Xin Kang1, Chun Wang1, Dawei Chen1, Lifang Lv1, Guanjian Liu2, Jie Xiao1, Yanzhi Yang1, Liping He1, Lihong Chen1, Xiujun Li1, Haoming Tian1, Weiping Jia3, Xingwu Ran1. 1. 1 Department of Endocrinology and Metabolism, West China Hospital, Sichuan University , Chengdu, Sichuan, People's Republic of China . 2. 2 Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University , Chengdu, Sichuan, People's Republic of China . 3. 3 Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University , Shanghai, People's Republic of China .
Abstract
OBJECTIVE: The aim of this preliminary study is to investigate contributions of basal glucose (BG) and postprandial glucose (PPG) increments to overall hyperglycemia in newly diagnosed patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: We evaluated the relative contributions of BG and PPG to overall hyperglycemia in 59 newly diagnosed T2DM patients according to BG baseline value of 6.1 mmol/L and 24-h glucose profiles of normal glucose tolerance (NGT) subjects obtained by continuous glucose monitoring as baseline, respectively. RESULTS: When the baseline was 24-h glucose profiles of the NGT subjects, the relative contributions of PPG in the T2DM patients with hemoglobin A1c (HbA1c) levels of ≤ 7.0%, 7.0-9.0%, and >9.0% were 57.58%, 44.69%, and 21.56%, respectively. When the baseline value was equal to 6.1 mmol/L, the relative contributions of PPG in the T2DM patients with HbA1c levels of ≤ 7.0%, 7.0-9.0%, and >9.0% were 77.23%, 53.43%, and 22.78%, respectively. Compared with the 24-h glucose profiles of the NGT subjects as the baseline, the relative contribution of PPG was overestimated by about 10-20% in the T2DM patients with HbA1c levels of ≤ 9.0% when 6.1 mmol/L was chosen as the baseline. CONCLUSIONS: In the newly diagnosed T2DM patients with mild hyperglycemia, PPG is a predominant contributor, whereas the relative contributions of BG gradually increase from mild to severe hyperglycemia and obviously exceed PPG in the T2DM patients with HbA1c levels of >9.0%. This finding implies that the initial pharmacotherapy may target PPG in those patients with mild hyperglycemia and target BG in those patients with severe hyperglycemia.
OBJECTIVE: The aim of this preliminary study is to investigate contributions of basal glucose (BG) and postprandial glucose (PPG) increments to overall hyperglycemia in newly diagnosed patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: We evaluated the relative contributions of BG and PPG to overall hyperglycemia in 59 newly diagnosed T2DM patients according to BG baseline value of 6.1 mmol/L and 24-h glucose profiles of normal glucose tolerance (NGT) subjects obtained by continuous glucose monitoring as baseline, respectively. RESULTS: When the baseline was 24-h glucose profiles of the NGT subjects, the relative contributions of PPG in the T2DM patients with hemoglobin A1c (HbA1c) levels of ≤ 7.0%, 7.0-9.0%, and >9.0% were 57.58%, 44.69%, and 21.56%, respectively. When the baseline value was equal to 6.1 mmol/L, the relative contributions of PPG in the T2DM patients with HbA1c levels of ≤ 7.0%, 7.0-9.0%, and >9.0% were 77.23%, 53.43%, and 22.78%, respectively. Compared with the 24-h glucose profiles of the NGT subjects as the baseline, the relative contribution of PPG was overestimated by about 10-20% in the T2DM patients with HbA1c levels of ≤ 9.0% when 6.1 mmol/L was chosen as the baseline. CONCLUSIONS: In the newly diagnosed T2DM patients with mild hyperglycemia, PPG is a predominant contributor, whereas the relative contributions of BG gradually increase from mild to severe hyperglycemia and obviously exceed PPG in the T2DM patients with HbA1c levels of >9.0%. This finding implies that the initial pharmacotherapy may target PPG in those patients with mild hyperglycemia and target BG in those patients with severe hyperglycemia.
Authors: Curt L Rohlfing; Hsiao-Mei Wiedmeyer; Randie R Little; Jack D England; Alethea Tennill; David E Goldstein Journal: Diabetes Care Date: 2002-02 Impact factor: 19.112
Authors: E Bonora; F Calcaterra; S Lombardi; N Bonfante; G Formentini; R C Bonadonna; M Muggeo Journal: Diabetes Care Date: 2001-12 Impact factor: 19.112
Authors: M Bouma; J H Dekker; J J de Sonnaville; F E van der Does; H de Vries; D M Kriegsman; P J Kostense; R J Heine; J T van Eijk Journal: Diabetes Care Date: 1999-06 Impact factor: 19.112