Optimizing postprandial glucose management in adults with insulin-requiring diabetes: Report and recommendations

John L. Leahy*, Grazia Aleppo, Vivian A. Fonseca, Satish K. Garg, Irl B. Hirsch, Anthony L. McCall, Janet B. McGill, William H. Polonsky

*Corresponding author for this work

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Faster-acting insulins, new noninsulin drug classes, more flexible insulin-delivery systems, and improved continuous glucose monitoring devices offer unprecedented opportunities to improve postprandial glucose (PPG) management and overall care for adults with insulin-treated diabetes. These developments led the Endocrine Society to convene a working panel of diabetes experts in December 2018 to assess the current state of PPG management, identify innovative ways to improve self-management and quality of life, and align best practices to current and emerging treatment and monitoring options. Drawing on current research and collective clinical experience, we considered the following issues for the;200 million adults worldwide with type 1 and insulin-requiring type 2 diabetes: (i) the role of PPG management in reducing the risk of diabetes complications; (ii) barriers preventing effective PPG management; (iii) strategies to reduce PPG excursions and improve patient quality of life; and (iv) education and clinical tools to support endocrinologists in improving PPG management. We concluded that managing PPG to minimize or prevent diabetes-related complications will require elucidating fundamental questions about optimal ways to quantify and clinically assess the metabolic dysregulation and consequences of the abnormal postprandial state in diabetes and recommend research strategies to address these questions. We also identified practical strategies and tools that are already available to reduce barriers to effective PPG management, optimize use of new and emerging clinical tools, and improve patient self-management and quality of life.

Original languageEnglish (US)
Pages (from-to)1942-1957
Number of pages16
JournalJournal of the Endocrine Society
Volume3
Issue number10
DOIs
StatePublished - Oct 2019

Keywords

  • Diabetes
  • Diabetes technology
  • Insulin therapy
  • PPG
  • Postprandial excursions

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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    Leahy, J. L., Aleppo, G., Fonseca, V. A., Garg, S. K., Hirsch, I. B., McCall, A. L., McGill, J. B., & Polonsky, W. H. (2019). Optimizing postprandial glucose management in adults with insulin-requiring diabetes: Report and recommendations. Journal of the Endocrine Society, 3(10), 1942-1957. https://doi.org/10.1210/js.2019-00222