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The Importance of Hyperglycemia in the Nonfasting State to the Development of Cardiovascular Disease

Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78284-7873

I. Introduction

II. Correlation Between Hyperglycemia and CVD

A. Type 2 diabetes

B. Elevated glucose concentrations in the nondiabetic range

C. Atherosclerosis in subjects with asymptomatic hyperglycemia

III. Causal Relationship of Postprandial Hyperglycemia to CVD

A. Direct effects of hyperglycemia

B. Insufficient insulin production

C. Insulin resistance and hyperinsulinemia

D. Association with risk factors for CVD

IV. Therapeutic Interventions for Type 2 Diabetes

A. Insulin therapy

B. Sulfonylureas

C. Biguanides

D. Acarbose

V. Studies to Prevent Type 2 Diabetes

VI. Conclusions