Plasma Glucose Levels Throughout the Day and HbA1c Interrelationships in Type 2 Diabetes
Abstract
OBJECTIVE—To evaluate the extent of plasma glucose excursions with meals, the relations between plasma glucose levels at different times of the day, and the relations between the latter and HbA1c in non–insulin-treated type 2 diabetic subjects. RESEARCH DESIGN AND METHODS—Daily glucose profiles were assessed in non–insulin-treated type 2 diabetic patients. Outpatients at the diabetes clinic (n = 371; one daily plasma glucose profile) and at home (n = 30; five daily blood glucose profiles over 1 month) as well as inpatients (n = 455; profile of plasma glucose on the day of admission) were examined. Subjects had plasma/blood glucose assessment before and 2–3 h after breakfast, lunch, and dinner. HbA1c was also measured. RESULTS—After the meals many subjects had glucose levels >8.9 mmol/l (160 mg/dl) and/or glucose excursions >2.2 mmol/l (40 mg/dl). This was also often found when HbA1c was satisfactory (<7%). The coefficients of simple correlation among plasma/blood glucose at different times of the day ranged from 0.52 to 0.88. Correlations between HbA1c and plasma/blood glucose at different times of the day ranged from 0.44 to 0.67. The strongest correlation was between HbA1c and mean daily glucose (r = 0.57–0.69). Multiple regression analyses showed that premeal but not postmeal plasma/blood glucose levels were independent predictors of HbA1c. CONCLUSIONS—These results suggest that 1) the majority of non–insulin-treated type 2 diabetic patients have exaggerated plasma/blood glucose excursions with meals, and many of them have higher-than-recommended glucose concentrations 2 h after the meals; 2) plasma/blood glucose levels throughout the day are not as strongly interrelated as one might believe; and 3) HbA1c is more related to preprandial than postprandial plasma/blood glucose levels. These findings have potential implications for treatment and monitoring of metabolic control in type 2 diabetes.
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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 [13]
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- Authors
- Bonora, E., Calcaterra, F., Lombardi, S., Bonfante, N., Formentini, G., Bonadonna, R. C., & Muggeo, M.
- Affiliations
- University of Verona (IT)
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2001-12-01
- Volume
- 24
- Issue
- 12
- Pages
- 2023-2029
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2077702349
- Cited by
- 235
- References
- 28
- Citations by year
- 2024: 1 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 10 · 2016: 20 · 2015: 10 · 2014: 4 · 2013: 12 · 2012: 7
- FWCI
- 8.98
- 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, HbA1c, preprandial glucose, postprandial blood glucose, non-insulin-treated diabetes, glycemic control
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Fasting, Female, Food, Glycated Hemoglobin, Humans, Male, Middle Aged, Regression Analysis, Time Factors
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