Abstract
The prevalence of type 2 diabetes across the world has been described as a global pandemic. Despite significant efforts to limit both the increase in the number of cases and the long-term impact on morbidity and mortality, the total number of people with diabetes is projected to continue to rise and most patients still fail to achieve adequate glycaemic control. Optimal management of type 2 diabetes requires an understanding of the relationships between glycosylated haemoglobin (HbA 1c), fasting plasma glucose and postprandial glucose (the glucose triad), and how these change during development and progression of the disease. Early and sustained control of glycaemia remains important in the management of type 2 diabetes. The contribution of postprandial glucose levels to overall glycaemic control and the role of postprandial glucose targets in disease management are currently debated. However, many patients do not reach HbA 1C targets set according to published guidelines. As recent data suggest, if driving HbA 1C down to lower target levels is not the answer, what other factors involved in glucose homeostasis can or should be targeted? Has the time come to change the treatment paradigm to include awareness of the components of the glucose triad, the existence of glucose variability and their potential influence on the choice of pharmacological treatment? It is becomingly increasingly clear that physicians are likely to have to consider plasma glucose levels both after the overnight fast and after meals as well as the variability of glucose levels, in order to achieve optimal glycaemic control for each patient. When antidiabetic therapy is initiated, physicians may need to consider selection of agents that target both fasting and postprandial hyperglycaemia.
| Original language | English |
|---|---|
| Pages (from-to) | 1705-1711 |
| Number of pages | 7 |
| Journal | International Journal of Clinical Practice |
| Volume | 64 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Nov 2010 |
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ASJC Scopus subject areas
- Medicine(all)
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The glucose triad and its role in comprehensive glycaemic control : Current status, future management. / Ceriello, A.
In: International Journal of Clinical Practice, Vol. 64, No. 12, 11.2010, p. 1705-1711.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The glucose triad and its role in comprehensive glycaemic control
T2 - Current status, future management
AU - Ceriello, A.
PY - 2010/11
Y1 - 2010/11
N2 - The prevalence of type 2 diabetes across the world has been described as a global pandemic. Despite significant efforts to limit both the increase in the number of cases and the long-term impact on morbidity and mortality, the total number of people with diabetes is projected to continue to rise and most patients still fail to achieve adequate glycaemic control. Optimal management of type 2 diabetes requires an understanding of the relationships between glycosylated haemoglobin (HbA 1c), fasting plasma glucose and postprandial glucose (the glucose triad), and how these change during development and progression of the disease. Early and sustained control of glycaemia remains important in the management of type 2 diabetes. The contribution of postprandial glucose levels to overall glycaemic control and the role of postprandial glucose targets in disease management are currently debated. However, many patients do not reach HbA 1C targets set according to published guidelines. As recent data suggest, if driving HbA 1C down to lower target levels is not the answer, what other factors involved in glucose homeostasis can or should be targeted? Has the time come to change the treatment paradigm to include awareness of the components of the glucose triad, the existence of glucose variability and their potential influence on the choice of pharmacological treatment? It is becomingly increasingly clear that physicians are likely to have to consider plasma glucose levels both after the overnight fast and after meals as well as the variability of glucose levels, in order to achieve optimal glycaemic control for each patient. When antidiabetic therapy is initiated, physicians may need to consider selection of agents that target both fasting and postprandial hyperglycaemia.
AB - The prevalence of type 2 diabetes across the world has been described as a global pandemic. Despite significant efforts to limit both the increase in the number of cases and the long-term impact on morbidity and mortality, the total number of people with diabetes is projected to continue to rise and most patients still fail to achieve adequate glycaemic control. Optimal management of type 2 diabetes requires an understanding of the relationships between glycosylated haemoglobin (HbA 1c), fasting plasma glucose and postprandial glucose (the glucose triad), and how these change during development and progression of the disease. Early and sustained control of glycaemia remains important in the management of type 2 diabetes. The contribution of postprandial glucose levels to overall glycaemic control and the role of postprandial glucose targets in disease management are currently debated. However, many patients do not reach HbA 1C targets set according to published guidelines. As recent data suggest, if driving HbA 1C down to lower target levels is not the answer, what other factors involved in glucose homeostasis can or should be targeted? Has the time come to change the treatment paradigm to include awareness of the components of the glucose triad, the existence of glucose variability and their potential influence on the choice of pharmacological treatment? It is becomingly increasingly clear that physicians are likely to have to consider plasma glucose levels both after the overnight fast and after meals as well as the variability of glucose levels, in order to achieve optimal glycaemic control for each patient. When antidiabetic therapy is initiated, physicians may need to consider selection of agents that target both fasting and postprandial hyperglycaemia.
UR - http://www.scopus.com/inward/record.url?scp=78349291472&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78349291472&partnerID=8YFLogxK
U2 - 10.1111/j.1742-1241.2010.02517.x
DO - 10.1111/j.1742-1241.2010.02517.x
M3 - Article
C2 - 20860758
AN - SCOPUS:78349291472
VL - 64
SP - 1705
EP - 1711
JO - International Journal of Clinical Practice
JF - International Journal of Clinical Practice
SN - 1368-5031
IS - 12
ER -