Postprandial Glucose Regulation and Diabetic Complications

Ceriello, Antonio; Hanefeld, Markolf; Leiter, Lawrence A.; Monnier, L.; Moses, Alan C.; Owens, David R.; Tajima, Naoko; Tuomilehto, Jaakko

doi:10.1001/archinte.164.19.2090

Cited by 319 publications

(193 citation statements)

References 47 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, our results show that diabetic patients with postprandial hyperglycaemia also have daily episodes of significant changes in their vascular tree. This, together with the observation of the effect of postprandial hyperglycaemia on HbA 1c in patients with type 1 diabetes in the Diabetes Control and Complications Trial (DCCT) [41,42], is an additional reason to strictly control daily blood glucose levels.…”

Section: Discussionmentioning

confidence: 99%

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

et al. 2007

View full text Add to dashboard Cite

Aims/hypothesis Augmentation index (AIx) and pulse wave velocity (PWV), both measures of arterial stiffness, constitute risk factors for cardiovascular disease. Notably, hyperglycaemia during an acute cardiovascular event is associated with poor prognosis. The objective of this study was to investigate whether acute hyperglycaemia increases arterial stiffness in patients with type 1 diabetes and in healthy subjects. Methods Twenty-two male patients with type 1 diabetes and thirteen healthy men, who were age-matched nonsmokers and without any diabetic complications, underwent a 120 min hyperglycaemic clamp (15 mmol/l). AIx was calculated to assess arterial stiffness. Before and during the clamp, carotid-radial (brachial) and carotid-femoral (aortic) PWV was measured. Results At baseline there was a difference in the AIx between patients with type 1 diabetes and healthy volunteers (−5±2.7 vs −20±2.8%, p<0.05). Acute hyperglycaemia rapidly increased AIx in patients with type 1 diabetes (−5±2.7 vs 8±2.5%, p<0.001) and healthy volunteers (−20±2.8 vs 6±8.8%, p<0.001). Brachial PWV increased during acute hyperglycaemia in patients with type 1 diabetes (7.1±1.2 vs 8.0±1.0 m/s, p<0.001), but not in healthy men (7.4±1.7 vs 7.3±1.4 m/s, NS). Conclusions/interpretation Acute hyperglycaemia increases the stiffness of intermediate-sized arteries and resistance arteries in young patients with type 1 diabetes and consequently emphasises the importance of strict daily glycaemic control. No change was observed in aortic PWV during the clamp, indicating that acute hyperglycaemia does not affect the large vessels.

show abstract

Section: Discussionmentioning

confidence: 99%

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

et al. 2007

View full text Add to dashboard Cite

show abstract

“…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%

“…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

View full text Add to dashboard Cite

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.

show abstract

“…The stored data pairs from each patient include the pre-meal glucose readings with the dates and times of ascertainment. While pre-meal readings were taken on a daily basis, postprandial blood glucose concentrations [15] were also measured, but less frequently.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

et al. 2005

View full text Add to dashboard Cite

Aims/hypothesis: Diabetic subjects do home monitoring to substantiate their success (or failure) in meeting blood glucose targets set by their providers. To succeed, patients require decision support, which, until now, has not included knowledge of future blood glucose levels or of hypoglycaemia. To remedy this, we devised a glucose prediction engine. This study validates its predictions. Methods: The prediction engine is a computer program that accesses a central database in which daily records of self-monitored blood glucose data and life-style parameters are stored. New data are captured by an interactive voice response server on-line 24 h a day, 7 days a week. Study subjects included 24 patients with debilitating hypoglycaemia (unawareness), which qualified them for islet cell transplantation. Comparison of each prediction with the actually observed data was done using a Clarke Error Grid (CEG). Patients and providers were blinded as to the predictions. Results: Prior to transplantation, a total of 31,878 blood glucose levels were reported by the study subjects. Some 31,353 blood glucose predictions were made by the engine on a total of 8,733 days-used. Of these, 79.4% were in the clinically acceptable Zones of the CEG. Of 728 observed episodes of hypoglycaemia, 384 were predicted. After transplantation, a total of 45,529 glucose measurements were reported on a total of 12,906 days-used. Some 42,316 glucose predictions were made, of which 97.5% were in the acceptable CEG Zones A and B. Successful transplantation eliminated hypoglycaemia, improved glycaemic control, lowered HbA 1 c and freed 10 of 24 patients from daily insulin therapy. Conclusions/ interpretation: It is clinically feasible to generate valid predictions of future blood glucose levels. Prediction accuracy is related to glycaemic stability. Risk of hypoglycaemia can be predicted. Such knowledge may be useful in self-management.

show abstract

Postprandial Glucose Regulation and Diabetic Complications

Cited by 319 publications

References 47 publications

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

Acute hyperglycaemia rapidly increases arterial stiffness in young patients with type 1 diabetes

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

Home blood glucose prediction: clinical feasibility and validation in islet cell transplantation candidates

Contact Info

Product

Resources

About