Type 2 diabetes subjects carry an excess risk for micro- and
macrovascular disease and a higher cardiovascular morbidity and
mortality rate. The beneficial impact of tight glycaemic control -
evidenced by the integrated marker of fasting glucose and postprandial
glucose values, the HbA(1c) - for the prevention of microvascular
complications is definitely confirmed. Over the past few years, several
studies have identified postprandial hyperglycaemia as a better
predictor of cardiovascular or even of all-cause mortality, as well as
an independent risk factor for atherosclerosis. The continuous glucose
monitoring could offer a rationale means for the detection of
postprandial hyperglycaemia and ultimately for its effective management.
Advances in technology keep a promise for a reliable, convenient and
closer to the idea of the artificial endocrine pancreas glucose sensor.
Subcutaneous glucose levels charted by one of the new sensors were found
to be well correlated with venous glucose measurements. Intervention for
a healthy lifestyle is frequently hampered by patients’ poor compliance.
The availability of diverse antidiabetic agents provides options for
targeting the glycaemic goal and a choice more fitted to the
particularized pathophysiology of each individual subject. Drugs
targeting postprandial glycaemia may prove to represent the ‘sine qua
non’ for the ‘return’ of postprandial glucose values at a
‘non-deleterious’ threshold, either as monotherapy for the early stages
of the disease or as combination therapy later in the progression of
diabetes. Copyright (C) 2004 John Wiley Sons, Ltd
