https://youtube.com/embed/10nP2o_aZjI Your blood glucose level after you eat can affect your risk for cardiovascular disease. Several studies show a correlation between blood glucose levels and what happens to your arteries. The most common ways to evaluate the blood glucose metabolism is to measure fasting blood glucose and Hemoglobin A1c (HbA1c). Hemoglobin A1c is usually used to monitor long-term glucose control, 2-3 months.
More and more research is, however, documenting the importance of also knowing what the blood glucose level is after a meal, and that is not checked routinely. In the following study, the participants were divided into 4 groups based on coronary angiography (Sasso FC, et.al., 2004). One group had no significant stenosis (calcification), the other groups had documented disease in 1 and up to 3 vessels. Several tests were performed to evaluate the glucose metabolism, including the glucose and insulin levels after eating. For patients with a so-called normal glucose tolerance, it was interesting that the most important test correlating with cardiovascular risk was the glucose level after eating, and the next was Hemoglobin A1c. In patients with coronary artery disease the researchers showed that even with normal Hemoglobin A1c levels, the participants with an abnormal glucose tolerance test (glucose after a meal) had greater progression of coronary artery lesions (Wang H, et.al., 2014). It was not even a difference in risk between patients with an impaired glucose tolerance and patients who had type 2 diabetes. This shows that you donâ€™t have to have progressed to having diabetes to have an increased risk for cardiovascular disease. Researchers have found that there is a linear relationship between the risk of cardiovascular death and the 2-hour glucose tolerance test (Leiter LA, et.al., 2005). The 2 -hour glucose tolerance test measures the blood glucose level 2 hours after a test drink has been ingested. These researchers found increased mortality at an oral 2-hour glucose tolerance test of approximately 90 mg/dl which is well below the level of what type 2 diabetes patients have. Research is showing us that what we used to think of as normal and good test results are not good enough. Thatâ€™s probably why we see a lot of people dying from a cardiovascular disease with laboratory values in the normal range. References Leiter LA, Ceriello A, Davidson JA, Hanefeld M, Monnier L, Owens DR, Tajima N, Tuomilehto J ; International Prandial Glucose Regulation Study Group. Clin Ther. 2005;27 Suppl B:S42-56. Sasso FC, Carbonara O, Nasti R, Campana B, Marfella R, Torella M, Nappi G, Torella R, Cozzolino D, Glucose metabolism and coronary heart disease in patients with normal glucose tolerance. JAMA. 2004 Apr 21;291(15):1857-63. Wang H, Tang Z, Li X, Hu B, Feng B. Angiographic evaluation of the effects of glucose metabolic status on progression of coronary artery lesions in patients with coronary artery disease. J Diabetes. 2014 Nov;6(6):541-6.