Management of diabetes mellitus in developing countries: The relevance of postprandial hyperglycaemia

The prevalence of diabetes mellitus is rising globally and its complications present an immense public health burden to all health economies world-wide. The objective of this review article is to present the relevance of postprandial hyperglycaemia in the management of diabetes, which should guide clinicians in developing countries. It will discuss the definition, epidemiology, pathophysiology, complications and treatment strategies for postprandial hyperglycaemia. Sources of Data/Study selection: The data search used in this review covered studies published from 1965-2008 obtained from recent international conferences, World Health reports, prevalence studies, hospital- based studies, registry reports, hospital statistics, government estimates, United Nations Resolution on diabetes, International Diabetes Federation Declarations and clinical practice guidelines. Data Extraction: The MEDLINE database, the Internet (e-medicine, medscape resource centre), World Health and International Diabetes Federation Monographs were used for data extraction. The global explosion of diabetes as a pandemic is well recognized as well as preventive measures and effective treatments. This current knowledge however is under-utilized because in practice only about a third of people living with diabetes achieve optimum targets for glycaemic control. Hyperglycaemia is the central disorder in diabetes mellitus. It has been shown in several studies that the development of complications of diabetes is directly due to prolonged exposure of the body cells to glucose. There is a lot of emphasis on monitoring and treatment of fasting hyperglycaemia in diabetics. Drugs which target postprandial hyperglycaemia are not widely in use in developing countries. It is hoped that this review will emphasize the need to use these drugs to the benefit of our patients.