From the Guidelines
Postprandial plasma glucose excursion refers to the rise in blood glucose levels that occurs after eating a meal, peaking within 1-2 hours, and is an important clinical marker for overall glycemic control and cardiovascular risk. This excursion represents the difference between the highest glucose level reached after eating and the pre-meal baseline glucose level. In individuals with diabetes or impaired glucose tolerance, these excursions are often higher in magnitude and longer in duration 1. The body normally manages these excursions through insulin secretion, which helps cells absorb glucose from the bloodstream. Factors affecting the magnitude of these excursions include:
- Meal composition (particularly carbohydrate content and type)
- Meal timing
- Physical activity levels
- Medication timing for those on glucose-lowering therapies Monitoring postprandial glucose excursions is valuable for adjusting treatment strategies in diabetes management, especially for optimizing mealtime insulin dosing or determining the effectiveness of medications that specifically target post-meal glucose spikes 1. It is reasonable to recommend postprandial testing for individuals who have premeal glucose values within target but A1C values above target, and to use treatments aimed at reducing postprandial plasma glucose values to <180 mg/dL (10.0 mmol/L) to help lower A1C 1.
From the FDA Drug Label
During treatment initiation and dose titration (see below), one-hour postprandial plasma glucose may be used to determine the therapeutic response to acarbose tablets and identify the minimum effective dose for the patient. The therapeutic goal should be to decrease both postprandial plasma glucose and glycosylated hemoglobin levels to normal or near normal by using the lowest effective dose of acarbose tablets, either as monotherapy or in combination with sulfonylureas, insulin or metformin
Postprandial plasma glucose excursion refers to the increase in blood glucose levels after a meal. In the context of the provided drug labels, postprandial plasma glucose is used as a measure to determine the therapeutic response to acarbose tablets and to identify the minimum effective dose for the patient. The goal of treatment with acarbose is to decrease postprandial plasma glucose levels to normal or near normal, in addition to decreasing glycosylated hemoglobin levels 2.
From the Research
Definition of Postprandial Plasma Glucose Excursion
- Postprandial plasma glucose excursion refers to the increase in blood glucose levels after a meal, typically measured as the difference between the peak glucose level and the pre-meal glucose level 3, 4, 5.
- This excursion is an important aspect of glucose metabolism, as excessive postprandial glucose excursions have been linked to an increased risk of micro- and macrovascular complications in individuals with diabetes 3, 5.
Factors Influencing Postprandial Plasma Glucose Excursion
- The magnitude of postprandial plasma glucose excursion is influenced by various factors, including the type and amount of carbohydrate consumed, the presence of insulin resistance or deficiency, and the use of certain medications such as alpha-glucosidase inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists 3, 4, 6, 7.
- Additionally, individual characteristics such as age, body mass index, and duration of diabetes can also impact postprandial glucose excursion 4.
Measurement and Clinical Significance
- Postprandial plasma glucose excursion can be measured using various methods, including continuous glucose monitoring or oral glucose tolerance tests 4, 5.
- The clinical significance of postprandial plasma glucose excursion lies in its relationship to overall glycemic control and the risk of diabetes-related complications, highlighting the importance of managing postprandial glucose levels in individuals with diabetes 3, 5.