Zbynek Schroner
Finding the significance of postprandial hyperglycemias in the risk of onset and progression of diabetic complications, emphasised complex approach to the glycemic control also with the importance of prandial control (regulation) of glycemias in patients with type 2 diabetes mellitus. To the pharmacologic agents with accentated influence on postprandial glycemia mainly belong prandial insulin analogues (lispro, aspart, glulisin) and derivates of meglitinides (repaglinid, nateglinid). In type 2 diabetes mellitus prandial insulin analogues in comparison with regular short- acting insulins more closely mimic physiologic prandial insulin response, lead to lower interprandial insulinemias, more constant absorption of insulin. They offer more flexible daily regimen to the patient. Derivates of meglitinides stimulate secretion of insulin during meals. They don´t stimulate insulin in late postprandial and fasting period. They stimulate insulin only in the presence of glucose. Regular monitoring of fasting glyemias, glycosylalated hemoglobin (HbA1c) and also postprandial glycemias is necessary in patients with type 2 diabetes mellitus.