Postprandial and basal hyperglycaemia in type 2 diabetes: Contributions to overall glucose exposure and diabetic complications

Diabetes & Metabolism
L Monnier, C Colette

Abstract

Both postprandial and fasting (basal) hyperglycaemia contribute to overall hyperglycaemia (ambient hyperglycaemia) in type 2 diabetes (T2D). Postprandial glucose is the main contributor in fairly well controlled individuals, whereas basal hyperglycaemia becomes the preponderant contributor in poorly controlled patients. A more generally acceptable description of the contribution of postprandial glucose is to simply say that the absolute impact of postprandial glucose to HbA1c remains constant at approximately 1% across the entire HbA1c spectrum of non-insulin-treated patients with T2D. While epidemiological and pathophysiological studies seem to indicate that excessive postprandial glucose excursions play a role in or are predictors of cardiovascular diseases, there is still currently a lack of clinical evidence that correcting post-meal hyperglycaemia can improve clinical outcomes. However, even in the absence of consensus, there are many reasons for thinking that excessive postprandial glucose might be an independent risk factor for diabetic complications as it contributes to both overall glucose exposure and glycaemic variability, especially in those who have HbA1c levels < 7.5-8%. Given that excessive glucose fluctuations f...Continue Reading

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Citations

Jul 1, 2017·Nature Reviews. Endocrinology·Emanuel GasserRonald M Evans
Mar 16, 2018·Journal of Korean Medical Science·Hyo Kyoung NamByung Kyu Suh
Jun 20, 2018·Diabetes Technology & Therapeutics·Halis Kaan AkturkSatish K Garg
Sep 29, 2018·Diabetic Medicine : a Journal of the British Diabetic Association·A C PaingS F M Chastin
Aug 2, 2017·BMJ Open Diabetes Research & Care·Rogelio U AlmarioSidika E Karakas
Feb 21, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Denisa Janíčková ŽďárskáJan Brož
Dec 24, 2018·The British Journal of Nutrition·Dean M AllertonEmma J Stevenson
Oct 28, 2019·Medicine and Science in Sports and Exercise·Kenneth VerbovenDominique Hansen
Jun 23, 2020·Circulation Research·Michelle C FlynnAndrew J Murphy
Sep 2, 2018·European Journal of Applied Physiology·Richard S MetcalfeGareth W Davison
Jan 31, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Yo KohataSho-Ichi Yamagishi
Mar 21, 2021·Scientific Reports·Jose A AdamsMarvin A Sackner
Jun 11, 2021·The Journal of Clinical Endocrinology and Metabolism·Kirstin A MacGregorColin N Moran

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