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DOI: 10.1055/s-2006-947838
© Georg Thieme Verlag KG Stuttgart · New York
Relationship between Diurnal Glucose Levels and HbA1c in Type 2 Diabetes
Publikationsverlauf
Received 8 February 2006
Accepted after revision 12 April 2006
Publikationsdatum:
24. August 2006 (online)
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Abstract
Aims and methods: Study results still conflict on the contribution of diurnal blood glucose (BG) values to HbA1c in type 2 diabetes. We investigated the relationship between HbA1c and diurnal BG obtained under standardized conditions - before breakfast, two hours after breakfast, before lunch, two hours after lunch, before dinner, two hours after dinner, and at 10 PM, 12 midnight and 3 AM in 68 type 2 diabetic patients before and after optimizing glycemic control. The areas under the curve above fasting BG (AUC1) and above 5.6 mmol/l (AUC2) were calculated for further evaluation. HbA1c was measured at baseline and after a mean of 89 (74 to 108) days. Results: Each BG value at baseline and after treatment optimization significantly correlated with baseline and follow-up HbA1c, respectively. The pre-breakfast BG showed the closest correlation with HbA1c. The relative contribution of postprandial BG concentrations (AUC1) to overall hyperglycemia (AUC2) decreased with poorer glycemic control. However, treatment optimization mainly resulted in improved blood glucose values in patients with the poorest glycemic control at baseline. Multiple regression analysis demonstrated that fasting (AUC2-AUC1) and postprandial (AUC1) hyperglycemia independently determined HbA1c or the change in HbA1c after treatment optimization. Conclusions: Our findings indicate that intensive blood glucose monitoring during fasting and postprandial states is important for glycemic control, and is therefore an essential part of good clinical practice.
Key words
HbA1c - type 2 diabetes - fasting glucose - postprandial glucose
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Correspondence
Dr. Frank Pistrosch
University Hospital Dresden·Nephrology·Dept. of Medicine
Fetscherstrasse 74·01307 Dresden·Germany
Telefon: +49/351/458 22 29
eMail: frankpistrosch@hotmail.com