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01.12.2012 | Review | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

Postprandial hyperglycemia and endothelial function in type 2 diabetes: focus on mitiglinide

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Lisa Kitasato, Taiki Tojo, Yuko Hatakeyama, Ryo Kameda, Takehiro Hashikata, Minako Yamaoka-Tojo
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2840-11-79) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

LK participated in the preparation of the manuscript. TT co-designed the review. YH collected data. MYT wrote the final manuscript. All authors have read and approved the final manuscript.

Abstract

The risk of cardiovascular complication in a diabetes patient is similar to that in a nondiabetic patient with a history of myocardial infarction. Although intensive control of glycemia achieved by conventional antidiabetic agents decreases microvascular complications such as retinopathy and nephropathy, no marked effect has been reported on macrovascular complications or all-cause mortality. Evidence from VADT, ACCORD, and ADVANCE would suggest that glycemic control has little effect on macrovascular outcomes. Moreover, in the case of ACCORD, intensive glycemic control may be associated with an increased risk of mortality. There is sufficient evidence that suggests that postprandial hyperglycemia may be an independent risk factor for cardiovascular disease in diabetes patients. However, there are no prospective clinical trials supporting the recommendation that lowering postprandial blood glucose leads to lower risk of cardiovascular outcomes. Mitiglinide is a short-acting insulinotropic agent used in type 2 diabetes treatment. It has a rapid stimulatory effect on insulin secretion and reduces postprandial plasma glucose level in patients with type 2 diabetes. Because of its short action time, it is unlikely to exert adverse effects related to hypoglycemia early in the morning and between meals. Mitiglinide reduces excess oxidative stress and inflammation, plays a cardioprotective role, and improves postprandial metabolic disorders. Moreover, mitiglinide add-on therapy with pioglitazone favorably affects the vascular endothelial function in type 2 diabetes patients. These data suggest that mitiglinide plays a potentially beneficial role in the improvement of postprandial hyperglycemia in type 2 diabetes patients and can be used to prevent cardiovascular diseases. Although the results of long-term, randomized, placebo-controlled trials for determining the cardiovascular effects of mitiglinide on clinical outcomes are awaited, this review is aimed at summarizing substantial insights into this topic.
Zusatzmaterial
Authors’ original file for figure 1
12933_2012_536_MOESM1_ESM.pptx
Authors’ original file for figure 2
12933_2012_536_MOESM2_ESM.pdf
Literatur
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