Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), C/ Rosselló, 149-153, 08036, Barcelona, Spain.
Centro de Investigacion Biomèdica en Red de Diabetes y Enfermedades Metabolicas Asociadas (CIBERDEM), Barcelona, Spain.
Rev Endocr Metab Disord. 2016 Mar;17(1):111-6. doi: 10.1007/s11154-016-9341-8.
Type 2 diabetes is characterized by a gradual decline in insulin secretion in response to nutrient loads; hence, it is primarily a disorder of postprandial glucose regulation. However, physicians continue to rely on fasting plasma glucose and glycated hemoglobin to guide management. There is a linear relationship between the risk of cardiovascular death and the 2-h oral glucose tolerance test, while a study confirms postprandial hyperglycemia as independent risk factor for cardiovascular disease in type 2 diabetes. At the same time, several studies show that postprandial hypertriglyceridemia may also be a cardiovascular risk factor. Interestingly, the simultaneous presence of postprandial hyperglycemia and postprandial hypertriglyceridemia has an additive effect in worsening endothelial function and inflammation. Evidence supports the hypothesis glucose postprandial hyperglycemia and hypertriglyceridemia may favor the appearance of the cardiovascular disease through the generation of an oxidative stress. Furthermore, clinical data suggest that postprandial hyperglycemia is a common phenomenon even in patients who may be considered in "good metabolic control". Therefore, physicians should consider monitoring and targeting postprandial plasma glucose, as well as glycated hemoglobin and fasting plasma glucose, in patients with type 2 diabetes.
2 型糖尿病的特征是对营养负荷的胰岛素分泌逐渐减少；因此，它主要是一种餐后血糖调节紊乱。然而，医生仍然依赖空腹血糖和糖化血红蛋白来指导治疗。心血管死亡风险与 2 小时口服葡萄糖耐量试验之间存在线性关系，而一项研究证实餐后高血糖是 2 型糖尿病心血管疾病的独立危险因素。同时，几项研究表明，餐后高甘油三酯血症也可能是心血管危险因素。有趣的是，餐后高血糖和餐后高甘油三酯血症同时存在会加重内皮功能障碍和炎症。有证据支持这样一种假设，即餐后高血糖和高甘油三酯血症可能通过产生氧化应激而有利于心血管疾病的发生。此外，临床数据表明，即使在可能被认为“代谢控制良好”的患者中，餐后高血糖也是一种常见现象。因此，医生应考虑监测和针对 2 型糖尿病患者的餐后血浆葡萄糖、糖化血红蛋白和空腹血浆葡萄糖。
