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Targeting postprandial hyperglycemia.

Marc S Rendell1, Lois Jovanovic

  • 1Creighton Diabetes Center, Omaha, NE 68131, USA.

Metabolism: Clinical and Experimental
|August 22, 2006
PubMed
Summary
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Managing postprandial glucose (PPG) is crucial for diabetes care. New treatments targeting PPG, similar to those for diabetic pregnancies, can improve outcomes for individuals with diabetes and impaired glucose tolerance.

Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Cardiovascular Health

Background:

  • Basal insulin secretion maintains fasting glucose; however, postprandial glucose (PPG) control relies on rapid insulin release stimulated by glucose and incretins.
  • Diabetic individuals exhibit insufficient postprandial insulin secretion, leading to excessive PPG rises.
  • Elevated PPG poses a greater vascular risk than fasting hyperglycemia, particularly in individuals with impaired glucose tolerance and normal fasting glucose.

Purpose of the Study:

  • To highlight the increasing importance of managing postprandial glucose (PPG) in diabetes.
  • To advocate for a treatment paradigm shift towards prioritizing PPG control.
  • To propose an aggressive PPG-focused treatment approach for diabetes and impaired glucose tolerance.

Main Methods:

Related Experiment Videos

  • Review of existing evidence on PPG's impact on vascular health.
  • Analysis of current and emerging pharmacologic and lifestyle interventions for PPG reduction.
  • Examination of successful PPG control strategies in gestational diabetes and diabetic pregnancies.

Main Results:

  • Individuals with impaired glucose tolerance and normal fasting glucose have a significantly increased risk of cardiovascular events.
  • Dietary management, exercise, and various oral antidiabetic agents effectively counteract PPG elevation.
  • Newer agents like GLP-1 agonists, DPP-IV inhibitors, advanced insulin analogs, and inhaled insulin offer novel approaches to PPG suppression.

Conclusions:

  • Management of diabetes and impaired glucose tolerance should increasingly focus on controlling postprandial glucose (PPG) levels.
  • An aggressive PPG-centric treatment strategy, mirroring successful approaches in diabetic pregnancies, is proposed.
  • This approach aims to mitigate the deleterious vascular effects of elevated PPG and improve patient outcomes.