Post-meal glucose peaks at home associate with carotid intima-media thickness in type 2 diabetes.
BACKGROUND
Two-hour postprandial hyperglycemia is related to chronic complications of diabetes and is currently used in the international guidelines to drive the therapy.


OBJECTIVE
Our objective was to assess the size and timing of post-meal glucose peaks in the everyday life of type 2 diabetic patients and the relationship with carotid atherosclerosis.


METHODS
This was an observational study performed in 644 outpatients with type 2 diabetes attending diabetes clinics located in the area of the Campania County, South Italy, who provided complete home blood glucose profiles and centralized carotid intima-media thickness (CIMT) assessment. The study was conducted from 2001-2005.


METHODS
Incremental glucose peak (IGP) was the maximal incremental increase in blood glucose obtained at any point after the meal. CIMT was assessed by carotid sonography.


RESULTS
The level of glycosylated hemoglobin and CIMT progressively increased across quintiles of IGP (P for trend = 0.01 for both). In univariate analysis, all examined glycemic parameters were significantly correlated with CIMT. IGP (r = 0.40; P = 0.006) showed the strongest correlation with CIMT, which remained significant in multiple linear regression analysis (R(2) = 0.26; P = 0.01). IGP was associated with a significant increase of CIMT in tertiles of glycosylated hemoglobin. IGP occurred within 1 h from the start of the meal in 95% of the entire diabetic population.


CONCLUSIONS
IGPs are frequent in the everyday life of patients with type 2 diabetes, occur for most (95%) within 1 h after meal, timing of IGPs is not influenced by treatment (diet or drugs), and IGPs correlate with CIMT.
Esposito
Katherine
K
Chair and Division of Metabolic Diseases, Second University of Naples, Piazza L. Miraglia, 80138 Napoli, Italy.
Ciotola
Miryam
M
Carleo
Diego
D
Schisano
Bruno
B
Sardelli
Luigi
L
Di Tommaso
Domenico
D
Misso
Lucio
L
Saccomanno
Franco
F
Ceriello
Antonio
A
Giugliano
Dario
D
D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D015203:Reproducibility of Results; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human