Resolving the glucose response curve: the underestimated importance of postprandial glucose

Although the measures fasting plasma glucose, postprandial glucose, and hemoglobin A1c are accepted methods for identifying clinical diabetes, discussion has arisen over which measure is the most informative and the precise role of each in the disease. The American Diabetes Association and the World Health Organization have chosen different metrics for their categorization of clinical diabetes, and their respective classification systems identify substantially different populations of patients with diabetes. Increasing evidence has suggested that elevated postprandial glucose has a significant role in the progression of diabetes and as an independent risk factor for diabetes-related complications. Glycemic metrics in terms of their physiological basis and ability to identify populations at risk of diabetes and diabetes-related complications are discussed.