The impact of regulation of postprandial glucose in practice

: Meal and post-meal periods define a post-prandial state covering about 66% of day duration and characterized by a glucose and other nutrients influx into the blood flow. Post-prandial hyperglycemia can be an early feature of glucose intolerance, indicating a failure to control for post-prandial glucose load, but mostly characterizes type 2 diabetes, reflecting quantitative and/or qualitative abnormalities in insulin secretion by pancreatic beta cells. Post-prandial hyperglycemia contributes to raise glycated hemoglobin (HbA1c) level, which as an indicator of total glycemic load, is tightly correlated with the incidence of micro- and macroangiopathy in type 2 diabetes. It can induce or deteriorate fasting hyperglycemia and be associated with coagulation activation and/or lipid metabolism abnormalities, the latter being considered as cardiovascular risk factors, even in non diabetic populations. Therefore caring for post-prandial glucose regulation is particularly relevant in glucose intolerant and type 2 diabetic patients. Accordingly, several pharmacological treatments have been designed, among which repaglinide recently emerged as an efficient, safe and convenient regulator of post-prandial glycemia.