“Mild dysglycemia” in type 2 diabetes: to be neglected or not?

Abstract : "Mild dysglycemia" in type 2 diabetes can be defined by the range of HbA1c levels≥6.5% (48 mmol/mol) and<7% (53 mmol/mol), which corresponds to when the risk for vascular complications begins to increase. This "mild dysglycemia" is characterized by both a dawn phenomenon (a spontaneous blood glucose rise in the early morning) and an excess of post-prandial glucose excursions in the absence of abnormal elevation in basal glucose, especially during nocturnal periods. This represents an intermediary stage between pre-diabetes (HbA1c≥5.7%, 39 mmol/mol, and<6.5%, 48 mmol/mol) and those who begin to show a steadily progressive worsening in basal glucose (HbA1c≥7%, 53 mmol/mol). Should this relatively minor intermediate dysglycemic phase deserve more attention, that is the question. The now available incretin-based therapies, and more specifically the DPP-4 inhibitors provide the clinician with the possibility to reduce or eradicate both the dawn phenomenon and post-meal glucose excursions with minimal side effects. The availability of 24-h glycemic profiles in those with "mild dysglycemia" will help to describe their individual glycemic phenotype, based on which the early and appropriate life style changes and/or pharmacological interventions can be introduced.
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Soumis le : vendredi 24 mai 2019 - 11:16:32
Dernière modification le : vendredi 24 mai 2019 - 11:16:33

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Louis Monnier, Claude Colette, Sylvie Dejager, David Owens. “Mild dysglycemia” in type 2 diabetes: to be neglected or not?. Journal of Diabetes and its Complications, Elsevier, 2015, 29 (3), pp.451-458. ⟨10.1016/j.jdiacomp.2014.12.004⟩. ⟨hal-02138870⟩

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