Fasting and After-Meal Glucose Levels and Cardiovascular Disease

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Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study, by F. Cavalot and colleagues. J Clin Endocrinol Metab 91:813–819, 2006.

What is the problem and what is known about it so far?

People with type 2 diabetes are more likely to suffer from cardiovascular disease (disease of the heart and blood vessels). Heart and blood vessel disease has been linked to high levels of blood glucose, but scientists disagree about which test for measuring glucose levels is most useful for identifying patients who are most likely to develop heart and blood vessel disease.

Why did the researchers do this particular study?

The researchers wanted to compare measuring a person's blood glucose -- before and after meals -- to see whether one or the other is linked to heart and blood vessel disease.

Who was studied?

The study included 529 men and women with type 2 diabetes who were cared for at a medical center in Turin, Italy.

How was the study done?

The men and women had a physical exam and blood drawn for lab tests. Each person had their height and weight measured so researchers could calculate their body mass index (a way of comparing weight to height). Several blood glucose tests were done, including after fasting overnight, after breakfast, after lunch, and before dinner. The researcher's also measured the men and women's A1C levels; A1C is a measure of long-term glucose control.

Patients were followed up for five years while researchers kept track problems related to heart and blood vessel disease, such as heart attack, stroke, or death.

What did the researchers find?

Blood glucose levels after eating was a better sign of which people were likely to get heart and blood vessel disease than fasting glucose levels. Those participants with the highest after-meal glucose levels were 5.5 times more likely to have a heart and blood vessel disease-related event than those with the lowest levels. The relationship between after-meal glucose levels and heart and blood vessel disease was strongest among women.

What were the limitations of the study?

There were a fairly small number of heart and blood vessel disease-related events among women in the study, so the results may not apply to a larger group.

What are the implications of the study?

Doctors should pay close attention to controlling after-meal glucose levels in patients, especially in female patients.

FOR MORE INFORMATION

Managing Your Blood Glucose

Heart Disease Is Greatest Threat to Women

Diabetes Burnout