Glucose intolerance: postprandial hyper glucose, risk factor for diabetic macroangiopathy

Major prospective studies about diabetes showed simply improving glucose control is not sufficient to prevent diabetes macroangiopathy. Hence, postprandial hyperglycemia is focused as new risk factor of diabetes macroangiopathy. It is getting common that IGT (impaired glucose tolerance) is a major risk of cardiovascular disease. Our previous data suggest that the risk of macroangiopathy is not postprandial hyperglycemia itself but pathophysiology of causing postprandial hyperglycemia; reducing insulin sensitivity and/or delayed and hyper insulin level. To prevent postprandial hyperglycemia, there are three strategies according to pathophysiology. Improving insulin sensitivity of liver, delaying glucose flux to portal vein and reviving fast insulin secretion. Recent study shows each strategy can reduce risk of diabetes macroangiopathy.