Post Prandial Hyperglycemia: A Real Threat for Patients with Type 2 Diabetes Mellitus

The aim of this article is to evaluate the impact of postprandial hyperglycemia in patients with type 2 diabetes mellitus (T2DM). Postprandial hyperglycemia is a major determinant in overall glycemic control. Diabetic mellitus is an endocrine disorder steadily increasing worldwide, particularly in the developing countries like India. Diabetic patients are at high risk of cardiovascular events and mealtime plasma glucose fluctuations are important cardiovascular risk factors in type 2 diabetic patients. Diabetes is also one of the most important risk factors for chronic kidney disease. For diabetic patients with chronic kidney disease (CKD), the risk of cardiovascular disease is even higher. CKD can impair the ability of the kidneys to metabolize drugs and as a consequence a dose adjustment or an extended dose interval is usually needed in CKD patients in order to keep an optimal safety/efficacy profile. Oral hypoglycemic agents like glinides and alpha glucosidase inhibitors do not require dose adjustments and hence can be used safely in patients with CKD. Oral treatment with Repaglinide has proven beneficial effect on cardiovascular risk factors. It is therefore very important to use pharmacological tools allowing keeping post-meal glucose oscillations within narrow range. Regimens that target both fasting and post meal glycemia are needed to achieve optimal glucose control to prevent microvascular and macrovascular complications.