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- December 1, 2008 |
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| Presentation |
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"Postprandial Hyperglycemia and Cardiovascular Disease"Prof. Antonio Ceriello (biography)
English - 2005-04-16 - 31 minutes
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 | (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 :
The DECODE study group on behalf of the Europe an Diabetes Epidemiology GroupGlucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria Lancet Volume 354, Issue 9179 , 21 August 1999, Pages 617-621
M Tominaga, H Eguchi, H Manaka, K Igarashi, T Kato, and A SekikawaImpaired glucose tolerance is a risk factor for cardiovascular disease, but not impaired fasting glucose. The Funagata Diabetes StudyDiabetes Care 22: 920-924.
B Balkau, M Shipley, RJ Jarrett, K Pyorala, M Pyorala, A Forhan, and E EschwegeHigh blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men. 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen StudyDiabetes Care 21: 360-367
E Barrett-Connor and A FerraraIsolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men. The Rancho Bernardo StudyDiabetes Care 21: 1236-1239
Markolf Hanefeld, Jean Louis Chiasson, Carsta Koehler, Elena Henkel, Frank Schaper, and Theodora Temelkova-Kurktschiev Acarbose Slows Progression of Intima-Media Thickness of the Carotid Arteries in Subjects With Impaired Glucose Tolerance Stroke 2004 35: 1073 - 1078
M. Hanefeld, M. Cagatay, T. Petrowitsch, D. Neuser, D. Petzinna, and M. RuppAcarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of seven long-term studiesEur. Heart J., January 2004; 25: 10 - 16.
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
Francesco Perticone, Roberto Ceravolo, Arturo Pujia, Giorgio Ventura, Saverio Iacopino, Angela Scozzafava, Alessandro Ferraro, Massimo Chello, Pasquale Mastroroberto, Paolo Verdecchia, and Giuseppe SchillaciPrognostic Significance of Endothelial Dysfunction in Hypertensive PatientsCirculation, Jul 2001; 104: 191 - 196.
Antonio CerielloNew Insights on Oxidative Stress and Diabetic Complications May Lead to a "Causal" Antioxidant TherapyDiabetes Care 26: 1589-1596
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.
Louis Monnier, Hélène Lapinski, and Claude ColetteContributions of Fasting and Postprandial Plasma Glucose Increments to the Overall Diurnal Hyperglycemia of Type 2 Diabetic Patients: Variations with increasing levels of HbA1c Diabetes Care 26: 881-885
Curt L. Rohlfing, Hsiao-Mei Wiedmeyer, Randie R. Little, Jack D. England, Alethea Tennill, and David E. GoldsteinDefining the Relationship Between Plasma Glucose and HbA1c: Analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial Diabetes Care 25: 275-278.
EJ Bastyr, CA Stuart, RG Brodows, S Schwartz, CJ Graf, A Zagar, and KE RobertsonTherapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study GroupDiabetes Care 23: 1236-1241
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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