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Blood glucose patterns in type 2 diabetic patients with optimal fasting plasma glucose but high HbA1c

Woranan Charoenhirunyingyos1, Wannee Nitiyanant, Porkeaw Thabsang

  • 1Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|May 13, 2011
PubMed

Insights

Fasting plasma glucose (FPG) alone is insufficient for assessing type 2 diabetes control. Frequent monitoring of pre- and post-meal capillary plasma glucose (CPG) is crucial for evaluating overall glycemic control, especially when HbA1c is elevated despite normal FPG.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetes Management

Background:

  • Fasting plasma glucose (FPG) targets may not accurately reflect overall glycemic control.
  • Hemoglobin A1c (HbA1c) levels can remain elevated even when FPG is within target range.
  • Understanding glucose patterns is vital for effective diabetes management.

Purpose of the Study:

  • To identify blood glucose patterns in type 2 diabetes patients with HbA1c > 7% despite FPG < 130 mg/dl.
  • To examine the correlation between HbA1c and plasma glucose levels at various times.
  • To determine the influence of diet (caloric intake, carbohydrate consumption, glycemic index) on plasma glucose.

Main Methods:

  • Study included type 2 diabetes patients with FPG < 130 mg/dl and HbA1c > 7%.
  • Participants self-monitored capillary plasma glucose (CPG) before and after meals, and at bedtime over 4 weeks.
  • Daily food intake was recorded to assess dietary contributions.

Main Results:

  • Elevated post-meal glucose was observed in 21.7% of patients.
  • High pre- and post-meal glucose with normal FPG occurred in 36.7%.
  • Elevated glucose at all measured times was found in 41.7% of patients. Significant correlations were found between HbA1c and pre/post-meal CPG (p=0.01). No correlation was observed between CPG and dietary factors.

Conclusions:

  • FPG alone is not a reliable indicator of glycemic control in type 2 diabetes.
  • Elevated blood glucose at multiple time points is common in patients with seemingly controlled FPG but high HbA1c.
  • Frequent pre- and post-meal CPG monitoring aids in assessing overall glycemic control.
Abstract

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