Glucose metabolism and the postprandial state

Disturbances of postprandial glucose metabolism are now thought to contribu te to cardiovascular disease. Postprandial glucose excursions can be affect ed by a number of factors, such as the types of carbohydrates ingested and the way they are metabolized. In Type 2 diabetes, factors that contribute t o excessive postprandial glucose excursions include disruption of insulin s ecretion, insufficient inhibition of hepatic glucose production and defecti ve glucose storage in muscle. A number of measures may attenuate excessive postprandial blood glucose excursions. These include a diet high in 'low gl ycaemic index' foods and treatment with drugs that improve or restore the h ormonal response (e.g. the sulphonylureas and the newer beta-cell mediated insulinotropic drugs such as repaglinide), that improve insulin sensitivity or that delay gastric emptying.