Postprandial hyperglycemia is common in diabetics and it precedes fasting hyperglycemia.
Indian diet is rich in carbohydrates unlike Western diet. High dietary carbohydrate load is associated with increased risk of T2DM.
PPG is important because T2DM patients may be in the postprandial state for more than 12 hours in a day.
Increased PPG is associated with endothelial dysfunction and oxidative and nitrosative stress making it a strong predictor of CV events in diabetic patients (DECODE, Honolulu Heart study, DECODA).
Postmeal plasma glucose should be measured 1-2 hours after a meal.
For good glycemic control, both FPG and PPG should be normal or at least near normal levels.
If A1c <7.5%, initial therapy should address PPG, preferentially.
Reducing postprandial hyperglycemia → decreased CVD related morbidity and mortality.
α-glucosidase inhibitors like voglibose and voglibose-based combination therapy can effectively control postprandial hyperglycemia as they delay absorption of carbohydrates and also offer added advantages of being weight neutral & least risk of hypoglycemia.