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April 13, 2013Diabetes Care333 citationsOpen Access

Relationships Between Gastric Emptying, Postprandial Glycemia, and Incretin Hormones

CMChinmay S. MaratheRoyal Adelaide HospitalCRChristopher K. RaynerRoyal Adelaide HospitalKJKaren L. JonesRoyal Adelaide Hospital

Key Points

  • To review the physiological relationships between gastric emptying rates, postprandial glucose excursions, and incretin hormone responses in type 2 diabetes management.
  • Synthesized clinical literature examining the relative contributions of preprandial and postprandial blood glucose levels to overall glycated hemoglobin (HbA1c).
  • Evaluated physiological interactions linking gastrointestinal motility, gut incretin secretion, and systemic glucose regulation.
  • Postprandial glycemic excursions account for approximately 70% of total glycemic variability when HbA1c is below 7.3%.
  • Achieving recommended HbA1c targets below 7.0% requires managing post-meal glucose spikes to prevent and delay microvascular complications.

Abstract

The importance of achieving tightglycemic control, usually assessedby glycated hemoglobin (HbA1c), for both the prevention and delay in the progression of diabetes-relatedmicrovascu-lar complications, is established, and the American Diabetes Association/European Association for the Study of Diabetes joint committee has recommended an HbA1c,7 % as the goal in patients with type 2 diabetes (1). The relative contributions of pre- and postprandial glycemia to HbA1c have been clarified during the last decade following the seminal report by Monnier et al. (2) indicating that in type 2 diabetes, postprandial glycemic excursions ac-count for about 70 % of variability when HbA1c is,7.3%, while the contribution

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Cite This Study

Marathe et al. (2013) studied this question.

synapsesocial.com/papers/6a0283a767f6ea5cc8754453https://doi.org/10.2337/dc12-1609
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