Type 2 diabetes--which BGLs matter?--The fasting, pre- and post-prandial glycaemia debate.
BACKGROUND
There is vigorous debate about the relative importance of targeting fasting blood glucose levels (BGLs) and postprandial BGLs.


OBJECTIVE
This article assesses the contribution of pre- and post-prandial BGLs to overall glycaemia and provides a practical strategy for improving overall glycaemia in patients on insulin.


CONCLUSIONS
In most patients who need to commence insulin therapy, the A1c is 8.0% or more. At these levels, fasting and other premeal BGLs contribute more to the A1c than does postprandial BGL. The higher the A1c, the more important the fasting and premeal BGLs. The 'keep insulin safe and simple' (KISS) approach is useful when starting insulin in type 2 diabetes.
Phillips
Patrick J
PJ
Department of Endocrinology, The Queen Elizabeth Hospital, South Australia. patrick.phillips@nwahs.sa.gov.au
Twigg
Stephen M
SM
D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism*; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D019518:Postprandial Period
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human