Postprandial glycemia – review of current pathophysioogical, epidemiological and clinical aspects

One of the most difficult current medical problems is the growing epidemics of diabetes mellitus. The contemporary treatment aims are not only to secure the patients survival and to protect them from the acute symptoms but also to avoid the occurence of the chronic complications of the disease. This paper contains a review of the role that postprandial hyperglycemia plays in the treatment of diabetes mellitus especially type 2. The authors summarize the findings of patophysiological and epidemiological macroangiopathy studies that indicate the use of prandial glucose regulation in clinical practice. This review contains discussion on the postulated mechanism in which short-lasting increases in plasma glucose concentration can damage vessel wall leading to atherosclerosis. Epidemiological studies showing the strong correlation between postprandial (and post-challenge) plasma glucose levels with cardiovascular endpoints are also discussed. Moreover, in this paper the reader may find a discussion on practical aspects of postprandial hyperglycemia monitoring in the treatment of diabetic patient, focusing on the relationship between prandial glycaemia and long term glycaemia control expressed by HbA1c measurements. The guidelines for monitoring postprandial glycaemia are also included. The modern therapeutic possibilities aiming at post-prandial hyperglycaemia are also showed.