ORIGINAL INVESTIGATION Relationship between fluc n e

Kitakyushyu-shi 807-8555, JapanDeath due to ischemic heart disease and onset of myocardial infarction are approximately 2 to 6 times greater and the risk of stroke is approximately 2 to 3 times greater in patients with type 2 diabetes than normal popu-lation [1-5]. Microvascular complications may be amelio-rated and/or inhibited by the control of blood glucose levels through maintenance of hemoglobin A1c (HbA1c) below a critical level. However, the outcome of recent large-scale clinical studies suggested that strict glycemic risk of macrovascular complications [6,7]; rather, the total number of deaths remained significantly high after inten-sive therapy [7]. In this regard, severe hypoglycemia has been reported to be an important cause of increased inci-dence of sudden cardiovascular death [8]. In addition to HbA1c, any glucose-lowering therapy tai-lored to reduce diabetic angiopathy should also improve postprandial hyperglycemia, which is known to worsen ar-teriosclerosis, without causing hypoglycemia. In patients with abnormal glucose tolerance, vascular endothelial dysfunction is considered one of the main changes in the initial stage of atherosclerogenesis [9], and is involved i