Esposito, Katherine, Ciotola, Miryam, Carleo, Diego, Schisano, Bruno, Sardelli, Luigi, Di Tommaso, Domenico, Misso, Lucio, Saccomanno, Franco, Ceriello, Antonio and Giugliano, D. (Dario). (2008) Post-meal glucose peaks at home associate with carotid intima-media thickness in type 2 diabetes. Journal of Clinical Endocrinology & Metabolism , Volume 93 (Number 4). pp. 1345-1350. ISSN 0021-972x

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Abstract

Context: 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. Design, Setting, and Patients: 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. Main Outcome Measures: 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. Conclusion: 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.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Metabolic and Vascular Health Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Non-insulin-dependent diabetes, Hyperglycemia, Glycemic index
Journal or Publication Title:	Journal of Clinical Endocrinology & Metabolism
Publisher:	Endocrine Society
ISSN:	0021-972x
Date:	April 2008
Volume:	Volume 93
Number:	Number 4
Number of Pages:	6
Page Range:	pp. 1345-1350
Identification Number:	10.1210/jc.2007-2000
Status:	Peer Reviewed
Publication Status:	Published
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URI:	http://wrap.warwick.ac.uk/id/eprint/30294

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