Persistent hyperglycemia increases the risk of cardiovascular events in patients with type 2 diabetes mellitus who have a history of acute myocardial infarction. Whether clinicians should target prandial glucose levels rather than basal glucose levels to reduce this excess risk is keenly debated.
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References
Bretzel, R. G. et al. Once-daily basal insulin glargine versus thrice-daily prandial insulin lispro in people with type 2 diabetes on oral hypoglycaemic agents (APOLLO): an open randomised controlled trial. Lancet 371, 1073–1084 (2008).
Holman, R. R. et al. Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes. N. Engl. J. Med. 357, 1716–1730 (2007).
Raz, I. et al. Effects of prandial versus fasting glycemia on cardiovascular outcomes in type 2 diabetes: the HEART2D trial. Diabetes Care 32, 381–386 (2009).
Nathan, D. M. et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 32, 193–203 (2009).
International Diabetes Federation. Guideline for management of postmeal glucose [online], http://www.idf.org/webdata/docs/Guideline_PMG_final.pdf (2007).
Kilpatrick, E. S., Rigby, A. S. & Atkin, S. L. The effect of glucose variability on the risk of microvascular complications in type 1 diabetes. Diabetes Care 29, 1486–1490 (2006).
Lachin, J. M. et al. Effect of glycemic exposure on the risk of microvascular complications in the Diabetes Control and Complications Trial—revisited. Diabetes 57, 995–1001 (2008).
Monnier, L. et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 295, 1681–1687 (2006).
Brownlee, M. Biochemistry and molecular cell biology of diabetic complications. Nature 414, 813–820 (2001).
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Monnier, L., Colette, C. The HEART2D trial—new questions beyond answers. Nat Rev Endocrinol 5, 299–300 (2009). https://doi.org/10.1038/nrendo.2009.98
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DOI: https://doi.org/10.1038/nrendo.2009.98
