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Abstract
Poorly controlled diabetes is associated with development of various diabetic complications. Large controlled clinical trials have demonstrated that intensive glycemic control can significantly decrease the development and/or progression of microvascular complications of diabetes. Until recently, the goal of treatment in diabetic subjects has been reducing HbA1c level, with a strong emphasis on fasting plasma glucose. Although control of fasting hyperglycemia is necessary, that alone is not sufficient to obtain optimal glycemic control. Recently, a growing body of evidence has suggested that postprandial hyperglycemia has greater impact on diabetes complications than does average blood glucose as measured by HbA1c or fasting plasma glucose. This report briefly reviews the measurement and treatment goal of postprandial glucose.
Figures and Tables
Fig. 1
Average glucose level vs. glucose variability. Will two patients with the same mean blood glucose level but very different glucose variability have similar HbA1c levels?
Fig. 2
Relative contributions of fasting and postprandial hyperglycemia to overall diurnal hyperglycemia over quintiles of HbA1c.
Adapted from Monnier et al. Diabetes Care 2003;26:881-5 [16].
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