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This version published online on December 13, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-1005
A more recent version of this article appeared on March 1, 2006
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Submitted on May 5, 2005
Accepted on December 5, 2005

POSTPRANDIAL BLOOD GLUCOSE IS A STRONGER PREDICTOR OF CARDIOVASCULAR EVENTS THAN FASTING BLOOD GLUCOSE IN TYPE 2 DIABETES MELLITUS, PARTICULARLY IN WOMEN, Lessons from the San Luigi Gonzaga Diabetes Study

F. Cavalot, A. Petrelli, M. Traversa, K. Bonomo, E. Fiora, M. Conti, G. Anfossi, G. Costa, and M. Trovati*

Diabetes Unit, Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Orbassano (Turin), Italy and Department of Public Health, University of Turin, Italy

* To whom correspondence should be addressed. E-mail: mariella.trovati{at}unito.it.

Objective: The influence of postprandial blood glucose on diabetes complications is intensively debated. We aimed to evaluate the predictive role of both fasting and postprandial blood glucose on cardiovascular events in Type 2 diabetes and the influence of gender.

Methods: In a population of 529 (284 men and 245 women) consecutive Type 2 diabetic patients attending our Diabetes Clinic, we evaluated the relationships -corrected for cardiovascular risk factors and type of treatment- between cardiovascular events in a 5-year follow-up and baseline values of HbA1c and blood glucose measured: i)after overnight fast; ii)after breakfast; iii)after lunch; iv)before dinner. Continuous variables were categorized into tertiles.

Results: We recorded cardiovascular events in 77 subjects: 54/284 men (19%) and 23/245 women (9.4%). Univariate analysis indicated that cardiovascular events were associated with increasing age, longer diabetes duration, higher HbA1c and fibrinogen in men, and with higher systolic blood pressure, albumin excretion rate, HbA1c and all blood glucose values in women. Smoking was more frequent in subjects with events. When all blood glucose values and HbA1c were introduced simultaneously in the models, only blood glucose after lunch predicted cardiovascular events, with hazard ratio of the third tertile vs. the first and the second greater in women (5.54;CI:1.45-21.20) than in men (2.12;CI:1.04-4.32)(P < 0.01).

Conclusions: Postprandial, but not fasting, blood glucose is an independent risk factor for cardiovascular events in Type 2 diabetes, with a stronger predictive power in women than in men, suggesting that more attention should be paid to postprandial hyperglycemia, particularly in women.


Key words: Diabetes mellitus • Cardiovascular disease • Postprandial glucose • Glycated haemoglobin • Risk Factors • Gender


Find additional patient-related information at:

Fasting and After-Meal Glucose Levels and Cardiovascular Disease


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