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Anales de la Facultad de Ciencias Médicas (Asunción)

Print version ISSN 1816-8949


BENITEZ, A  and  HOSPITAL DE CLINICAS et al. Importance of the postprandial glycemic control in the patient with Type 2 Diabetes Mellitus. An. Fac. Cienc. Méd. (Asunción) [online]. 2015, vol.48, n.1, pp.83-100. ISSN 1816-8949.

ABSTRACT Postprandial hyperglycemia is frequent in Diabetes Mellitus sufferers, even when, according to the glycosylated hemoglobin levels, general metabolic control appears adequate. Various studies have shown the correlation between the postprandial glucose values and cardiovascular illness, irrespective of the fasting plasma glucose values. Type 2 Diabetes Mellitus is a progressive pathology, and postprandial fluctuations in glucose seem to play a relevant role in vascular complications. The various Clinical Practice Guides emphasize the importance of individualizing the suggested therapeutic approach. All guides emphasize the need to take the patient quickly out of the state of hyperglycemia, and of early combination of changes in lifestyle with changes in drug therapy, in a rapid progression towards double and triple non-insulin therapy or early establishment of insulin therapy, combined with other drugs. A rational approach based on the physiopathology of the illness has made possible a remarkable development in the drug-therapy offer. It is important to analyze the intervention options on postprandial hyperglycemia, given the negative experiences related to control optimization and given existing doubts about the safety of medications. After analyzing all the alternatives for controlling postprandial glucose, at the moment the most effective interventions would be the incretin mimetics (GLP lag y DPP-4I) with greater benefits on the GPP, HbA1c and weight. The general objective for patients who suffer from DMT2 is an HbA1c = 7% in order to decrease the risk of complications, but it is reasonable to individualize treatment, balancing risks, benefits and costs of the proposed therapeutic approach. Key Words: Diabetes, Incretin, Postprandial Hyperglycemia, Cardiovascular Risk, GLP-1 Receptor Agonists, Glucagon-like peptide-1

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