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The Diabetes Educator, Vol. 32, No. 4, 513-522 (2006)
DOI: 10.1177/0145721706290832
© 2006 American Association of Diabetes Educators; Published by SAGE Publications

PHARMACY UPDATE

Clinicians Can Help Their Patients Control Postprandial Hyperglycemia as a Means of Reducing Cardiovascular Risk

John E. Gerich, MD

From the General Clinical Research Center, University of Rochester, New York.

Correspondence to John E. Gerich, MD, General Clinical Research Center, University of Rochester, 601 Elmwood Avenue, Box MED/CRC, Rochester, NY 14642 (johngerich{at}compuserve.com).

Cardiovascular disease is the leading cause of morbidity and mortality among patients with diabetes. Having diabetes is now recognized as conferring the same risk for cardiovascular disease as hyperlipidemia, hypertension, and smoking. HbA1c levels are the primary indicator of diabetes control and overall glycemic exposure. And recent research has pointed to postprandial hyperglycemia as conferring a greater risk of cardiovascular disease than elevated fasting plasma glucose levels. Unfortunately, clinicians sometimes forget that elevated HbA1c levels can arise from both fasting hyperglycemia and postprandial hyperglycemia. This is particularly important to remember when treating patients whose HbA1c levels may be higher than the desired target while fasting plasma glucose test results are within reference range. This article reviews the evidence supporting the view that postprandial hyperglycemia is a risk factor for cardiovascular disease and therefore should be controlled. Case studies are presented to aid clinicians in helping patients learn how to measure and control their postprandial glucose levels.


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