Type 2 diabetes managed by diet and lifestyle: HbA1c can identify significant post-prandial hyperglycaemia

Susan McGeoch, Alexandra Johnstone, Gerald Lobley, D. W. Pearson, Prakash Abraham, Ian L Megson, Sandra M MacRury

Research output: Contribution to journalArticle

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Abstract

Post-prandial hyperglycaemia is predictive of cardiovascular disease risk. Therefore, the International Diabetes Federation (IDF) recommends that 2-hour post-meal glucose should not exceed 7.8mmol/L. There are limited data regarding the extent of post-prandial hyperglycaemia in those with well-controlled type 2 diabetes and how this relates to HbA1c values.

Twenty-nine volunteers with diet-controlled type 2 diabetes were recruited (mean HbA1c 50mmol/mol [6.7%], SD 6.5 [0.6]); mean age 62 years [SD 5.8]; mean BMI 31.9kg/m2 [SD 5.3]), and underwent a three-day period of continuous glucose monitoring (CGMS) at home.

Compared with volunteers with an HbA1c >48mmol/mol (6.5%), those with an HbA1c =48mmol/mol (6.5%) – mean HbA1c 54 (7.1%) vs 44.9mmol/mol (6.3%), p<0.0001 – had lower mean 24-hour glucose levels (8.4 vs 7.2mmol/L, p=0.02), reduced fasting glucose concentrations (8.0 vs 6.6mmol/L, p=0.01), and spent less time with glucose concentrations >8mmol/L (703.1 vs 338.5 min, p=0.01). HbA1c showed reasonable correlation with time spent with glucose >8mmol/L (r2=0.48, p<0.0001).

Even volunteers with reasonably well-controlled, diet-managed type 2 diabetes spent a large proportion (9/24 hours) of the day with glucose concentrations in excess of 8mmol/L, suggesting that implementation of the IDF guidelines presents a challenge in normal clinical practice. HbA1c was a good indicator of post-prandial hyperglycaemia.
Original languageEnglish
Pages (from-to)58-60
Number of pages3
JournalPractical Diabetes
Volume29
Issue number2
Early online date6 Mar 2012
DOIs
Publication statusPublished - Mar 2012

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Hyperglycemia
Type 2 Diabetes Mellitus
Meals
Life Style
Diet
Glucose
Volunteers
Cardiovascular Diseases
Guidelines

Keywords

  • type 2 diabetes
  • post-prandial hyperglycaemia
  • CGMS

Cite this

Type 2 diabetes managed by diet and lifestyle : HbA1c can identify significant post-prandial hyperglycaemia. / McGeoch, Susan; Johnstone, Alexandra; Lobley, Gerald; Pearson, D. W.; Abraham, Prakash; Megson, Ian L; MacRury, Sandra M.

In: Practical Diabetes, Vol. 29, No. 2, 03.2012, p. 58-60.

Research output: Contribution to journalArticle

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