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Targeting postprandial glycaemia in children with diabetes: Opportunities and challenges

Myfanwy C Geyer1,2, Christopher K Rayner3,4, Michael Horowitz3,5

  • 1Discipline of Paediatrics, University of Adelaide, Adelaide, Australia.

Diabetes, Obesity & Metabolism
|October 27, 2017
PubMed

Insights

Managing postprandial glucose levels is crucial for children with diabetes, especially when preprandial glucose is controlled. This review explores factors influencing postprandial hyperglycemia and therapeutic strategies for better diabetes management in pediatric patients.

Area of Science:

  • Endocrinology
  • Pediatric Diabetes Management
  • Metabolic Research

Background:

  • Postprandial hyperglycemia significantly impacts overall glycemic control in diabetes.
  • It is particularly relevant for pediatric patients with well-controlled preprandial glucose and modestly elevated HbA1c.
  • Understanding the determinants of postprandial glucose excursions is key for effective diabetes management in children.

Purpose of the Study:

  • To review the factors influencing postprandial hyperglycemia in children with diabetes.
  • To discuss therapeutic strategies for targeting postprandial glucose control in pediatric diabetes.
  • To highlight the evolving landscape of diabetes management technologies and treatments for children.

Main Methods:

  • Literature review focusing on determinants of postprandial glycemia.
  • Analysis of continuous glucose monitoring (CGM) data patterns.
  • Evaluation of therapeutic interventions targeting the incretin system and gastric emptying.

Main Results:

  • Postprandial glycemia is influenced by preprandial glucose, nutrient absorption, insulin dynamics, enteroendocrine function, and gastric emptying.
  • Continuous glucose monitoring systems provide detailed insights into postprandial glucose patterns.
  • Challenges remain in closed-loop systems regarding glucose and insulin delivery timing.
  • Incretin system augmentation offers a promising approach, particularly for type 2 diabetes in children.

Conclusions:

  • Targeting postprandial hyperglycemia is becoming increasingly important in pediatric diabetes care.
  • Therapeutic strategies involving the incretin system show potential for improving glucose control in children.
  • Advancements in technology and understanding of physiological mechanisms are driving new treatment approaches for pediatric diabetes.

Keywords:
childrendiabetesgastric emptyingincretinspostprandial glycaemia

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