Relationship between Fasting and 2-Hour Postprandial Plasma Glucose Levels and Vascular Complications in Patients with Type 2 Diabetes Mellitus

Abstract

OBJECTIVE: To investigate the relationship between fasting and 2-h postprandial plasma glucose concentrations and vascular complications in type 2 diabetes. METHODS: Consecutive patients with type 2 diabetes admitted for blood glucose control were grouped according to their fasting and 2-h postprandial plasma glucose levels. Frequency and severity of diabetic retinopathy and nephropathy, number of carotid artery plaques, coefficient of variation of R—R intervals (CVRR), brachial—ankle pulse wave velocity (baPWV), intima—media thickness, brain natriuretic peptide level, ankle—brachial index, and high-sensitivity C-reactive protein levels were compared. RESULTS: In the 206 patients studied, mean ± SD age, glycosylated haemoglobin and duration of diabetes were 63.4 ± 13.7 years, 9.8 ± 1.8% and 13.4 ± 8.9 years, respectively. Patients with high fasting plasma glucose levels had a higher frequency of proliferative retinopathy than those with low fasting levels. Patients with medium or high 2-h postprandial plasma glucose levels had higher baPWV and lower CVRR, respectively, than those with low 2-h levels. There was an inverse correlation between baPWV and CVRR. CONCLUSION: Elevated fasting and postprandial plasma glucose levels are risk factors for vascular complications in type 2 diabetes mellitus.