Eleven insulin-dependent (type I) diabetic subjects were studied during a 24-h period to assess intraday blood glucose (BG) variation and related free insulin (FI) levels. Ten patients exhibited the dawn phenomenon, a rise in early morning fasting blood glucose (123 ± 81.1 m/dl; mean ± SD). This increase was positively and significantly correlated with the morning postprandial BG peak (r = 0.723; P = 0.012). FI/BG ratios were highest during the night (0.717 and 0.666 at 2200 and 0400 h, respectively) and lowest during the early morning (0.294 at 0800 h) (P < 0.01). Three of the four observed hypoglycemic episodes occurred during the period when free insulin levels were high relative to BG. We conclude that the dawn phenomenon contributed directly and significantly to the BG maximum and indirectly, in some cases, to nocturnal hypoglycemia. It thus played an important role in the intraday blood glucose variation of such patients.
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Original Articles|
November 01 1981
The Dawn Phenomenon, an Early Morning Glucose Rise: Implications for Diabetic Intraday Blood Glucose Variation
Maria Ines Schmidt;
Maria Ines Schmidt
Departments of Pediatrics and Medicine, the Johns Hopkins Hospital
Baltimore, Maryland
, and Department of Pharmacology
UFRGS, Brazil
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Angeliki Hadji-Georgopoulos;
Angeliki Hadji-Georgopoulos
Departments of Pediatrics and Medicine, the Johns Hopkins Hospital
Baltimore, Maryland
, and Department of Pharmacology
UFRGS, Brazil
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Marc Rendell;
Marc Rendell
Departments of Pediatrics and Medicine, the Johns Hopkins Hospital
Baltimore, Maryland
, and Department of Pharmacology
UFRGS, Brazil
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Simeon Margolis;
Simeon Margolis
Departments of Pediatrics and Medicine, the Johns Hopkins Hospital
Baltimore, Maryland
, and Department of Pharmacology
UFRGS, Brazil
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Avinoam Kowarski
Avinoam Kowarski
Departments of Pediatrics and Medicine, the Johns Hopkins Hospital
Baltimore, Maryland
, and Department of Pharmacology
UFRGS, Brazil
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Address reprint requests to Maria Ines Schmidt, Endocrine Division, Medicine, The N.C. Memorial Hospital, Chapel Hill, North Carolina 27514.
Citation
Maria Ines Schmidt, Angeliki Hadji-Georgopoulos, Marc Rendell, Simeon Margolis, Avinoam Kowarski; The Dawn Phenomenon, an Early Morning Glucose Rise: Implications for Diabetic Intraday Blood Glucose Variation. Diabetes Care 1 November 1981; 4 (6): 579–585. https://doi.org/10.2337/diacare.4.6.579
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