Recommended Care
• Postprandial hyperglycaemia is defined as having postprandial glucose level higher than the target after usual meal and on medications (if any)
• PPG should be measured 2-h after a usual meal and medications (if any).
• Target PPG: 160 mg/dL as long as hypoglycaemia is avoided.
• Both non-pharmacologic and pharmacologic therapies should be considered
▫ MNT: diet with low glycaemic load is recommended
▫ AGIs (acarbose, miglitol or voglibose), DPP4 inhibitors, SGLT2 inhibitors or GLP-1 analogues (preferably short acting) as the first add on to metformin therapy
▫ Glinides and short acting sulfonylureas as alternative options
▫ Rapid acting insulin analogues may be considered over the regular insulin when postprandial hyperglycaemia is a concern especially when the risk of hypoglycaemia is high.
• Combination therapy of AGI with other agents may be considered.
• SMBG should be considered as it is the most practical method for monitoring postprandial glycaemia.
• Efficacy of treatment regimens should be monitored frequently to guide therapy towards achieving PPG targets.