Rarity of a Marked “Dawn Phenomenon” in Diabetic Subjects Treated by Continuous Subcutaneous Insulin Infusion

• DOI: 10.2337/diacare.8.1.28
• Publication Date: 2007-03-05T22:51:27Z
• Authors: Jeremy J Bending; John C Pickup; Andrea C G Collins; Harry Keen
• Keywords: Basal (medicine); Nadir

We assessed the quality of overnight glycemic control and frequency “dawn phenomenon” (nadir–0800 h increase) in 41 insulin-dependent diabetic patients treated by continuous subcutaneous insulin infusion (CSII). Mean plasma glucose levels were near-normal during 24 and, particular, constant throughout night. In a subset six free concentrations also CSII. The majority profiles (88%) showed nadir from 2.0 to 5.9 mmol/L (most frequently at 0600 h) had an 0800 value 6.9 (92%). A large proportion (46%) zero or negative nadir-0800 increase. 22 with three more recorded same basal rate, only one 103 fasting increase greater than arbitrary 5.0 (5.3), although many exhibited small dawn increases (e.g., 14 mean 0 2 mmol/L). 12 subjects 15% reduction rate increased ± SEM 0.58 0.25 2.7 0.76 (P < 0.025) as well significantly increasing nocturnal concentrations. Thus, marked phenomenon is rare when single but adequate used for CSII, this questions need preprogrammable pumps changes.