Diabetes mellitus has recently been classified as a major independent risk factor for the development of coronary heart disease.1 Patients with diabetes have increased risk of cardiovascular morbidity and mortality. Diabetic patients without previous myocardial infarction have outcomes similar to non-diabetic patients who have a previous myocardial infarction.2 The importance of postprandial blood glucose is evident in the literature. Postprandial hyperglycemia (PPH) has been associated with increased risk of microvascular and macrovascular complications.3-7 The Diabetes Intervention Study had showed that PPH was an independent risk factor for myocardial infarction and cardiac death.8 We aim in our study to determine the frequency of diabetic patients, attending the outpatient medical clinic of King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia (KSA), with optimal postprandial blood glucose level.

Methods. A cross-sectional study in which type-2 diabetic patients being followed in the outpatient medical clinic of King Abdul-Aziz University Hospital, Jeddah, KSA, from January 1999 to December 2001 were studied. The mean level of the last 2 fasting and 2-hours postprandial blood glucose (which were measured on an average of 6-12 weeks apart) was recorded. According to the expert committee report of the American Diabetes Association in 1999,9 the goal 2-hour postprandial blood glucose has to be 160 mg/dl (8.8 mmol/l) and action should be taken if it reaches 180 mg/dl (10 mmol/l); for fasting it is 120mg/dl (6.6 mmol/l) with action to be taken if it reaches 140 mg/dl (7.7 mmol/l). In 2002 a recommendation for a wider range for fasting 90-130 mg/dl (5-7 mmol/l)] was proposed and action suggested if it reached >150 mg/dl (8.3 mmol/l) and for bed time glucose it was 110-150 mg/dl (6-8.3mmol/l) and >180mg/dl (10 mmol/l).10 As we are using mmol/l unit for the measurement of plasma glucose in our hospital we classify the patients according to the 2-hours postprandial blood glucose level into 3-categories; goal <9 mmol/l, border line 9.1-10 mmol/l, poor >10 mmol/l. while for fasting; goal <7 mmol/l, borderline 7.1-8 mmol/l, poor >8 mmol/l. The following data was also collected from the study group; age, sex, body mass index (BMI), duration of diabetes, type of treatment (diet, oral hypoglycemic agents, insulin or combined), presence of hypertension (defined as blood pressure >140/90 mm Hg or if the patient is known hypertensive), hyperlipidemia (defined as low density lipoprotein (LDL) >2.6 mmol/l, high density lipoprotein (HDL) <1.1 mmol/l, triglyceride >1.7 mmol/l), history of smoking, history of ischemic heart disease (assessed by patient’s history or changes on electrophysiological studies), and mortality. The frequency of diabetic patients in each group was calculated, and the relations between them and cardiovascular risk factors and mortality were determined. Statistical analysis was carried out using the Statistical Package for Social Sciences 9.1 software. Values as mean + standard deviation were given for quantitative data and frequency for categorical variables. Chi-square was used to analyze group differences for categorical variables. For continuous variables t- test was used when comparing 2 groups. P-value <0.05 was considered significant.

Results. A total of 443 patients were enrolled in the study. Out of which 217 (49%) were males. The mean age was 54.8 ± 16.2 years and the mean BMI 25.5 ± 3.6 m2/kg. Two hundred and seventy (61% were on oral hypoglycemic agents, 133/443 (30%) on insulin, 27/443(6%) on diet and 13/443 (3%) on combined treatment. The mean fasting blood glucose for the study group was 9.7 ± 3.2 mmol/l while for 2-hour postpran

Received 12th May 2003. Accepted for publication in final form 5th July 2003.