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Inicio Endocrinología y Nutrición Hiperglucemia posprandial: importancia y tratamiento
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Vol. 53. Núm. 2.
Páginas 137-142 (febrero 2006)
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Vol. 53. Núm. 2.
Páginas 137-142 (febrero 2006)
Curso de formación continuada en endocrinología y nutrición
Acceso a texto completo
Hiperglucemia posprandial: importancia y tratamiento
Postprandial hyperglycemia: relevance and treatment
Visitas
29155
E. Faure-Nogueras
Autor para correspondencia
endh@hcu-lblesa.es

Correspondencia: Dr. E. Faure-Nogueras. Hospital Clínico Universitario Lozano Blesa. Secretaría Endocrinología y Nutrición. Avda. San Juan Bosco, 15. Planta 11. 50009 Zaragoza. España.
Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
Este artículo ha recibido
Información del artículo

Se revisa la hiperglucemia pospandrial como factor de riesgo cardiovascular. Se han encontrado suficientes datos fisiopatológicos y de asociación, lo que ha permitido a los estudios de intervención catalogarla con un nivel de evidencia IIb, con un grado de recomendación B. Se recomienda su determinación a las 2 h postingesta y con la frecuencia de la que se deriven modificaciones terapéuticas. Se hace una revisión de diversos fármacos útiles, para lo que se propone un esquema general terapéutico.

Palabras clave:
Hiperglucemia postprandial
Factor de riesgo macrovascular
Tratamiento

Postprandial hyperglycemia as a cardiovascular risk factor is reviewed. Sufficient physiological and associated data were found to allow intervention studies to classify it with level IIb evidence and grade B recommendation. Determinations should be performed 2 hours after food intake and when therapy is modified. Several useful drugs are reviewed and a general therapeutic protocol is proposed.

Key words:
Postprandial hyperglycemia
Macrovascular risk factor
Treatment
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Bibliografía
[1.]
B. Tamayo, E. Faure, M.J. Roche, E. Rubio, E. Sánchez, J.A. Salvador.
Prevalence of diabetes and impaired glucose tolerance in Aragón, Spain.
Diabetes Care, 20 (1977), pp. 534-536
[2.]
S.M. Haffner, S. Lehto, T. Ronnemaa, K Pyorala, M. Laakso.
Mortality fron coronary heart disease in subjects with type 2 diabets and in nondiabetic subjects with and without prior myocardial infarction.
New Engl J Med, 339 (1998), pp. 229-234
[3.]
C. Do Lee, A.R. Folsom, J.S. Pankow, F.L. Brancati, For the atherosclerosis risk in communities (ARIC) study investigators.
Cardiovascular events in diabetic and nondiabetic adults with or without history of myocardial infarction.
Circulation, 109 (2004), pp. 855-860
[4.]
S.C. Grundy, R. Pasternak, P. Greenland, J. Smith, V. Fuster.
Assessment of cardiovascular risk by use of multiple risk factor assessment equations.
Circulation, 100 (1999), pp. 1481-1482
[5.]
D.A. Greene, S.A. Lattimer, A.A.F. Sima.
Sorbitol, phosphoinositides, and sodium-potassium ATPase in the pathogenesis of diabetic complications.
N Engl J Med, 316 (1987), pp. 599-606
[6.]
P. Xia, T. Inoguchi, T.S. Kern, R.L. Engerman, P.J. Oates, G.L. King.
Characterization of the mechanism for the chronic activation of diacyglycerol-proteinkinase C pathway in diabetes and hypergalactosemia.
Diabetes, 43 (1994), pp. 1122-1129
[7.]
A. Ceriello.
Perspectives in diabetes. Postprandial hyperglycemia and diabetes complications. Is it time to treat?.
Diabetes, 54 (2005), pp. 1-7
[8.]
V. Kolm-Litly, U. Sauer, A. Nerlich, R. Lehmann, E.D. Scheleicher.
High glucose-induced transforming growth factor beta 1 production is mediated by hexosamina pathway in porcine glomerular mesangial cells.
J Clin Invest, 101 (1998), pp. 160-169
[9.]
R. Marfella, K. Esposito, R. Giunta, G. Coppola, L. De Angelis, B. Farzati, et al.
Circulating adhesion molecules in humans: role of hyperglycemia and hyperinsulinemia.
Circulation, 101 (2000), pp. 2247-2251
[10.]
K. Esposito, F. Nappo, R. Marfella, G. Giugliano, F. Giugliano, M. Ciotola, et al.
Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans role of oxidative stress.
Circulation, 106 (2002), pp. 2067-2072
[11.]
T. Nishikawa, D. Edelstein, X.L. Du, S. Yamagishi, T. Matsumura, Y. Kaneda, et al.
Normalizing mitochondrial superoxide production blocks three pathways of hyperglycaemic damage.
Nature, 13 (2000), pp. 787-790
[12.]
The DECODE Study Group; European Diabetes Epidemiology Group.
Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria.
Lancet, 354 (1999), pp. 617-621
[13.]
M. Coutinho, H.C. Gerstein, Y. Wang, S. Yusuf.
The relationship between glucose and incident cardiovascular events a metaregression analysis of published data from 20 studies of 95,783 individuals followed for 12.4 years.
Diabetes Care, 22 (1999), pp. 233-240
[14.]
T.S. Temelkova-Kurktschiev, C. Koehler, F. Schaper, W. Leonhardt, H. Henkel, M. Hanefeld.
Postchallenge plasma glucose and glycemic spikes are more strongly associated with atherosclerosis than fasting glucose and HbA1c level.
Diabetes Care, 23 (2000), pp. 1830-1834
[15.]
J.L. Chiasson, R.G. Josee, R. Gomis, M. Hanefeld, A. Karasik, M. Laakso, The STOP-NIDDM Trial Research Group.
Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance.
JAMA, 290 (2003), pp. 486-494
[16.]
M. Hanefeld, M. Cagatay, T. Petrowitsch, D. Neuser, D. Petzinna, M. Rupp.
Acarbose reduces the risk for myocardial infarction in type 2 diabetic patients: meta-analysis of sseven long-term studies.
Eur Heart J, 25 (2004), pp. 10-16
[17.]
K. Malmberg, L. Ryden, H. Wedel, K. Birkeland, A. Bootsma, K. Dickstein, et al.
Fasttrack intense metabolic control by means of insulin in patients with diabetes mellitus and acute myocardial infarction (DIGAMI 2): effects on mortality and morbidity.
Eur Heart J, 26 (2005), pp. 650-661
[18.]
K. Esposito, D. Giugliano, F. Nappo, R. Marfella, The Campanian postprandial hyperglycemia study group.
Regression of carotid atherosclerosis by control of postprandial hyperglycemia in type 2 diabetes mellitus.
Circulation, 110 (2004), pp. 214-219
[19.]
T.M.S. Wolever, J.L. Chiasson, A. Csima, J.A. Hunt, C. Palmason, S.A. Ross, et al.
Variation of postprandial plasma glucose, palatability, and symptoms associated with a standardized mixed test meal versus 75 g oral glucose.
Diabetes Care, 21 (1998), pp. 336-340
[20.]
American Diabetes Association.
Postprandial blood glucose.
Diabetes Care, 24 (2001), pp. 775-778
[21.]
E. Faure, L.F. Pallardo, J. Mesa, M. Puig-Domingo, R. García-Mayor, P. Benito, et al.
HbA1c and glycemic profile, basal and post-treatment with miglitol, in an area with a Mediterranean diet.
Diabetes Care, 25 (2002), pp. 1896-1897
[22.]
E. Faure.
Nuevos tratamientos en la diabetes mellitus.
Endocr Nutr, 48 (2001), pp. 174-176
[23.]
O.G. Kolterman, J.B. Buse, M.S. Fineman, E. Gaines, S. Heintz, T.A. Bicsak, et al.
Synthetic exendin-4 (exenatide) significantly reduces postprandial and fasting plasma glucose in subjects with type 2 diabetes.
J Clin Endocrinol Metab, 88 (2003), pp. 3082-3089
[24.]
R.A. De Fronzo, R.E. Ratner, J. Han, D.D. Kim, M.S. Finemna, A.D. Baron.
Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformin-treated patients with type 2 diabetes.
Diabetes Care, 28 (2005), pp. 1092-1100
[25.]
D.M. Kendall, M.C. Riddle, J. Rosenstock, D. Zhuang, D.D. Kim, M.S. Fineman, et al.
Effects of exenatide (exendin-4) on glycemic control over 30 weeks in patients with type 2 diabetes treated with metformin and a sulfonylurea.
Diabetes Care, 28 (2005), pp. 1083-1091
[26.]
J.H. Anderson, R.L. Brunelle, V.A. Koivisto, A. Pfützner, M.E. Trautmann, L. Vignati, et al.
Reduction of postprandial hyperglycemia and frequency of hypoglycemia in IDDM patients on insulin-analog treatment.
Diabetes, 46 (1997), pp. 265-270
[27.]
P.A. Holander, L. Blonde, R. Rowe, A.E. Mehta, J.L. Milburn, K.S. Hershon, et al.
Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 2 diabetes.
Diabetes Care, 27 (2004), pp. 2356-2362
[28.]
T. Quattrin, A. Belanger, N.H.J.V. Bohannon, S.L. Schwartz, The exubera phase III study group.
Efficacy and safety of inhaled insulin (exubera) compared with subcutaneous insulin therapy in patients with type 1 diabetes.
Diabetes Care, 27 (2004), pp. 2622-2627
Copyright © 2006. Sociedad Española de Endocrinología y Nutrición
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