Should Postprandial Glucose Be Measured and Treated to a Particular Target? Yes.
2003; American Diabetes Association; Volume: 26; Issue: 6 Linguagem: Inglês
10.2337/diacare.26.6.1919
ISSN1935-5548
Autores Tópico(s)Diabetes, Cardiovascular Risks, and Lipoproteins
ResumoIn August 2001, the American College of Endocrinology (ACE) published its recommendations for glycemic targets in the management of diabetes. Included in those recommendations was a target for 2-h postprandial glucose (PPG) of <140 mg/dl; current American Diabetes Association (ADA) guidelines do not include a PPG target, nor have they for several years. The European Association for the Study of Diabetes (EASD/IDF-Europe) have a postprandial target of <7.5 mmol/l (135 mg/dl) as well. Ever since ACE presented its recommendations to the health care community, there has been considerable debate about the appropriateness of recommending a PPG target to the health care community and lay public. Should PPG be monitored and treated? If so, what should the goal be? The purpose of this report is to answer some central questions regarding the evidence and rationale that support the use of a 2-h postprandial target of <140 mg/dl. The goal is to provide health care providers and other interested parties with the information they need to make informed decisions about patient care. It is important to note that although this debate has been broadened to include issues regarding the frequency of testing, no organization has proposed any form of recommendation for “routine” PPG testing. Epidemiological studies have shown very significant correlations between glycemic status and both microvascular and macrovascular complications (1). Furthermore, tight glycemic control in interventional studies unequivocally delayed, and possibly prevented, the development and progression of the microvascular complications (2–4). Additionally, there is no glycemic threshold for risk reduction, even into the normal range; the lower the A1C, the less risk of complications (1). Despite new advances in therapies and glucose monitoring technology, combined with our growing understanding of diabetes and its complications, we have been unsuccessful in achieving tight glycemic control in our patients using the …
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