1. Postprandial Hyperglycemia [email_address]

3. “ DIABETIC EXPLOSION” [email_address]

7. What is driving Diabetes Epidemic in INDIA??? OR [email_address]

9. Glycemic Targets in Clinical Practice: Postprandial vs Preprandial and Fasting? [email_address]

10. POST PRANDIAL HYPERGLYCEMIA – THE DARK FACE [email_address]

15. Patients With Type 2 Diabetes May Spend More Than 12 Hours per Day in the Postprandial State Adapted from Monnier L. Eur J Clin Invest. 2000;30(suppl 2):3-11. Duration of postprandial state Breakfast Lunch Dinner Midnight 4 AM Breakfast 8 AM 11 AM 2 PM 5 PM Postprandial Postabsorptive Fasting [email_address]

16. Correlation between plasma glucose levels after OGTT and standard mixed meal Wolever TMS et al. Diabetes Care 1998;21:336–40 [email_address] r=0.97

18. Relationship between HbA1C, FPG and 2 h. PPG Van Haeften T et al Metabolism 2000 [email_address]

19. As Patients Get Closer to A1C Goal, the Need to Successfully Manage PPG Significantly Increases Adapted from Monnier L, Lapinski H, Collette C. Contributions of fasting and postprandial plasnma glucose increments to the overall diurnal hyper glycemia of Type 2 diabetic patients: variations with increasing levels of HBA(1c). Diabetes Care. 2003;26:881-885. [email_address]

20. Post-Prandial Hyperglycemia Antecedes Fasting Hyperglycemia Monnier L et al Diabetes Care 30:263-269, 2007 [email_address]

22. Relative risk for death increases with 2-hour blood glucose irrespective of the FPG level <6.1 6.1–6.9  7.0  11.1 7.8–11.0 <7.8 Fasting plasma glucose (mmol/l) 2-hour plasma glucose (mmol/l) 2.5 2.0 1.5 1.0 0.5 0.0 Hazard ratio Adjusted for age, center, sex DECODE Study Group. Lancet 1999;354:617–621 [email_address]

24. Long-Term Problems Source: Kidney Intl. 1987; 32 (supp 22): S53-S56 [email_address] Post-prandial glucose Range Time to onset of proteinuria Persistent <200 110-198 23 yrs Intermittent >200 118-228 19 yrs Persistent > 200 201 + 14 yrs

25. Long-Term Problems 22-yr CVD Mortality Risk by Baseline post-challenge glucose Source: Chicago Heart Study, Lowe et al, Diabetes Care, 1997; 20: 163-170. [email_address]

26. Effects of Reducing PPHG [email_address] Risk of progression to diabetes Risk of cardiovascular events Risk of development of new cases of hypertension

32. Results & Conclusion Voglibose, in addition to lifestyle modification, can reduce the development of type 2 diabetes in high-risk individuals with impaired glucose tolerance. [email_address]

33. Br J Clin Pharmacol / 66:2 / 318–319 [email_address]