The Importance of Hyperglycemia in the Nonfasting State to the Development of Cardiovascular Disease

Haffner, S M

doi:10.1210/er.19.5.583

Cited by 89 publications

(77 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Post-prandial hyperglycaemia may be a key metabolic disturbance contributing to the chronic complications of type 2 diabetes [1][2][3][4]. Despite the potential importance of post-prandial hyperglycaemia, its prevalence and correlates are incompletely understood.…”

Section: Discussionmentioning

confidence: 99%

“…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%

See 1 more Smart Citation

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

et al. 2006

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…In the latest reports from the World Health Organization and the American Diabetes Association (ADA), IGT is categorised as a stage in the natural history of glucose metabolism disorders [4,5]. However, the glycaemic cut-off value for IGT was not based on the risk of cardiovascular disease (CVD), and growing evidence suggests that the risk of cardiovascular events and the development of type 2 diabetes extends to concentrations below present diagnostic thresholds [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

High normal 2-hour plasma glucose is associated with insulin sensitivity and secretion that may predispose to type 2 diabetes

et al. 2005

View full text Add to dashboard Cite

“…Although insulin resistance and glucose intolerance are important risk factors for type 2 diabetes, the majority of subjects who exhibit these alterations do not develop diabetes or persistent endothelial dysfunction [5,6]. Thus, adaptive responses, particularly maintenance of vascular function, may prevent manifestation of diabetic symptoms.…”

Section: Introductionmentioning

confidence: 99%

Acute effects of glucose and insulin on vascular endothelium

et al. 2004

View full text Add to dashboard Cite

Aims/hypothesis. Chronic exposure to high concentrations of glucose has consistently been demonstrated to impair endothelium-dependent, nitric oxide (NO)-mediated vasodilation. In contrast, several clinical investigations have reported that acute exposure to high glucose, alone or in combination with insulin, triggers vasodilation. The aim of this study was to examine whether elevated glucose itself stimulates endothelial NO formation or enhances insulin-mediated endothelial NO release. Methods. We measured NO release and vessel tone ex vivo in porcine coronary conduit arteries (PCAs). Intracellular Ca 2+ was monitored in porcine aortic endothelial cells (PAECs) by fura-2 fluorescence. Expression of the Na + /glucose cotransporter-1 (SGLT-1) was assayed in PAECs and PCA endothelium by RT-PCR. Results. Stimulation of PCAs with D-glucose, but not the osmotic control L-glucose, induced a transient increase in NO release (EC 50 ≈10 mmol/l), mediated by a rise in intracellular Ca 2+ levels due to an influx from the extracellular space. This effect was abolished by inhibitors of the plasmalemmal Na + /Ca 2+ exchanger (dichlorobenzamil) and the SGLT-1 (phlorizin), which was found to be expressed in aortic and coronary endothelium. Alone, D-glucose did not relax PCA, but did augment the effect of insulin on NO release and vasodilation. Conclusions/interpretation. An increased supply of extracellular D-glucose appears to enhance the activity of the endothelial isoform of nitric oxide synthase by increasing intracellular Na + concentrations via SGLT-1, which in turn stimulates an extracellular Ca 2+ influx through the Na + /Ca 2+ exchanger. This mechanism may be responsible for glucose-enhanced, insulin-dependent increases in tissue perfusion (including coronary blood-flow), thus accelerating glucose extraction from the blood circulation to limit the adverse vascular effects of prolonged hyperglycaemia.

show abstract

The Importance of Hyperglycemia in the Nonfasting State to the Development of Cardiovascular Disease

Cited by 89 publications

References 0 publications

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

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

High normal 2-hour plasma glucose is associated with insulin sensitivity and secretion that may predispose to type 2 diabetes

Acute effects of glucose and insulin on vascular endothelium

Contact Info

Product

Resources

About