Postprandial Blood Glucose Outweighs Fasting Blood Glucose and HbA1c in screening Coronary Heart Disease

Abstract

The objective of the present study is to assess the performance of fasting blood glucose (FBG), postprandial blood glucose (PBG), and glycated hemoglobin (HbA1c) as screening for coronary heart disease (CHD) in an inpatient population undergoing coronary angiography. 1852 consecutive patients scheduled for coronary angiography were classified into Normal Glucose Tolerance (NGT), Impaired Glucose Regulation (IGR), and diabetes, based on FBG, PBG, and HbA1c. Correlations of Gensini score with glucose metabolism and insulin resistance were analyzed. The associations between glycemic variables and Gensini score or the presence of CHD were analyzed by multiple linear regression and logistic regression, respectively. CHD was diagnosed in 488, 622, and 414 patients with NGT, IGR, and diabetes, respectively. Gensini score was positively correlated with FBG (r = 0.09, p < 0.01), PBG (r = 0.20, p < 0.01), and HbA1c (r = 0.19, p < 0.01). Gensini score was not correlated with fasting insulin (r = −0.081, p = 0.36), post-prandial insulin (r = −0.02, p = 0.61), or HOMAIR (r = −0.0059, p = 0.13). When FBG, PBG and HbA1c were pooled altogether, only PBG persisted in its association with Gensini score and the prevalence of CHD. The severity of CHD was associated with glucose rather than insulin resistance in this Chinese population. PBG was optimally correlated with the presence and severity of CHD.

Type-4 Resistant Starch in Substitution for Available Carbohydrate Reduces Postprandial Glycemic Response and Hunger in Acute, Randomized, Double-Blind, Controlled Study

“…Postprandial blood glucose control has long been recognized as a predictor of diabetes development. More recently, poor postprandial blood glucose control correlated with the presence of coronary heart disease [ 5 ], thus demonstrating the value of improved postprandial blood glucose control.…”

Impact of free-living pattern of sedentary behaviour on intra-day glucose regulation in type 2 diabetes

“…This suggests that behavioural intervention aimed at modifying sedentary behaviour in type 2 diabetes could be used as a therapeutic modality to control glycaemia throughout the day. There is evidence that pre-breakfast glucose, pre-dinner glucose, post-breakfast glucose and post-lunch glucose are associated with cardiovascular complications and allcause mortality in those with type 2 diabetes (Cavalot et al 2011;Tanaka 2012;Jiang et al 2017). This highlights the importance of glucose control before and after meals, and every 1 mmol/L increase in pre-meal glucose and post-meal glucose can increase the risk of a cardiovascular event by 11% and 8%, respectively (Kilpatrick et al 2008).…”

Are glucose profiles well-controlled within the targets recommended by the International diabetes Federation in type 2 diabetes? A meta-analysis of results from continuous glucose monitoring based studies

“…There is strong observational evidence that fasting glucose is associated with vascular events and mortality, and HbA1c level is consistently influenced by fasting glucose or pre-breakfast glucose and pre-lunch glucose but not with pre-dinner glucose [4,8,14,29,30,31,32]. High postprandial glucose after breakfast and lunch can also predict the cardiovascular events in type 2 diabetes, and this effect is independent and stronger than fasting glucose and HbA1c [33,34]. In general, the association of HbA1c with postprandial glucose was well established [4,35,36] but not with postprandial glucose after each meal in a day.…”