Management of Postprandial Blood Glucose in Diabetes Mellitus
Journal Title: Archives of Diabetes & Obesity - Year 2018, Vol 1, Issue 5
Abstract
Patients with type-2 diabetes have more than half the day in the post meal state. Elevation in post meal plasma glucose is due to loss of first phase insulin secretion, decreased insulin sensitivity in peripheral tissues and consequent decreased suppression of hepatic glucose output after meals due to insulin deficiency. Elevated or exaggerated post meal response is directly responsible for endothelial dysfunction and pro-atherogenic states. Post-meal hyperglycemia is a prominent early defect in type-2 diabetes patients. 80% of total caloric intake is carbohydrate rich in our country. The higher glucose load in the diets is responsible for an exaggerated prandial glycemic response. This in turn leads to a higher lipaemic peak which has a direct correlation with cardiovascular disease. Even before diagnosis of clinical diabetes, these metabolic abnormalities are first evident as elevation in post- meal plasma glucose. HbA1c levels reflect overall glycemic exposure and are determined by both fasting and PPG exposure. In a study patient who achieved fasting plasma glucose levels of < 100 mg/ dl, 64% achieved HbA1c level of <7% and of patients who achieved PPG levels < 140 mg/dl, 94% achieved an HbA1c < 7%. In diabetic patients with HbA1c levels between 6.8 to 8.9, PPG contributed to almost 70% of the HbA1c level.
Authors and Affiliations
Poondy Gopalratnam Raman
Keywords
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- EP ID EP589327
- DOI 10.32474/ADO.2018.01.000124
- Views 51
- Downloads 1
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