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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