One More Reason to Control Glucose

Lowering your after-meal BG levels can also lower your risk of heart disease. Researchers who determined that measuring blood-glucose levels two hours after eating say after-meal BG levels are a better indicator of risk factors for heart disease than either fasting levels or HbA1cs.

Researchers writing in the December 2000 issue of Diabetes Care examined the relationship between a variety of BG parameters to the thickness of the common carotid artery, which is an accepted marker of atherosclerosis, or hardening, of the artery. Testing was done on 582 individuals between the ages of 40 and 70 who were at risk for, or in the early stages of, type 2 diabetes.

Running high blood-glucose levels after meals is not always reflected in the HbA1c, but there is increasing evidence of its importance in contributing to diabetes complications that involve the carotid artery, researchers say. The risk is also present in people who have impaired glucose tolerance. Researchers expressed surprise that more research has not been done on how post-meal rises in blood-glucose levels contribute to atherosclerosis.

During testing, each subject consumed 75 grams of glucose during a fasting oral glucose tolerance test, then blood-glucose levels were taken every 30 minutes for up to two hours. Using an ultrasound, the carotid artery wall was measured twice and an average taken. Other tests included maximal plasma glucose levels, post-challenge glucose spikes, glucose levels that were under the fasting glucose test curve and HbA1cs.

While all of the tests taken showed the odds of having thicker artery walls, the two-hour reading was the strongest indicator that artery walls would be thicker, researchers say. HbA1c and fasting levels were not significant in showing a risk for atherosclerosis.

Two-hour levels greater than 140 mg/dl were determined to be significant markers of atherosclerosis.

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