Nonfasting Plasma Glucose is a Better Marker of Diabetic Control Than Fasting Plasma Glucose in Type 2 Diabetes
Abstract
OBJECTIVE: To evaluate the relative value of plasma glucose (PG) at different time points in assessing glucose control of type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Glycemic profiles, i.e., PG at prebreakfast (8:00 A.M.), prelunch (11:00 A.M.), postlunch (2:00 P.M.), and extended postlunch (5:00 P.M.) times over the same day, were obtained in 66 type 2 diabetic patients on an ambulatory basis. The different time points of PG were compared with a measurement of HbA1c made in a reference laboratory. RESULTS: Extended postlunch PG was lower than prebreakfast PG (104 ± 21 vs. 133 ± 35 mg/dl, P < 0.02) in patients demonstrating good diabetic control (HbA1c ≤ 7.0%), was not different from prebreakfast PG (149 ± 47 vs. 166 ± 26 mg/dl, NS) in patients demonstrating fair diabetic control (7.0% < HbA1c ≤ 8.5%), and was higher than prebreakfast PG (221 ± 62 vs. 199 ± 49 mg/dl, P ≤ 0.01) in those demonstrating poor diabetic control (HbA1c ≤ 8.5%). Prebreakfast, prelunch, postlunch, and extended postlunch PG values were all significantly correlated with HbA1c. Multiple linear regression analysis demonstrated that postlunch PG and extended postlunch PG correlated significantly and independently with HbA1c, but that prebreakfast PG and prelunch PG did not. Moreover, postlunch PG and extended postlunch PG demonstrated better sensitivity, specificity, and positive predictive value in predicting poor glycemic control than did prebreakfast PG or prelunch PG. CONCLUSIONS: In type 2 diabetes, postlunch PG and extended postlunch PG are better predictors of glycemic control than fasting plasma glucose (FPG). We therefore suggest that they be more widely used to supplement, or substitute for, FPG in evaluating the metabolic control of type 2 diabetic patients.
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Only two small series of type 2 diabetes subjects have collected data on circadian glucose levels, and their results were partially conflicting.
“only in two small series of subjects with type 2 diabetes have data on circadian glucose levels been collected, and the results were partially conflicting [13][14][15][16].”
From Prevalence and correlates of post-prandial hyperglycaemia in a large sample of patients with type 2 diabetes mellitus (2006) · cites this paper as [14]
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- Authors
- Avignon, A., Radauceanu, A., & Monnier, L.
- Affiliations
- Centre Hospitalier Universitaire de Montpellier (FR)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1997-12-01
- Volume
- 20
- Issue
- 12
- Pages
- 1822-1826
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2084772097
- Cited by
- 363
- References
- 0
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 9 · 2016: 9 · 2015: 14 · 2014: 9 · 2013: 14 · 2012: 4
- FWCI
- 4.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- 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, fasting blood glucose, postprandial blood glucose, HbA1c, glycemic markers, glycemic variability
- MeSH terms
- Adult, Aged, Blood Glucose, Circadian Rhythm, Diabetes Mellitus, Type 2, Fasting, Female, Glycated Hemoglobin, Humans, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Biomarkers, Linear Models, Postprandial Period
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