What is post meal blood glucose?

Post meal blood glucose is the blood glucose level measured 2 hours after a meal.

What is HbA1c?

HbA1c referes to glycated hemoglobin.

Hemoglobin that carries oxygen throughout the body joins with glucose in the blood and becomes glycated.

What is the link between PMBG and HbA1c?

Post meal blood glucose
Increases levels of glycation end products and oxidative stress to cellular and plasma proteins
Increases HbA1c levels
Diabetic complications

According to guideline for management of post meal glucose in diabetes

  • Reducing post meal blood glucose (PMBG) is very important for achieving HbA1c goals
  • Decreases in PMBG account for nearly twice the decrease in HbA1c compared with decreases in fasting blood glucose (FBG)
  • 94% of patients who achieved the postprandial target of <7.8 mmol/l (140 mg/dl) achieved an HbA1c <7%

Hence, reduction in PMBG leads to more patients achieving the goal of HbA1c <7%

How is the Indian diabetic patient different?

Genes

Genetic makeup predisposes Indians towards high prevalence of type 2 diabetes

How is the Indian diabetic patient different?

Genes

Family history - High prevalence of type 2 diabetes is seen in first-degree relatives as well as in two generations down the line

How is the Indian diabetic patient different?

Diet

Rapid urbanization – High calorie, high carbohydrate, high fat food choices

How is the Indian diabetic patient different?

Diet

Traditional Indian diet consists of conventional carbohydrates

How is the Indian diabetic patient different?

Bigger belly

High waist circumference as well as waist-to-hip ratio amongst Indians makes it more difficult to achieve the HbA1c goal

What are the complications of high PMBG & HbA1c?

Heart Attack

Brain stroke

What are the complications of high PMBG & HbA1c?

Numbness and pain in hands and legs

Eye damage

What are the complications of high PMBG & HbA1c?

Certain cancers

Mental health disorders in elderly