Feature Article

Finding and fixing postprandial hyperglycaemia in type 2 diabetes

Pat Phillips
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Postprandial blood glucose levels that are above the target range can be controlled by diet amendments, increased physical activity, oral and injectable hypoglycaemic agents and bolus insulins.

Key Points

  • Postprandial hyperglycaemia can be caused by a high preprandial value and/or a high prandial increment.
  • The preprandial value should be on target before checking postprandial values.
  • The current recommended postprandial blood glucose level targets in Australia are 6 to 10 mmol/L.
  • If glycaemia before breakfast and the evening meal is controlled by basal insulin, any high values of blood glucose (‘hypers’) are likely to be caused after breakfast (i.e. before lunch) and/or after the evening meal (i.e. before bed).
  • Strategies to control postprandial hyperglycaemia include lifestyle measures (diet and physical activity), noninsulin hypoglycaemic strategies (oral and injectable hypoglycaemic agents) and bolus insulins.
  • The guiding principle is that hypoglycaemic therapy should not require changes In lifestyle that are not achievable or acceptable for the patient.