All About Diabetes in Women
 
Targeting postprandial glucose levels to attain glycemic control in Diabetes
HbA (1c) is the gold standard measure of glycaemic control but recent evidence suggests that postmeal hyperglycaemia also plays an important role in the etiology of diabetes-associated complications.
Health issues in diabetic women – latest information
Diabetes has been associated with fertility issues, higher inflammatory stress & has been found to contribute to increased prevalence and incidence of atrial fibrillation… in women.
Unique benefits of Voglibose in diabetics
This article discusses the unique benefits of Voglibose. Voglibose prevents pioglitazone-induced body weight gain in Type 2 diabetic patients, reduces oxidative stress markers and soluble intercellular adhesion molecule 1 in obese type 2 diabetic patients & reduces the progression of carotid intima-media thickness.
 
Targeting postprandial glucose levels to attain glycemic control in Diabetes
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.

Glycaemic control remains fundamental to the successful management of
PPG levels
diabetes. HbA (1c) is the gold standard measure of glycaemic control but recent evidence suggests that postmeal hyperglycaemia also plays an important role in the etiology of diabetes-associated complications and control of PPG levels is vital to the achievement of recommended HbA (1c) targets.
Woo V et al. Int J Clin Pract. 2008 Dec;62(12):1935-42.

 
International Diabetes Federation guideline for management of post meal glucose
As a global issue, diabetes outcome is closely tied to the management strategies and resources available in the various regions of the world. However, even within the limitations of healthcare resources in certain nations, there is a need to optimize diabetes management to minimize related morbidity and mortality. Traditionally, intervention has largely focused on optimizing overall glycaemic control as
  Assessed by glycated haemoglobin (HbA 1c ) and
  Fasting plasma glucose (FPG) values.
  pmg
 
However, studies have highlighted the importance of targeting postmeal hyperglycaemia and demonstrate a strong relationship between elevated postmeal glucose (PMG) and the risk of complications. As part of a global mission to promote diabetes care, prevention and to find a cure the post meal guideline was developed under the direction of the International Diabetes Federation.
 
Rationale for post meal glucose control
For the post meal guideline, post meal hyperglycaemia is defined as a plasma glucose level > 7.8 mmol/l (140 mg/dl) 2 h after the ingestion of food.
Development of post meal hyperglycaemia
  Post Meal Glocose
  Coincides with a loss of first-phase insulin secretion
  A decrease in insulin sensitivity and
  An inability to adequately suppress hepatic glucose production

The contribution of postmeal plasma glucose to HbA 1c is proportionally greatest with HbA 1c values of 6.5%, while nocturnal FPG is at a near-normal level. As HbA 1c rises above 8%, the relative contribution of postmeal hyperglycaemia to overall glycaemic control diminishes, while the contribution of FPG predominates.

These results explain previous findings that, while the contribution of postmeal plasma glucose to overall glycaemia is ~70% at HbA 1c values < 7.3%, the postmeal contribution is ~40% with HbA 1c values above 9.3%. Such findings form the basis for a glucose triad model of diabetes management, in which all three glycaemic parameters of HbA 1c, PMG and FPG interrelate, and are essential targets for intervention in attempts to optimize overall glycaemic control (Fig.).
A Ceriello and S Colagiuri et al. Diabet Med. 2008 October; 25(10): 1151–1156.

  
In diabetic individuals, postprandial insulin secretion is insufficient to suppress an excessive rise in PPG. There is increasing evidence that elevated PPG exerts a more deleterious effect on the vascular system than elevation of fasting plasma glucose. In particular, individuals with normal fasting plasma glucose but impaired glucose tolerance have significantly increased risk of cardiovascular events.
Rendell MS, Metabolism. 2006 Sep;55(9):1263-81
With the recognition of the importance of PPG and the availability of pharmacologic options, management of diabetes will shift to greater attention to PPG levels.
Rendell MS, Metabolism. 2006 Sep;55(9):1263-81.