The case for a role for postprandial glucose monitoring in diabetes management.

Strategies for the management of diabetes have evolved considerably over the last few years. We have moved from an era where glycemic control was aimed primarily at avoiding the symptoms associated with hyperglycemia (polyuria, polydipsia, weight loss, and fatigue) to an era where the primary objective is to attain near normal glycemic control in an effort to prevent or delay the microvascular and macrovascular complications of diabetes. This switch in emphasis--and the parallel developments in pharmacologic agents and lifestyle intervention techniques--translates into greater attention to glycemic control in the postprandial state. An important role for postprandial glucose monitoring with therapy aimed at achieving postprandial glucose targets is suggested by teleologic argument, biochemical information, epidemiologic study, and limited clinical trial data.