Postprandial Hyperglycemia Is an Independent Risk for Retinopathy in Elderly Patients With Type 2 Diabetes Mellitus, Especially in Those With Near‐normal Glycosylated Hemoglobin

Aizawa, Toru; Katakura, Masafumi; Naka, Motoji; Kondo, Teruki

doi:10.1111/j.1532-5415.2010.02928.x

Cited by 5 publications

(3 citation statements)

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“…In contrast, although postprandial hyperglycemia was associated with increased macrovascular events in observational studies 3) , targeted lowering of postprandial glycemia in patients with diabetes did not necessarily produce a favorable CHD outcome 17,18) . The deleterious effect of postprandial hyperglycemia may be absent in patients with markedly elevated HbAc 19) and current data are compatible with such a notion. Favorable blood pressure control as a whole group in this cohort may have mitigated the facilitation of atherosclerosis by early phase diabetic nephropathy 3,4) .…”

Section: Discussionsupporting

confidence: 78%

Systematic Analysis of Risk Factors for Coronary Heart Disease in Japanese Patients with Type 2 Diabetes: A Matched Case-Control Study

Fumisawa

Funase

Yamashita

et al. 2012

JAT

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Section: Discussionsupporting

confidence: 78%

Systematic Analysis of Risk Factors for Coronary Heart Disease in Japanese Patients with Type 2 Diabetes: A Matched Case-Control Study

Fumisawa

Funase

Yamashita

et al. 2012

JAT

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“…Results of the Get‐Goal‐L study suggest this effect is less pronounced after other meals of the day, according to the 7‐point self‐measurement of plasmareferenced glucose (SMPG) . This is to be expected, since the drug is injected once daily (before breakfast) and its plasma half‐life is 3–4 h. Postprandial hyperglycaemia is commonly observed among patients with diabetes [], even among patients showing well‐controlled HbA1c levels and epidemiological studies have shown a link between blood sugar levels following meals and the risk of the onset of cardiovascular disease [] or retinopathy . However, it is still unclear whether the control of PPG levels confers advantages in terms of macrovascular disease.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta‐analysis of the efficacy of lixisenatide in the treatment of patients with type 2 diabetes

Schmidt

Habacher

Augustin

et al. 2014

Diabetes Obesity Metabolism

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The aim of this study is to assess the efficacy and safety of lixisenatide for treating type 2 diabetes. A systematic search in electronic databases (up to October 2012) was conducted and the manufacturer was contacted regarding unpublished data. Randomized controlled trials (RCTs) were included if they provided information on at least one of the following outcomes: mortality, health-related quality of life, hypoglycaemic events, adverse events, change in HbA1c, body weight, blood pressure, gastric emptying, fasting plasma glucose or 2 h postprandial glucose (PPG). Twenty-six publications and 10 unpublished study reports, relating to 14 RCTs (6156 patients) were included. Eleven studies related to placebo comparisons; active comparators were in three studies. Compared to placebo, lixisenatide significantly reduced HbA1c (-0.52%; 95% CI: -0.64 to -0.39), bodyweight (-0.65 kg; 95% CI: -0.94 to -0.37) and 2-h PPG level (-4.58 mmol/l; 95% CI: -5.88 to -3.28). There were significantly more symptomatic hypoglycaemic events among lixisenatide compared to placebo-treated patients (log OR: 0.54; 95% CI: 0.32-0.75), but significantly fewer compared to other incretin mimetics. In comparison to exenatide and liraglutide, lixisenatide was more effective in reducing 2 h-PPG with a better adverse events profile, but it showed a lower reduction in HbA1c and body weight. Lixisenatide improves HbA1c levels and moderately reduces body weight compared to placebo and showed less frequent symptomatic hypoglycaemic and gastrointestinal events and an improvement in PPG control compared to other GLP-1 agonists. Firm conclusions regarding the performance of lixisenatide compared to other incretin mimetics, however, can not yet be drawn, due to limited data.

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“…There is increasing evidence linking it with cardiovascular disease markers such as oxidative stress (33), carotid artery intima-media thickness (34), and endothelial dysfunction (33,35). Postprandial hyperglycemia has also been associated with retinopathy (36,37), cognitive impairment in elderly patients (38), and some cancer types (39)(40)(41)(42)(43). The combined control of FPG and PPG levels is necessary in order to achieve glycemic targets.…”

Section: Importance Of Ppg Controlmentioning

confidence: 99%

Use of Biphasic Insulin Aspart 30 in Type 2 Diabetes Treatment: Expert Panel Recommendations

Akalın¹,

Aydın²,

Balci³

et al. 2018

Turk J Endocrinol Metab

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The goals of Type 2 diabetes treatment are to eliminate the hyperglycemia resulting from insulin insufficiency and/or insulin resistance, delay beta cell damage/depletion, and prevent other metabolic co-morbidities and complications. In the current treatment algorithms, lifestyle changes (medical nutrition therapy, physical exercise) and oral anti-diabetics are followed by insulin therapy, which is considered a replacement therapy for Type 2 diabetes. Pre-mixed insulin preparations, which are an option for patients with poor blood glucose level control under oral anti-diabetics treatment, have been developed to meet both basal and prandial insulin needs by simulating the physiological changes in insulin levels. The consensus on the necessity of individualizing insulin therapy requires physicians to have a detailed knowledge of the various uses of insulin. Therefore, this comprehensive consensus statement has been prepared by a panel of expert endocrinologists from different regions of Turkey to help physicians use biphasic insulin aspart 30 in suitable patients at the right time. In this statement, expert panel opinions on (a) Recommendations for the appropriate initiation, titration, and intensification of insulin treatment, and (b) The treatment algorithms in initiation, titration, and intensification of biphasic insulin aspart 30 treatment and special conditions specific to changing treatment regimen are presented.Keywords: Biphasic insulin aspart 30; insulin intensification; premixed insulin; insulin analog Tip 2 diyabet (T2D) tedavisinde amaç, insülinin yetersiz salgısı ve/veya insülin direnci sonucu oluşan hiperglisemiyi ortadan kaldırmak, beta hücre harabiyetini/tükenişini yavaşlatmak, eşlik eden diğer metabolik sorunları düzeltmek ve komplikasyonları önlemektir. Güncel tedavi algoritmalarında yaşam tarzı değişikliği (tıbbi beslenme tedavisi, egzersiz) ve oral antidiyabetikler ile tedavi seçeneklerini izleyen aşamada yer alan insülin, T2D için bir yerine koyma tedavisi olarak değerlendirilmektedir. Hazır karışım insülinler, oral antidiyabetikler ile kan glukoz düzeyleri kontrol altına alınamayan hastaların tedavisinde yer alması önerilen tedavi seçeneklerinden olup, hem bazal hem de prandiyal insülin ihtiyacını fizyolojiye yakın biçimde karşılamak amacıyla geliştirilmişlerdir. İnsülin tedavisinin kişiye özel olması gerektiği konusundaki konsensüs, hekimlerin değişik insülinlerin kullanımları ile ilgili daha ayrıntılı bilgiye sahip olmalarını gerektirmektedir. Bu nedenle, ülkemiz koşullarında bifazik insülin aspart 30'un doğru hastada, doğru zamanda ve doğru biçimde kullanılmasını kolaylaştırmak ve hekimlere yardımcı olmak için Türkiye'nin farklı bölgelerinde görev yapmakta olan deneyimli endokrinologlardan oluşan bir uzman paneli tarafından, bu kapsamlı uzlaşı metni hazırlanmıştır. Bu uzlaşı metninde, uzman paneli görüşleri; a) İnsülin tedavisine uygun başlangıç, titrasyon ve yoğunlaştırma algoritma önerileri ve b) Bifazik insülin aspart 30 tedavisine özgü başlangıç, titrasyon ve yoğunlaştırma tedavi algor...

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Postprandial Hyperglycemia Is an Independent Risk for Retinopathy in Elderly Patients With Type 2 Diabetes Mellitus, Especially in Those With Near‐normal Glycosylated Hemoglobin

Cited by 5 publications

References 5 publications

Systematic Analysis of Risk Factors for Coronary Heart Disease in Japanese Patients with Type 2 Diabetes: A Matched Case-Control Study

Systematic Analysis of Risk Factors for Coronary Heart Disease in Japanese Patients with Type 2 Diabetes: A Matched Case-Control Study

A systematic review and meta‐analysis of the efficacy of lixisenatide in the treatment of patients with type 2 diabetes

Use of Biphasic Insulin Aspart 30 in Type 2 Diabetes Treatment: Expert Panel Recommendations

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