Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk

Vasc Health Risk Manag. 2010 Mar 24;6:145-55. doi: 10.2147/vhrm.s8216.

Abstract

Hyperglycemia is a major risk factor for both the microvascular and macrovascular complications in patients with type 2 diabetes. This review summarizes the cardiovascular results of large outcomes trials in diabetes and presents new evidence on the role of hyperglycemia, with particular emphasis on postprandial hyperglycemia, in adverse cardiovascular outcomes in patients with type 2 diabetes. Treatment options, including the new dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 mimetics that primarily target postprandial hyperglycemia, are also discussed. Hyperglycemia increases cardiovascular mortality, and reducing hyperglycemia lowers cardiovascular risk parameters. Control of both fasting and postprandial hyperglycemia is necessary to achieve optimal glycated hemoglobin control. Therefore, anti-hyperglycemic agents that preferentially target postprandial hyperglycemia, along with those that preferentially target fasting hyperglycemia, are strongly suggested to optimize individual diabetes treatment strategies and reduce complications.

Keywords: cardiovascular risk; diabetes mellitus; drugs; postprandial hyperglycemia.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2 / complications*
  • Diabetic Angiopathies / etiology*
  • Diabetic Angiopathies / prevention & control
  • Dipeptidyl-Peptidase IV Inhibitors / therapeutic use
  • Fasting / blood
  • Glycated Hemoglobin A / metabolism
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / complications*
  • Hyperglycemia / drug therapy
  • Hypoglycemic Agents / therapeutic use*
  • Risk

Substances

  • Dipeptidyl-Peptidase IV Inhibitors
  • Glycated Hemoglobin A
  • Hypoglycemic Agents