Targets and tactics: the relative importance of HbA1c, fasting and postprandial plasma glucose levels to glycaemic control in type 2 diabetes

Authors


  • Disclosures Through their roles in the Global Taskforce on Glycaemic Control (GTF), Dr Vincent Woo, Professor Marina V. Shestakova and Professor Antonio Ceriello have all received remuneration from Novo Nordisk A/S for their time and expenses. Dr Cathrine Ørskov is an employee of Novo Nordisk A/S. Editorial assistance in the preparation of this manuscript was provided by Axon Communications on behalf of Novo Nordisk A/S.

Dr Vincent Woo,
Health Sciences Centre, University of Manitoba, 838–715 McDermot Ave, Winnipeg, R3E 3P4, Canada
Tel.: + 1 204 957 3218
Fax: + 1 204 943 3516
Email: vwoo3@shaw.ca

Summary

Background:  The incidence of type 2 diabetes is reaching pandemic proportions, impacting patients and healthcare systems across the globe. Evidence suggests that a majority of patients are not achieving recommended blood glucose targets resulting in an increased risk of micro- and macro-vascular complications.

Aim:  To review literature on the significance of glycosylated haemoglobin (HbA1c), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG), their inter-relationships and relative importance in the treatment of diabetes, and to provide practical guidance on effective monitoring of patients.

Methods:  Clinical guidelines on diabetes management and clinical and preclinical studies of glycaemic control identified through a publications database search were reviewed.

Results:  Glycaemic control remains fundamental to the successful management of diabetes. HbA1c is the gold standard measure of glycaemic control but recent evidence suggests that postmeal hyperglycaemia also plays an important role in the aetiology of diabetes-associated complications and control of PPG levels is vital to the achievement of recommended HbA1c targets.

Conclusions:  The call for action on type 2 diabetes has never been more compelling; with a clear focus on strategies for glycaemic control, the impact of the diabetes pandemic can be limited.

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