Bell D S
Department of Medicine, University of Alabama at Birmingham School of Medicine, 35294, USA.
South Med J. 2001 Aug;94(8):804-9.
Although a traditional goal of glycemic control in the treatment of diabetes mellitus is to normalize fasting plasma glucose, emerging data indicate that modulation of postprandial plasma glucose levels plays an important role in overall glycemic control. This article reviews the evidence linking postprandial glucose levels with long-term indices of diabetes control, such as glycosylated hemoglobin, lipid abnormalities, and the risk of microvascular and macrovascular complications. Early in the development of type 2 diabetes, the initial burst of insulin release in response to food intake is compromised, allowing postprandial hyperglycemia to develop. Meal-associated hyperglycemia further contributes to increase insulin resistance and decrease insulin production. Evidence of a strong correlation between high postprandial glycemic levels and the development of vascular complications underscores the significance of treating mealtime glycemia. Emerging drugs that reduce postprandial hyperglycemia include the D-phenylalanine derivative nateglinide, amylin derivative pramlintide, and glucagon-like insulinotropic peptide.
尽管糖尿病治疗中血糖控制的传统目标是使空腹血糖正常化，但新出现的数据表明，餐后血糖水平的调节在整体血糖控制中起着重要作用。本文综述了餐后血糖水平与糖尿病控制长期指标（如糖化血红蛋白、脂质异常以及微血管和大血管并发症风险）之间关联的证据。在2型糖尿病发展早期，机体对食物摄入的初始胰岛素释放反应受损，导致餐后高血糖的发生。与进餐相关的高血糖进一步促使胰岛素抵抗增加和胰岛素分泌减少。餐后高血糖水平与血管并发症发生之间存在强相关性的证据突出了治疗进餐时高血糖的重要性。新型降低餐后高血糖的药物包括D - 苯丙氨酸衍生物那格列奈、胰淀素衍生物普兰林肽以及胰高血糖素样促胰岛素肽。
