This review will summarize evidence that postprandial hyperglycemia (1) is an independent risk factor for cardiovascular disease; (2) increases earlier and faster than fasting plasma glucose levels; and (3) contributes more to HbA(1c) levels than fasting hyperglycemia when HbA(1c) levels approach target values and, therefore, is the rate-limiting factor for achieving optimal glycemic control. Finally, treatment recommendations will be presented.