Persistent hyperglycemia increases the risk of cardiovascular events in patients with type 2 diabetes mellitus who have a history of acute myocardial infarction. Whether clinicians should target prandial glucose levels rather than basal glucose levels to reduce this excess risk is keenly debated.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Bretzel, R. G. et al. Once-daily basal insulin glargine versus thrice-daily prandial insulin lispro in people with type 2 diabetes on oral hypoglycaemic agents (APOLLO): an open randomised controlled trial. Lancet 371, 1073–1084 (2008).
Holman, R. R. et al. Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes. N. Engl. J. Med. 357, 1716–1730 (2007).
Raz, I. et al. Effects of prandial versus fasting glycemia on cardiovascular outcomes in type 2 diabetes: the HEART2D trial. Diabetes Care 32, 381–386 (2009).
Nathan, D. M. et al. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 32, 193–203 (2009).
International Diabetes Federation. Guideline for management of postmeal glucose [online], http://www.idf.org/webdata/docs/Guideline_PMG_final.pdf (2007).
Kilpatrick, E. S., Rigby, A. S. & Atkin, S. L. The effect of glucose variability on the risk of microvascular complications in type 1 diabetes. Diabetes Care 29, 1486–1490 (2006).
Lachin, J. M. et al. Effect of glycemic exposure on the risk of microvascular complications in the Diabetes Control and Complications Trial—revisited. Diabetes 57, 995–1001 (2008).
Monnier, L. et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. JAMA 295, 1681–1687 (2006).
Brownlee, M. Biochemistry and molecular cell biology of diabetic complications. Nature 414, 813–820 (2001).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Monnier, L., Colette, C. The HEART2D trial—new questions beyond answers. Nat Rev Endocrinol 5, 299–300 (2009). https://doi.org/10.1038/nrendo.2009.98
Issue Date:
DOI: https://doi.org/10.1038/nrendo.2009.98