Importance of PPG control in the treatment of diabetes
Dr. Antonio Ceriello
Professor of Endocrinology
Department of Pathology and Medicine
University of Udine, Italy
Antonio Ceriello教授指出，大量研究证实餐后高血糖是大血管疾病的独立危险因素。也正是因此，IDF专门发布了PPG控制指南，强调其危害并指出降低PPG可减少血管事件。
PPG升高在糖尿病进展中发生早，即使是对于HbA1c、空腹血糖（FPG）轻度升高者，PPG已明显升高，提示早期干预PPG的重要性。而且研究显示，要达到HbA1c靶标，必须同时控制好FPG和PPG。尤其是当HbA1c越接近靶标时，控制PPG在HbA1c达标中的贡献就越大（如HbA1c<7.3%时，PPG对HbA1c达标的贡献率为70%，FPG仅为30%）。这说明，控制血糖不仅要关注FPG，更要关注PPG。
据此，结合中国糖尿病患者β细胞功能衰减显著，胰岛素1相分泌受损严重的特点，早期使用同时干预FPG和PPG的胰岛素（如预混胰岛素类似物）对血糖的干预作用更强，患者获益也更多。
People with type 2 diabetes consistently demonstrate elevated postprandial plasma glucose (PPG) levels compared to normal individuals, which results from insufficient prandial insulin secretion. Postprandial plasma glucose has previously been linked to macrovascular complications and cardiovascular mortality. Recently, the IDF has developed recommendations from evidence-based medicine for the management of PPG. Professor Ceriello will examine these recommendations and the purpose for the following evidence statements:
1) Postprandial hyperglycaemia is harmful and should be addressed
2) Implement treatment strategies to lower postprandial plasma glucose in people with postprandial hyperglycaemia
The use of prandial insulin therapy such as premix analogues can be used as a means to reduce PPG excursions and improve insulin resistance thereby diminishing the harmful effects of inadequate glycaemic control.
Antonio Ceriello教授：餐后血糖控制的重要性
查看分页PPT： http://meeting.dxy.cn/2009asia_summit/article/i9917.html
