title: "Mild dysglycemia" in type 2 diabetes: to be neglected or not?
abstract: "Mild dysglycemia" in type 2 diabetes can be defined by the range of HbA1c levels≥6.5% (48 mmol/mol) and<7% (53 mmol/mol), which corresponds to when the risk for vascular complications begins to increase. This "mild dysglycemia" is characterized by both a dawn phenomenon (a spontaneous blood glucose rise in the early morning) and an excess of post-prandial glucose excursions in the absence of abnormal elevation in basal glucose, especially during nocturnal periods. This represents an intermediary stage between pre-diabetes (HbA1c≥5.7%, 39 mmol/mol, and<6.5%, 48 mmol/mol) and those who begin to show a steadily progressive worsening in basal glucose (HbA1c≥7%, 53 mmol/mol). Should this relatively minor intermediate dysglycemic phase deserve more attention, that is the question. The now available incretin-based therapies, and more specifically the DPP-4 inhibitors provide the clinician with the possibility to reduce or eradicate both the dawn phenomenon and post-meal glucose excursions with minimal side effects. The availability of 24-h glycemic profiles in those with "mild dysglycemia" will help to describe their individual glycemic phenotype, based on which the early and appropriate life style changes and/or pharmacological interventions can be introduced.
authors.affiliation: Institute of Clinical Research, University Montpellier 1, France. Electronic address: louis.monnier@inserm.fr.
authors.forename: Louis
authors.initials: L
authors.lastname: Monnier
authors.affiliation: Institute of Clinical Research, University Montpellier 1, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Colette
authors.affiliation: Department of Endocrinology, Hospital Pitié Salpétrière, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dejager
authors.affiliation: Diabetes Research Group, Swansea University, United Kingdom.
authors.forename: David R
authors.initials: DR
authors.lastname: Owens
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology; D018450:Disease Progression; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D019518:Postprandial Period; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human
keywords: DPP-4 inhibitors; Dawn phenomenon; Mild dysglycemia; Post-prandial glucose; Type 2 diabetes