<International Diabetes>: Firstly Professor Holman, postprandial hyperglycemia is an independent risk factor for cardiovascular disease and has been suggested as a new cardiovascular risk reduction intervention target. Do you agree that postprandial hyperglycemia’s impact on cardiovascular disease is mainly mediated by oxidative stress? By what mechanism does postprandial hyperglycemia increase oxidative stress and further lead to an increase in cardiovascular disease?
<International Diabetes>: Professor Pan, at this year’s IDF was there anything new regarding this area of postprandial hyperglycemia and cardiovascular disease risk and it’s relation to oxidative stress?
Prof. Pan: Surely the guidelines from IDF ask clinicians to pay more attention to postprandial glucose and also to initiate some preventative interventions against postprandial hyperglycemia. There was also information addressing patients classified as pre-diabetic, for example IGT or impaired glucose tolerance, with blood sugars between normal and the diabetic region normally associated postprandial hyperglycemia region. Some new information at the meeting stressed that missing some of this clinical information related to postprandial hyperglycemia and miss this particularly high-risk population. Because these pre-diabetics are in the so-called IGT stage, these patients present with abnormal postprandial hyperglycemia but may only be categorized as pre-diabetic when looking at other criteria. Early data suggests that the early diagnosis of these patients with postprandial hyperglycemia also have high risk of developing cardiovascular disease. This is why IDF included this in the most recently published guidelines.