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Relative and absolute contributions of postprandial and fasting plasma glucose to daytime hyperglycaemia and HbA(1c) in subjects with Type 2 diabetes.
Diabet Med. 2009 Oct; 26(10):974-80.DM

Abstract

AIMS

To determine the relative and absolute contributions of postprandial glucose (PPG) and fasting or preprandial plasma glucose (FPG) to daytime hyperglycaemia and HbA(1c) respectively, in persons with type 2 diabetes (T2DM).

METHODS

Subjects (n = 52; 37 men) had 12hr plasma glucose (PG) profiles determined in response to three serial identical test meals. PPG exposure was calculated for each meal. Excess hyperglycaemia was calculated above a PG concentration of 5.5 mmol/l. Fasting hyperglycaemia was the difference between excess hyperglycaemia and PPG exposure. Subjects were divided into three groups according to HbA(1c)-(Gp1:<7.3%;Gp2:7.3%-8.0%;Gp3:>8.0%) and the relative contribution of PPG exposure and fasting hyperglycaemia to excess hyperglycaemia calculated for each meal. The absolute contribution of PPG and fasting hyperglycaemia to excess HbA(1c) (mean HbA(1c)-5.1%) was also calculated.

RESULTS

The relative contributions of PPG exposure to excess hyperglycaemia for the three groups were: 58.3%, 54.3% and 35.4% (P = 0.483-Group 1 vs. Group 2; P = 0.002-Group 2 vs. Group 3) for meal 1; 69.8%, 54.7% and 23.7% (P = 0.163-Group 1 vs. Group 2; P = 0.005-Group 2 vs. Group 3) for meal 2; 85.8%, 70.2% and 48.6% (P = 0.153-Group 1 vs. Group 2; P = 0.046-Group 2 vs. Group 3) for meal 3. Absolute contributions of PPG to excess HbA(1c) in the three groups were 1.4%, 1.6% and 1.3% (P = NS).

CONCLUSION

The relative contribution of postprandial glucose to excess hyperglycaemia decreases as glycaemic control deteriorates, being dominant with HbA(1c)</= 7.3%, irrespective of the timing of the meal during the day. However, the absolute contribution of postprandial glucose to excess HbA(1c) does not differ significantly (approximately 1.5%) with varying glycaemic control.

Links

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Authors+Show Affiliations

Peter R
Diabetes Research Unit, University Hospital Llandough, Penarth, UK.
Dunseath G
No affiliation info available
Luzio SD
No affiliation info available
Chudleigh R
No affiliation info available
Choudhury SR
No affiliation info available
Owens DR
No affiliation info available

MeSH

AdultAgedAged, 80 and overBlood GlucoseDiabetes Mellitus, Type 2FastingFemaleGlycated Hemoglobin AHumansHyperglycemiaMaleMiddle AgedPostprandial Period

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19900228

Clinical Trial Links

The Study to Investigate the Contribution of Basal and Postprandial Glucose to Overall Hyperglycemia in T2DM

Citation

Peter, R, et al. "Relative and Absolute Contributions of Postprandial and Fasting Plasma Glucose to Daytime Hyperglycaemia and HbA(1c) in Subjects With Type 2 Diabetes." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 26, no. 10, 2009, pp. 974-80.
Peter R, Dunseath G, Luzio SD, et al. Relative and absolute contributions of postprandial and fasting plasma glucose to daytime hyperglycaemia and HbA(1c) in subjects with Type 2 diabetes. Diabet Med. 2009;26(10):974-80.
Peter, R., Dunseath, G., Luzio, S. D., Chudleigh, R., Choudhury, S. R., & Owens, D. R. (2009). Relative and absolute contributions of postprandial and fasting plasma glucose to daytime hyperglycaemia and HbA(1c) in subjects with Type 2 diabetes. Diabetic Medicine : a Journal of the British Diabetic Association, 26(10), 974-80. https://doi.org/10.1111/j.1464-5491.2009.02809.x
Peter R, et al. Relative and Absolute Contributions of Postprandial and Fasting Plasma Glucose to Daytime Hyperglycaemia and HbA(1c) in Subjects With Type 2 Diabetes. Diabet Med. 2009;26(10):974-80. PubMed PMID: 19900228.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relative and absolute contributions of postprandial and fasting plasma glucose to daytime hyperglycaemia and HbA(1c) in subjects with Type 2 diabetes. AU - Peter,R, AU - Dunseath,G, AU - Luzio,S D, AU - Chudleigh,R, AU - Choudhury,S R, AU - Owens,D R, PY - 2009/11/11/entrez PY - 2009/11/11/pubmed PY - 2010/5/12/medline SP - 974 EP - 80 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 26 IS - 10 N2 - AIMS: To determine the relative and absolute contributions of postprandial glucose (PPG) and fasting or preprandial plasma glucose (FPG) to daytime hyperglycaemia and HbA(1c) respectively, in persons with type 2 diabetes (T2DM). METHODS: Subjects (n = 52; 37 men) had 12hr plasma glucose (PG) profiles determined in response to three serial identical test meals. PPG exposure was calculated for each meal. Excess hyperglycaemia was calculated above a PG concentration of 5.5 mmol/l. Fasting hyperglycaemia was the difference between excess hyperglycaemia and PPG exposure. Subjects were divided into three groups according to HbA(1c)-(Gp1:<7.3%;Gp2:7.3%-8.0%;Gp3:>8.0%) and the relative contribution of PPG exposure and fasting hyperglycaemia to excess hyperglycaemia calculated for each meal. The absolute contribution of PPG and fasting hyperglycaemia to excess HbA(1c) (mean HbA(1c)-5.1%) was also calculated. RESULTS: The relative contributions of PPG exposure to excess hyperglycaemia for the three groups were: 58.3%, 54.3% and 35.4% (P = 0.483-Group 1 vs. Group 2; P = 0.002-Group 2 vs. Group 3) for meal 1; 69.8%, 54.7% and 23.7% (P = 0.163-Group 1 vs. Group 2; P = 0.005-Group 2 vs. Group 3) for meal 2; 85.8%, 70.2% and 48.6% (P = 0.153-Group 1 vs. Group 2; P = 0.046-Group 2 vs. Group 3) for meal 3. Absolute contributions of PPG to excess HbA(1c) in the three groups were 1.4%, 1.6% and 1.3% (P = NS). CONCLUSION: The relative contribution of postprandial glucose to excess hyperglycaemia decreases as glycaemic control deteriorates, being dominant with HbA(1c)</= 7.3%, irrespective of the timing of the meal during the day. However, the absolute contribution of postprandial glucose to excess HbA(1c) does not differ significantly (approximately 1.5%) with varying glycaemic control. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/19900228/Relative_and_absolute_contributions_of_postprandial_and_fasting_plasma_glucose_to_daytime_hyperglycaemia_and_HbA_1c__in_subjects_with_Type_2_diabetes_ L2 - https://doi.org/10.1111/j.1464-5491.2009.02809.x DB - PRIME DP - Unbound Medicine ER -