One of the most difficult current medical problems is the growing epidemics of diabetes mellitus. The contemporary treatment aims not only to secure the patients survival and to protect from the acute symptoms but also to avoid the occurrence of the chronic complications of the disease. This paper contains a review of the role that postprandial hyperglycemia plays in the treatment of diabetes mellitus especially type 2. Authors summarize findings of pathophysiological and epidemiological macroangiopathy studies that indicate the use of prandial glucose regulation in clinical practice. This review contains discussion of postulated mechanism in which short-lasting increases in plasma glucose concentration can damage vessel wall lead to atherosclerosis. Epidemiological studies showing the strong correlation between postprandial (and post-challenge) plasma glucose levels with cardiovascular endpoints are also discussed. Moreover, in this paper the reader may find a discussion on practical aspects of postprandial hyperglycemia monitoring in the treatment of diabetic patient, focusing at the relationship between prandial glycaemia and long term glycaemia control expressed by HbA(1c) measurements. The guidelines for monitoring postprandial glycaemia are also included. The modern therapeutic possibilities aiming post-prandial hyperglycaemia are also showed.