Postprandial plasma glucose: a good index of glycemic control in type 2 diabetic patients having near-normal fasting glucose levels

• Published in: Diabetes research and clinical practice Vol. 46; no. 1; pp. 23 - 27
• Main Authors: Soonthornpun, Supamai, Rattarasarn, Chatchalit, Leelawattana, Rattana, Setasuban, Worawong
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 01.10.1999; Elsevier Science
• Subjects: Biological and medical sciences; Blood Glucose - metabolism; C-Peptide - blood; Diabetes Mellitus, Type 2 - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Fasting; Female; Glycated Hemoglobin A - analysis; Glycosylated hemoglobin; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Middle Aged; Postprandial Period; Postprandial plasma glucose; Tropical medicine; Type 2 diabetes; Thailand; Asia; Type 2 diabetes; Glycosylated hemoglobin; Postprandial plasma glucose; Endocrinopathy; Human; Hemoglobin A1c; Postprandial; Adult; Non insulin dependent diabetes; Elderly; Comparative study; Glycemia; Biological monitoring; Blood plasma
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/S0168-8227(99)00061-3

To investigate the effect of postprandial plasma glucose (PG) concentrations on HbA1c levels in type 2 diabetic patients, we evaluated the relationship between HbA1c levels and postprandial PG concentrations after a meal tolerance test in 35 type 2 diabetic patients who had fasting PG concentrations persistently <7.8 mmol/l and stable HbA1c levels. Two-hour postprandial PG concentrations were found to be more strongly correlated ( r=0.51) with HbA1c levels than 1-h postprandial PG ( r=0.35) and fasting PG ( r=0.46) concentrations. Patients whose HbA1c levels were high (HbA1c≥7%) had significantly higher 2-h postprandial PG concentrations and areas under the glucose curve than those whose HbA1c levels were lower (8.12±1.10 (SD) vs 6.70±2.22 mmol l −1, P=0.004 and 17.43±1.92 vs 15.58±3.26 mmol h −1 l −1, P=0.02, respectively). Although fasting PG concentrations of patients with higher HbA1c levels were slightly higher, they did not differ significantly from those with lower HbA1c levels (6.21±0.89 vs 5.73±0.68 mmol l −1). Age, duration of diabetes, body mass index, serum C-peptide, both fasting and postprandial, did not differ between these two groups. This study suggests that postprandial hyperglycemia, particularly 2-h postprandial PG concentrations, is associated with high HbA1c levels in type 2 diabetic patients whose fasting PG levels were within normal or near-normal levels.