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Controlling postprandial hyperglycemia

  • Robert E Ratner
    Correspondence
    Address for reprints: Robert E. Ratner, MD, Medstar Research Institute, 650 Pennsylvania Avenue SE, Suite 50, Washington, DC 20003-4393
    Affiliations
    Medstar Research Institute, Washington, DC, USA
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      Abstract

      A growing body of evidence indicates that measurements of postprandial glucose levels, in combination with glycosylated hemoglobin, are a more accurate predictor of metabolic abnormality than fasting or preprandial glucose levels for individuals with type 2 diabetes. Early identification of elevated postprandial blood glucose levels is an important step in predicting the onset of microvascular and macrovascular complications that can progress to full symptomatic diabetes. This article summarizes the research conducted to date on the diagnostic import of postprandial glucose and the parameters established for judging the need for treatment. When individuals cannot reach target glucose levels through diet and exercise, medical treatment is necessary. The article reviews a range of treatment options, including insulin secretagogues, insulin sensitizers, antiabsorptive agents, weight reduction agents, and insulin and combination medical therapy.
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