Issue 165 Item 4 DECODE Study De-Emphasises Importance of Fasting Glucose

That, in contrast to post-load hyperglycemia, as the principal measurable determinant of exposure to the risk of cardiovascular disease in Type 2 diabetes.

Unravelling the precise association between cardiovascular disease and Type 2 (non-insulin-dependent) diabetes mellitus has proved problematic, largely as a result of the confusing variety of diagnostic criteria and methodologies used in previous studies of disease-associated risk. More recently, improved standardization and continuing refinements to risk analyses have begun to clarify the relative importance of individual risk factors for macrovascular complications and progression to cardiovascular disease. The evidence accumulated from several large-scale epidemiological and intervention studies strongly indicates that hyperglycemia and specifically the post-load hyperglycemia resulting from postprandial glucose excursions is the main factor associated with increasing the risks of morbidity and mortality in Type 2 diabetes.

The DECODE study has de-emphasized the importance of fasting glucose, in contrast to post-load hyperglycemia, as the principal measurable determinant

of exposure to the risk of cardiovascular disease in Type 2 diabetes. Similarly, the Diabetes Intervention Study identified mealtime hyperglycemia as an independent risk factor for myocardial infarction and all-cause mortality, while several other studies have also shown that such mortality is better predicted from post-challenge measurement criteria rather than from fasting-glucose criteria.

It is likely that postprandial hyperglycemia is an independent risk factor for atherosclerosis and is also exerting an atherogenic effect indirectly through the clustering of a number of risk factors for atherosclerosis. Whether the relation between post-load hyperglycemia and the risk of cardiovascular events is causal is still not known. [Diabetologia (2003) 46[Suppl1]:M17–M21]

===============================

Start your own 10,000 step program.
Pedometers available at special prices.
See the results of the 10,000 Step Program.
Purchase your own pedometers and receive the 10,000 Step Program at no charge with free shipping. Click Here

===============================

DID YOU KNOW: The prevalence of hypertension is increasing in the US, particularly among women, non-Hispanic blacks, and older individuals after an overall decline during the 1980s. Only about one fourth of individuals with diabetes and hypertension had blood pressure controlled to the target of less than 130/85. Almost 29% of the adult US population had blood pressure (BP) of 140/90 mm Hg or higher in 1999-2000. (NHANES) AMA July 9, 03