4: 8~9%; curve 5 > 9%.
Adapted from Monnier et al. Diabetes Care 2007;30:263-9 [7].
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