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 Presentation

"Postprandial Hyperglycemia and Cardiovascular Disease"

Prof. Antonio Ceriello (biography)
English - 2005-04-16 - 31 minutes
(25 slides)

Summary :
Increasing evidence suggests that the postprandial state is a contributing factor to the development of atherosclerosis. In diabetes, the postprandial phase is characterized by a rapid and large increase in blood glucose levels, and the possibility that the post-prandial hyperglycemic spikes may be relevant to the onset of cardiovascular complications has received recently much attention. Epidemiological studies and preliminary intervention studies have shown that postprandial hyperglycemia is a direct and independent risk factor for cardiovascular disease. Most of the cardiovascular risk factors are modified in the postprandial phase in diabetic subjects and directly affected by an acute increase of glycemia.The mechanisms through which acute hyperglycemia exerts its effects may be identified in the production of free radicals. This alarmingly suggestive body of evidence for a harmful effect of postprandial hyperglycemia on diabetic complications has been sufficient to influence guidelines from key professional scientific societies. Correcting the postprandial hyperglycemia may form part of the strategy for the prevention and management of cardiovascular diseases in diabetes.

Learning objectives :
After viewing this presentation, participants will be able to discuss:

- The relevance of postprandial hyperglycemia and hypertriglyceridemia on oxidative stress generation and endothelial dysfunction.
- The relationship of postprandial and fasting glucose levels with HbA1c levels

Bibliographic references :
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Katherine Esposito, Dario Giugliano, Francesco Nappo, Raffaele Marfella for the Campanian Postprandial Hyperglycemia Study Group Regression of Carotid Atherosclerosis by Control of Postprandial Hyperglycemia in Type 2 Diabetes Mellitus Circulation 2004 110: 214 - 219

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Irene M Stratton, Amanda I Adler, H Andrew W Neil, David R Matthews, Susan E Manley, Carole A Cull, David Hadden, Robert C Turner, and Rury R HolmanAssociation of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational studyBMJ, Aug 2000; 321: 405 - 412.

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Writing Team for the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research GroupSustained Effect of Intensive Treatment of Type 1 Diabetes Mellitus on Development and Progression of Diabetic Nephropathy: The Epidemiology of Diabetes Interventions and Complications (EDIC) StudyJAMA. 2003;290:2159-2167

The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group Intensive Diabetes Therapy and Carotid Intima–Media Thickness in Type 1 Diabetes MellitusNEJM 2003 (348):2294

   


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