Postprandial hyperglycemia and glycemic variability: new targets in diabetes management

Article - Vol.26 Supl. 1 April 2010
F.J. Ampudia-Blasco¹

 Author Affiliations

Abstract

Type 2 diabetes is characterized by the presence of both fasting and postpran- dial hyperglycemia. Currently, glycated hemoglobin (HbA1c) is considered the «gold standard» for assessing glycemic control in patients with diabetes. Inter- ventional studies in type 1 and type 2 diabetes have conclusively demonstrat- ed that reducing HbA1c to <7% prevent appearance and progression of chron- ic complications. Additionally, other epidemiological studies and preliminary intervention studies have shown that postprandial hyperglycemia is an inde- pendent risk factor for cardiovascular disease. Sustained chronic hyperglyc- emia produces excessive protein glycation, but people with diabetes suffers also from daily acute glucose fluctuations, i.e. glucose variability. Acute chang- es of blood glucose may activate oxidative stress and contribute to endothe- lial dysfunction, which may also play a role in the development of diabetic complications. In fact, in diabetic subjects, most of the cardiovascular risk fac- tors are modified in the postprandial period, being affected directly by acute oscillations of blood glucose. Therefore, reducing postprandial hyperglycemia and glucose variability are now recognized as a treatment priority and should form part of the strategy for prevention and management of cardiovascular disease in diabetes.

Correspondence

Correspondencia: F.J. Ampudia-B lasco Unidad de Referencia de Diabetes. Hospital Clínico Universitario. Valencia Resumen

Keywords

diabetes mellitus type 2 diabetes mellitus severe hypoglycemia cardiovascular disease postprandial hyperglycemia

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