Postprandial hyperglycaemia : a new risk factor for cardiovascular disease

Type 2 diabetes is primarily a disorder of post-prandial glucose regulation, characterized by a gradual decline in insulin secretion in response to nutrient loads. Despite this, physicians continue to rely on fasting blood glucose and glycosylated haemoglobin (HbA(1c)) to guide management. There is a linear relationship between the risk of cardiovascular death and the 2-hour oral glucose tolerance test (OGTT). A recent study demonstrated that postprandial hyperglycaemia is an independent risk factor for cardiovascular disease in type 2 diabetes. Also, several intervention studies have shown that treating postprandial hyoerglycaemia may reduce the incidence of new cardiovascular events. Evidence supports the hypothesis that post-prandial hyperglycaemia may lead to cardiovascular disease through the generation of oxidative stress. Furthermore, clinical data suggest that post-prandial hyperglycaemia is a common phenomenon, even in patients who may be considered as having good metabolic control.