The clinical importance of postprandial glucose

Atherosclerotic lesions develop over a long period of time and result from complex changes in the arterial wall. Although these changes are not fully understood, there is much evidence to suggest that elevated plasma glucose levels contribute to the development of atherosclerotic lesions. Many studies have shown that there is a strong correlation between elevated plasma glucose levels and the risk of developing cardiovascular disease. Effects of glucose on the arterial wall include immediate effects, which occur rapidly in response to elevated plasma glucose levels, and long-term effects, which result from non-enzymatic glycosylation of various proteins. These adverse effects of elevated plasma glucose levels suggest that tight control of blood glucose levels in patients with diabetes could possibly reduce the risk of cardiovascular complications. This is borne out by the results of clinical studies in patients with type 1 diabetes. Therapy to reduce blood glucose levels may also be appropriate in individuals with impaired glucose tolerance, as this condition is associated with postprandial hyperglycaemia and a significant risk of developing cardiovascular disease.