Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
5902505 | Journal of Diabetes and its Complications | 2015 | 8 Pages |
Abstract
“Mild dysglycemia” in type 2 diabetes can be defined by the range of HbA1c levels â¥Â 6.5% (48 mmol/mol) and < 7% (53 mmol/mol), which corresponds to when the risk for vascular complications begins to increase. This “mild dysglycemia” is characterized by both a dawn phenomenon (a spontaneous blood glucose rise in the early morning) and an excess of post-prandial glucose excursions in the absence of abnormal elevation in basal glucose, especially during nocturnal periods. This represents an intermediary stage between pre-diabetes (HbA1c â¥Â 5.7%, 39 mmol/mol, and < 6.5%, 48 mmol/mol) and those who begin to show a steadily progressive worsening in basal glucose (HbA1c â¥Â 7%, 53 mmol/mol). Should this relatively minor intermediate dysglycemic phase deserve more attention, that is the question. The now available incretin-based therapies, and more specifically the DPP-4 inhibitors provide the clinician with the possibility to reduce or eradicate both the dawn phenomenon and post-meal glucose excursions with minimal side effects. The availability of 24-h glycemic profiles in those with “mild dysglycemia” will help to describe their individual glycemic phenotype, based on which the early and appropriate life style changes and/or pharmacological interventions can be introduced.
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Authors
Louis Monnier, Claude Colette, Sylvie Dejager, David R. Owens,