Postprandial blood glucose as a risk factor for cardiovascular disease in Type II diabetes: the epidemiological evidence

Bonora, Enzo; Muggeo, Michele

doi:10.1007/s001250100020

Cited by 452 publications

(319 citation statements)

References 10 publications

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“…Postprandial hyperglycaemia has recently been proposed as an independent risk factor for CVD [6,7]. However, the effect of the postprandial state, particularly postprandial hyperglycaemia, on CVD is still a matter of debate [21,22]; studies show that postprandial hyperglycaemia is accompanied by an increase of both oxidative stress and inflammatory markers [11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

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Effects of S21403 (mitiglinide) on postprandial generation of oxidative stress and inflammation in type 2 diabetic patients

Assaloni

Ros

Quagliaro³

et al. 2005

Diabetologia

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Aim/hypothesis: Evidence suggests that postprandial hyperglycaemia may be a cardiovascular risk factor in diabetes. Oxidative stress and inflammation are involved in the pathogenesis of diabetic complications and previous studies have shown increased oxidative stress and inflammation in the postprandial phase in diabetic patients. The aim of the present study was to evaluate whether controlling postprandial hyperglycaemia with S21403 (mitiglinide) is accompanied by a reduced generation of oxidative stress and inflammation. Subjects and methods: Forty type 2 diabetic patients participated in the study. Two different breakfast-tests were performed in each patient, with placebo or S21403. Plasma nitrotyrosine, plasma malondialdehyde (MDA), oxidised LDL (oxLDL), plasma total radical-trapping antioxidant parameter (TRAP), IL-6, IL-18, TNF-α, plasma glucose and insulin were measured. Results: After the administration of S21403, 40 mg, a rapid stimulation of insulin secretion was observed, accompanied by a reduction of postprandial hyperglycaemia. With S21403, a significant decrease of either nitrotyrosine, MDA and oxLDL levels, and a preservation of plasma TRAP compared with placebo was found. Significant decreases of IL-6, IL-18 and TNF-α were also observed with S21403 compared with placebo. Conclusions/interpretation: This study shows that controlling postprandial hyperglycaemia with S21403 significantly improves the cluster of oxidative stress and inflammation markers that are increased in the postprandial state in diabetic patients.

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Section: Discussionmentioning

confidence: 99%

“…In recent years much attention has been paid to the causal relationship between the postprandial state and atherogenesis [2,3], even in diabetes mellitus [4,5], and it has been suggested that postprandial hyperglycaemia may be an independent risk factor for cardiovascular disease (CVD) [6,7].…”

Section: Introductionmentioning

confidence: 99%

Effects of S21403 (mitiglinide) on postprandial generation of oxidative stress and inflammation in type 2 diabetic patients

Assaloni

Ros

Quagliaro³

et al. 2005

Diabetologia

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show abstract

“…Over the last few years the concept has emerged that poorly controlled post-prandial glucose significantly contributes to high HbA 1c concentrations and to the development of chronic diabetic complications, particularly cardiovascular disease (CVD) [1][2][3][4]. The adverse impact of post-prandial or post-challenge (OGTT) hyperglycaemia seems to be even stronger than that of fasting hyperglycaemia [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and correlates of post-prandial hyperglycaemia in a large sample of patients with type 2 diabetes mellitus

et al. 2006

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Aims/hypothesis: Post-prandial glucose may be a risk factor for cardiovascular disease and chronic diabetic complications. We tested the hypothesis that post-prandial hyperglycaemia is common in type 2 diabetes, even among patients in apparently good glycaemic control, and that simple clinical characteristics identify subsets of diabetic patients with frequent post-prandial hyperglycaemia. Subjects and methods: Three self-assessed daily blood glucose profiles over a 1-week period, including 18 glucose readings before and 2 h after meals, were obtained from 3,284 unselected outpatients (men 51%; age 63±10 years) with non-insulin-treated type 2 diabetes mellitus attending 500 different diabetes clinics operating throughout Italy. Results: A post-prandial blood glucose value >8.89 mmol/l (160 mg/dl) was recorded at least once in 84% of patients, and 81% of patients had at least one Δglucose ≥2.22 mmol/l (40 mg/dl). Among patients with apparently good metabolic control, 38% had >40% of post-prandial blood glucose readings >8.89 mmol/l (≥4 of 9 meals in total), and 36% had >40% Δglucose ≥2.22 mmol/l. In multivariate analysis adjusted for pre-prandial glucose levels, older age, longer duration of diabetes, absence of obesity, hyperlipidaemia and hypertension, as well as treatment with sulfonylureas, were significantly associated with greater glucose excursions after meals. Conclusions/interpretation: These results indicate that post-prandial hyperglycaemia is a very frequent phenomenon in patients with type 2 diabetes mellitus on active treatment; can occur even when metabolic control is apparently good; and can be predicted by simple clinical features.

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“…The link between the magnitude of postprandial hyperglycemia and the risk of cardiovascular disease has been reported in other studies. 3 As improved postprandial hyperglycemia levels were associated with the regression of carotid medial intimal thickening (a commonly used direct assessment of early atherosclerosis), 12 it may be important to consider the dietary content (lower carbohydrate) in future studies seeking to evaluate the most effective strategies for lowering cardiovascular risk in patients with type 2 diabetes. Finally, it may be important to determine (in future studies) the value of postprandial hypotension and vascular stiffness in cardiovascular risk prevention strategies for patients with impaired glucose tolerance (pre-diabetes) and insulin resistance.…”

Section: Dietary Implications Of the Resultsmentioning

confidence: 99%

“…1,2 Poor glucose control seems to increase the risk of cardiovascular disease development during diabetes and recent evidence indicates that the postprandial state is an important contributing factor in the development of atherosclerosis. 3 During diabetes, the postprandial state is characterized by dramatic increase in blood glucose making the relationship between postprandial glucose and vascular function an important physiological consideration in the assessment of cardiovascular risk in patients with diabetes.…”

mentioning

confidence: 99%

Arterial stiffness and type 2 diabetes: dietary modulation after a single meal?

Phillips

2010

Hypertens Res

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Postprandial blood glucose as a risk factor for cardiovascular disease in Type II diabetes: the epidemiological evidence

Cited by 452 publications

References 10 publications

Effects of S21403 (mitiglinide) on postprandial generation of oxidative stress and inflammation in type 2 diabetic patients

Effects of S21403 (mitiglinide) on postprandial generation of oxidative stress and inflammation in type 2 diabetic patients

Prevalence and correlates of post-prandial hyperglycaemia in a large sample of patients with type 2 diabetes mellitus

Arterial stiffness and type 2 diabetes: dietary modulation after a single meal?

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