Relationship between Fasting and 2-hour Postprandial Plasma Glucose Levels and Vascular Complications in Patients with Type 2 Diabetes Mellitus

OBJECTIVE: To investigate the relationship between fasting and 2-h postprandial plasma glucose concentrations and vascular complications in type 2 diabetes. METHODS: Consecutive patients with type 2 diabetes admitted for blood glucose control were grouped according to their fasting and 2-h postprandial plasma glucose levels. Frequency and severity of diabetic retinopathy and nephropathy, number of carotid artery plaques, coefficient of variation of R-R intervals (CVRR), brachial-ankle pulse wave velocity (baPWV), intima-media thickness, brain natriuretic peptide level, ankle-brachial index, and high-sensitivity C-reactive protein levels were compared. RESULTS: In the 206 patients studied, mean +/- SD age, glycosylated haemoglobin and duration of diabetes were 63.4 +/- 13.7 years, 9.8 +/- 1.8% and 13.4 +/- 8.9 years, respectively. Patients with high fasting plasma glucose levels had a higher frequency of proliferative retinopathy than those with low fasting levels. Patients with medium or high 2-h postprandial plasma glucose levels had higher baPWV and lower CVRR, respectively, than those with low 2-h levels. There was an inverse correlation between baPWV and CVRR. CONCLUSION: Elevated fasting and postprandial plasma glucose levels are risk factors for vascular complications in type 2 diabetes mellitus.