[Postprandial hyperglycemia and diabetic complications].Recenti Prog Med. 2005 Sep; 96(9):436-44.RP
There is increasing evidence that the postprandial state is an important 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 postprandial hyperglycemic spikes may be relevant to the pathophysiology of late diabetic complications has received recently much more attention. The oral glucose tolerance test, although non-physiological, has been used highly as model of the postprandial state. Epidemiological studies have shown that, when impaired, oral glucose tolerance is associated with an increased risk of cardiovascular disease, being the glycemia after two hours of the glucose challenge a direct and independent risk factor. Moreover, the possibility that postprandial hyperglycemia is a risk factor for cardiovascular disease also in diabetic patients has been reported. 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 hyperglycaemia exerts its effects may be identified in labile non-enzymatic glycation and in production of free radicals. It is likely that the two mechanisms co-operate in causing the disorders induced by acute hyperglycemia. Correction of the postprandial hyperglycemia can be part of the strategy for the prevention and management of cardiovascular diseases in diabetes.