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Postprandial Hyperglycemia and Risk of Atherosclerosis—Reply

Joshua A. Beckman, MD, MS; Mark A. Creager, MD; Peter Libby, MD
JAMA. 2002;288(8):955. doi:10.1001/jama.288.8.955.
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In Reply: Dr Mikhail reinforces the importance of postprandial hyperglycemia as a cardiovascular risk predictor. We concur completely that increasing levels of glycemia, whether fasting,1 chronic,2 or postprandial,3 provide important prognostic information. We focused on implementation of therapies proven to limit the complications of atherosclerosis in diabetic individuals. Unfortunately, no data suggest that chronic tight glycemic control improves macrovascular outcomes.4 We hope that future studies will provide evidence supporting a role for additional hypoglycemic strategies in reducing atherosclerotic risk in this population.


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