THE CLINICAL IMPORTANCE OF POSTPRANDIAL GLUCOSE

Atherosclerotic lesions develop over a long period of time and result from complex changes in the arterial wall. Although these changes are not fully understood, there is much evidence to suggest that elevated plasma glucose levels contribute to the development of atherosclerotic lesions. Many studies have shown that there is a strong correlation b etween elevated plasma glucose levels and the risk of developing cardi ovascular disease. Effects of glucose on the arterial wall include imm ediate effects, which occur rapidly in response to elevated plasma glu cose levels, and long-term effects, which result from non-enzymatic gl ycosylation of various proteins. These adverse effects of elevated pla sma glucose levels suggest that tight control of blood glucose levels in patients with diabetes could possibly reduce the risk of cardiovasc ular complications. This is borne out by the results of clinical studi es in patients with type 1 diabetes. Therapy to reduce blood glucose l evels may also be appropriate in individuals with impaired glucose tol erance, as this condition is associated with postprandial hyperglycaem ia and a significant risk of developing cardiovascular disease. (C) 19 98 Elsevier Science Ireland Ltd. All rights reserved.