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- Title
Contribution of Postprandial and Fasting Plasma Glucose to Each of 3 Identical Meals During the Day and Also to Diurnal Hyperglycaemia in Persons with Type 2 Diabetes.
- Authors
Dunseath, Gareth; Peter, Rajesh; Chudleigh, Richard; Luzio, Stephen D.; Owens, David R.
- Abstract
It has been shown that in response to a standard meal, the contribution of postprandial glucose (PPG) to excess hyperglycaemia is predominant in the well controlled; while the contribution of fasting glucose (FPG) increases with worsening glycaemia in persons with type 2 diabetes (T2DM). The aim of this study was to investigate the contributions of PPG and FPG to excess hyperglycaemia in response to each of 3 identical meals over a 12 hour period. Non-insulin treated persons with T2DM (n=52; 37 men) were stratified into tertiles according to HbA1c [(Gp1: <7.3% (n= 18); Gp2:7.3 - 8.0% (n=l 7); Gp3: >8.0% (n= 17)]. All were on a stable dose of gliclazide for at least 3 months, with or without metformin. All subjects undertook 3 consecutive standard meal tolerance tests (MTT) at 08.00, 12.00 and 16.00hrs following an overnight fast with samples taken for plasma glucose at regular intervals for the 12 hour duration of the test. Relative contributions were calculated using areas under the glucose curve (AUC). PPG exposure was the AUC above actual FPG and excess hyperglycaemia was the AUC above 5.5mmol/L (ADA upper limit of normal FPG). Fasting related hyperglycaemia was the difference between the above two AUC values. Absolute contributions of PPG and FPG to excess HbA1c (HbA1c -5.1%) were also calculated. In all groups, the relative contribution of PPG exposure to excess hyperglycaemia was highest following the third meal of the day (Gp1: 58.3, 69.8, 85.8%; Gp2: 54.3, 54.7. 70.2%; Gp3: 33.4, 23.7, 48.6% for meals1, 2 and 3 respectively). Absolute contributions of PPG and FPG to excess HbA1c (>5.1%) were: Gp1: 1.4 vs. 0.3%; Gp2: 1.6 vs. 0.9%, and Gp3: 1.3 vs. 2.5%; PPG vs. FPG contribution respectively. These results confirm that the relative contribution of postprandial glucose to excess hyperglycaemia increases as glycaemic control improves. The absolute contribution of postprandial glucose to HbA[sub 1c] remains stable across the HbA[sub 1c] range, with the contribution from fasting glucose increasing as glycaemia deteriorates.
- Subjects
GLUCOSE; FOOD; HYPERGLYCEMIA; TYPE 2 diabetes; BLOOD sugar; GLYCOSYLATED hemoglobin
- Publication
Diabetes, 2007, Vol 56, pA681
- ISSN
0012-1797
- Publication type
Article