CoChat
Sign Up
Cited by 490Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes, Cardiovascular Risks, and Lipoproteins

The loss of postprandial glycemic control precedes stepwise deterioration of fasting with worsening diabetes

Open access
Monnier, Louis, Colette, Claude, Dunseath, Gareth J., Owens, David R.·2007·Diabetes Care
DOI 10.2337/dc06-1612
Open this paper in CoChat — free accountOpen PDF

Abstract

OBJECTIVE— The aim of the study was to determine whether the loss of fasting and postprandial glycemic control occurs in parallel or sequentially in the evolution of type 2 diabetes. RESEARCH DESIGN AND METHODS— In 130 type 2 diabetic patients, 24-h glucose profiles were obtained using a continuous glucose monitoring system. The individuals with type 2 diabetes were divided into five groups according to A1C levels: 1 (<6.5%, n = 30), 2 (6.5–6.9%, n = 17), 3 (7–7.9%, n = 32), 4 (8–8.9%, n = 25), and 5 (≥9%, n = 26). The glucose profiles between the groups were compared. The overall glucose concentrations for the diurnal, nocturnal, and morning periods, which represent the postprandial, fasting, and the dawn phenomenon states, respectively, were also compared. RESULTS— Glucose concentrations increased steadily from group 1 to 5 in a stepwise manner. The initial differences in mean glucose concentrations reaching statistical significance occurred 1) between groups 1 and 2 (6.4 vs. 7.7 mmol/l, P = 0.0004) for daytime postprandial periods, followed by differences; 2) between groups 2 and 3 (7.5 vs. 9.3 mmol/l, P = 0.0003) for the morning periods (dawn phenomenon); and finally 3) between groups 3 and 4 (6.3 vs. 8.4 mmol/l, P < 0.0001) for nocturnal fasting periods. CONCLUSIONS— The deterioration of glucose homeostasis in individuals with type 2 diabetes progressed from postprandial to fasting hyperglycemia following a three-step process. The first step related to the three diurnal postmeal periods considered as a whole, the second step occurred during the morning period, and the third and final step corresponded to sustained hyperglycemia over the nocturnal fasting periods. Such a description of the key stages in the evolution of type 2 diabetes may be of interest for implementing antidiabetes treatment.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.2337/dc06-1612

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A 2-hour PPG <8.0 mmol/L correlates best with an A1C <7.0%.

    “Another study using continuous glucose monitoring (CGM) demonstrated that a 2-hour PPG <8.0 mmol/L correlates best with an A1C <7.0% (40).”

    From Targets for Glycemic Control (2018) · cites this paper as [40]

    The Comparison of daytime postprandial periods section reports CGM-derived mean postprandial glucose of 7.7 mmol/L in the group with A1C of 6.5–6.9%, supporting a relationship between postprandial glucose and A1C. It does not establish that a glucose value measured two hours after a meal below 8.0 mmol/L correlates best with A1C below 7.0%. Page numbers are unavailable in our copy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • If an A1C target ≤7.0% cannot be achieved with a FPG target of 4.0-7.0 mmol/L and PPG target of 5.0-10.0 mmol/L, further FPG lowering to 4.0 to 5.5 mmol/L and/or PPG lowering to 5.0-8.0 mmol/L may be considered, but must be balanced against the risk of hypoglycemia.

    “If an A1C target ≤7.0%cannot be achieved with a FPG target of 4.0-7.0mmol/L and PPG target of 5.0-10.0mmol/L, further FPG lowering to 4.0 to 5.5 mmol/L and/or PPG lowering to 5.0-8.0 mmol/L may be considered, but must be balanced against the risk of hypoglycemia [Grade D, Level 4 (38) for FPG target for type 2 diabetes; Grade D, Consensus for FPG target for type 1 diabetes; Grade D, Level 4 (38,40”

    From Targets for Glycemic Control (2018) · cites this paper as [40]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Postprandial hyperglycemia begins prior to type 2 diabetes occurring.

    “Firstly, postprandial hyperglycemia has been shown to begin prior to type 2 diabetes occurring [3–5]”

    From Acute effect of Ceylon cinnamon extract on postprandial glycemia: alpha-amylase inhibition, starch tolerance test in rats, and randomized crossover clinical trial in healthy volunteers (2014) · cites this paper as [5]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [18]18. Zar JH: Testing for goodness of fit. In Bio- statistical Analysis. 4th ed. Upper Saddle River, NJ, Prentice Hall, 1999, p. 461- 485

Cited by

Sorted by citations

Related

Authors
Monnier, L., Colette, C., Dunseath, G. J., & Owens, D. R.
Affiliations
  • Hôpital Lapeyronie (FR)
  • Laboratory of Human Nutrition and Atherogenesis, University Institute of Clinical Research, Montpellier, France
  • University Hospital Llandough (GB)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2007-02-01
Volume
30
Issue
2
Pages
263-269
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc06-1612
OpenAlex
W2127454519
Cited by
490
References
31
Citations by year
2026: 7 · 2025: 12 · 2024: 17 · 2023: 16 · 2022: 17 · 2021: 20 · 2020: 14 · 2019: 22 · 2018: 27 · 2017: 33 · 2016: 31 · 2015: 24 · 2014: 40 · 2013: 35 · 2012: 27
FWCI
28.26
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
type 2 diabetes, glycemic control, postprandial hyperglycemia, fasting hyperglycemia, dawn phenomenon, HbA1c, disease progression, glucose homeostasis, continuous glucose monitoring
MeSH terms
Blood Glucose, Blood Pressure, Energy Intake, Diabetes Mellitus, Type 2, Eating, Fasting, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Disease Progression, Monitoring, Ambulatory, Postprandial Period, Glycemic Index

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review