Glycemic Variability Should we and can we prevent it?
Glycemic Variability Should we and can we prevent it?
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DOI：
10.2337/dc08-s241
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发表时间：
2008-02-01
期刊：
影响因子：
16.2
通讯作者：
Colette, Claude
中科院分区：
文献类型：
--
作者：
Monnier, Louis;Colette, Claude
糖尿病的特征是血糖紊乱，包括持续的慢性高血糖和急性血糖波动。现在有确凿的证据表明，持续的慢性高血糖会导致蛋白质过度糖化和氧化应激的产生。葡萄糖从峰值到最低点的变化的作用很少被记录，但有很多理由认为，葡萄糖在平均值附近的向上（餐后）和向下（餐间）的急性波动都会激活氧化应激。因此，强烈建议全球抗糖尿病策略应旨在将糖尿病的不同成分（即，A1 C，空腹和I）餐后血糖，以及血糖变异性）。所有作用于餐后葡萄糖波动的治疗剂似乎对降低后一参数（即，葡萄糖不稳定性）。应特别关注通过肠促胰岛素途径发挥作用的新兴治疗药物，如胰高血糖素样肽1激动剂和二肽基肽酶（DPP）-IV抑制剂。
Diabetes is characterized by glycemic disorders that include both sustained chronic hyperglycemia and acute glucose fluctuations. There is now cogent evidence for the deleterious effects of sustained chronic hyperglycemia that results in excessive protein glycation and generation of oxidative stress. The role of glucose variability from peaks to nadirs is less documented, but there are many reasons to think that both upward (postprandial) and downward (interprandial) acute fluctuations of glucose around a mean value activate the oxidative stress. As a consequence, it is strongly suggested that a global antidiabetic strategy should be aimed at reducing to a minimum the different components of dysglycemia (i.e., A1C, fasting and I)postprandial glucose, as well as glucose variability). All the therapeutic agents that act on postprandial glucose excursions seem of particular interest for reducing the latter parameter (i.e., the glucose instability). Particular attention should be paid to such emerging therapeutic agents as the glucagon-like peptide 1 agonists and the dipeptidyl peptidase (DPP)-IV inhibitors that act through the incretin pathway.