The Loss of Postprandial Glycemic Control Precedes Stepwise Deterioration of Fasting With Worsening Diabetes  

Oleh:

Monnier, Louis ; Colette, Claude ; Dunseath, Gareth J ; Owens, David R.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 30 no. 02 (Feb. 2007), page 263.

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K.2007.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE - The aim of the study was to determine whether the loss of fasting and postprnndial 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 rrofiles were obtained using a continuous glucose monitoring system. The individuals with type J~iabetes were divided into five groups according to AIC levels: 1 «6.5%, n = 30), 2 (05-6.9%, n = 17),3 (7-7.9%, n = 32),4 (8-8.9%, n = 25), and 5 (~9%, n = 26). The glucose ~rofiles 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 ocrurred 1) between groups 1 and 2 (6.4 vs. 7.7 mmolll, P = 0.0004) for daytime postprandial ~riods, followed by differences; 2) between groups 2 and 3 (7.5 vs. 9.3 mmolll, P = 0.0003) for tnemorning periods (dawn phenomenon); and finally 3) between groups 3 and 4 (6.3 vs. 8.4 mmolJl, P < 0.0001) for nocturnal fasting periods. (OMCLUSIONS - The deterioration of glucose homeostasis in individuals with type 2 ~mbetes progressed from postprandial to fasting hyperglycemia following a three-step process. Inefirststep 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 n}perglycernia 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

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