Postprandial hyperglycaemia

A modified amyhn, Pramlintide, is being investigated as a hypoglycaemic agent in early type 2 diabetes. It potently reduces glucagon secretion and therefore postprandial hyperglycaemia. 

MK-678 (L363,586) (58), a cyclic hexapeptide, lowers fasting and postprandial hyperglycaemia in IDDM patients, after i,v, or intranasal delivery [301], and, taken intranasally at bedtime, can abolish the morning... 

Variations in the pharmacokinetics of the sulphonylureas are clinically relevant because of the differences in their rate of onset and their duration of action. Differences in the rate of onset are important because they relate to the capacity to reduce the delay in acute insulin release after nutritional challenge and therefore their capacity to reduce the evaluation and prolongation of the postprandial hyperglycaemia. Differences in the duration of action are important because they relate to the risk of causing chronic hyperin-sulinaemia, long-lasting hypoglycaemia, and possibly desensitization to sulphonylureas (Melander et al., 1990). 

Clinical studies in healthy subjects demonstrate that the acute addition of the viscous types of dietary fibre such as the gel-forming polysaccharide guar leads to a decrease in postprandial hyperglycaemia by a reduction in gastric-emptying rates and slowing of intestinal carbohydrate absorption. 

In healthy humans, acarbose reduces postprandial hyperglycaemia, hyper-insulinaemia and hypertriglyceridaemia and may therefore be a useful tool for the treatment of diabetic patients and the metabolic syndrome. 

Type 2 diabetes meUitus is a complex chronic metabohc disorder, which results from defects in both insulin secretion and insuhn action. An elevated rate of basal hepatic glucose production in the presence of hyperin-suhnemia is the primary cause of fasting hypergly-caemia. After a meal, impaired suppression of hepatic glucose production by insulin and decreased insulin-mediated glucose uptake by muscle contribute almost equally to postprandial hyperglycaemia. 

Heine RJ, Dekker JM. Beyond postprandial hyperglycaemia metabolic factors associated with cardiovascular disease. Diabetologia 2002 45(4) 461 75. 

Murai, A. et al.. Control of postprandial hyperglycaemia by galactosyl maltobionolactone and its novel anti-amylase effect in mice. Life Sci., 71, 1405, 2002. 

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