Frequency of the Dawn Phenomenon in Type 2 Diabetes: Implications for Diabetes Therapy

Carroll, Mary F.; Hardy, Kevin; Burge, Mark R.; Schade, David S.

doi:10.1089/152091502320798213

Cited by 27 publications

(20 citation statements)

References 32 publications

(42 reference statements)

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“…So far over 180 articles about “dawn phenomenon” have been published. [10] The mechanism of “dawn phenomenon” includes Growth hormone is regarded as the primary factor in T1DM patients and as the second factor in T2DM patients, and the effect of growth hormone on glucose metabolism is time-dependent [11] ; Endogenous glucose production and insulin sensitivity exhibit circadian rhythm [12,13] ; Fibroblast growth factor-21 also shows circadian rhythm [14] ; and Carroll et al [11] found that the effects of glucagon and cortisol on hyperglycemia during dawn period is more affirmative, but the contribution of catecholamine to hyperglycemia during dawn period is limited. [12] These studies above all suggest that rhythmic changes in hormone secretion lead to “dawn phenomenon”.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous and transient predinner hyperglycemia in some patients with diabetes

Shi

et al. 2016

Medicine

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Blood glucose fluctuations have higher risk than absolute blood glucose level in diabetic chronic complications. At present, “dawn phenomenon” is well known by clinicians, but “dusk phenomenon” has not been recognized. This study explored the objective existence of “dusk phenomenon” (spontaneous and transient predinner hyperglycemia) and its clinical significance.The data of 54 patients with diabetes, who received routine insulin pump therapy between December 2010 and October 2012 in our hospital, were retrospectively analyzed. These patients included 4 patients with type 1 diabetes mellitus (DM) (T1DM) and 50 patients with type 2 DM (T2DM). According to the difference between predinner and postlunch blood glucose levels, the 50 patients with T2DM were divided into dusk phenomenon group (4 patients, all the differences ≥0 mmol/L during insulin pump therapy), nondusk phenomenon group (12 patients, all the differences <0 mmol/L during insulin pump therapy), and suspicious group (34 patients, the differences were uncertain during insulin pump therapy). In the 4 patients with T1DM of this study, the differences all were more than 0 mmol/L during insulin pump therapy. The changes in blood glucose levels were observed, and the correlations of blood glucose level with other factors were analyzed in T1DM and T2DM patients, respectively.In T1DM patients, blood glucose level was significantly higher in predinner than in prebreakfast and prelunch (all P < 0.01), and in postdinner 2 hour than in postlunch 2 hour (P = 0.021). The predinner blood level had no significant correlations with the blood glucose level at other time points and insulin dosages (all P > 0.05). In T2DM patients, the predinner blood glucose level was significantly higher in dusk phenomenon group than in suspicious group and nondusk phenomenon group (all P < 0.05). In dusk phenomenon group, the blood glucose level remained rising from predinner to prebed, and the predinner blood glucose level was only significantly correlated with postdinner 2-hour blood glucose level (P < 0.05).The “dusk phenomenon” (spontaneous and transient predinner hyperglycemia) is an objective existence in some patients with diabetes. The predinner hyperglycemia can affect blood glucose control between postdinner and prebed. Awareness of the “dusk phenomenon” has important clinical significance.

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Section: Discussionmentioning

confidence: 99%

Spontaneous and transient predinner hyperglycemia in some patients with diabetes

Shi

et al. 2016

Medicine

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“…The duration was assessed by measuring the time interval between the nadir and prebreakfast time points. On the basis of published studies (2,8,9), three definitions were used: an absolute dawn increase in glucose level above either 10 or 20 mg/dL and a relative increase >6.9% (10). The features of the dawn phenomenon as defined by these three criteria were compared among the three groups of subjects investigated.…”

Section: Methodsmentioning

confidence: 99%

Frequency and Severity of the Dawn Phenomenon in Type 2 Diabetes

Monnier¹,

Colette²,

Sardinoux

et al. 2012

Diabetes Care

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OBJECTIVETo know whether age has an independent effect on the dawn phenomenon in noninsulin-using type 2 diabetes.RESEARCH DESIGN AND METHODSEighty-one individuals with type 2 diabetes were matched for HbA1c and divided by age into three subgroups of 27 individuals (1: ≥70 years; 2: 60–69 years; and 3: ≤59 years). All underwent ambulatory continuous glucose monitoring for quantifying the dawn phenomenon (i.e., the absolute [∂G, mg/dL] or relative [∂G%] increments from nocturnal nadirs to prebreakfast time points).RESULTSHbA1c levels and 24-h glycemic profiles were similar across the three groups. Glucose increments (mean ± SEM) were identical in the three groups: ∂G (mg/dL), 22.0 ± 4.7 (1), 21.3 ± 3.6 (2), and 18.0 ± 3.6 (3) and δG (%), 19.9 ± 4.9 (1), 21.6 ± 4.4 (2), and 17.6 ± 4.2 (3). Using the most common definition (∂G >10 mg/dL), the prevalence of the dawn phenomenon was 52, 70, and 59% in groups 1, 2, and 3, respectively.CONCLUSIONSThe dawn phenomenon is present in the elderly.

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“…It is generally believed that dawn phenomenon is a result of pancreas islet beta-cell dysfunction, which involves increased endogenous glucose production, persistent insulin resistance, and hepatic glucose output in people with type 1 diabetes mellitus or T2DM [27, 28]. A study in Chinese people with type 2 diabetes proved that dawn phenomenon is closely associated with obesity and insulin resistance.…”

Section: Resultsmentioning

confidence: 99%

Self-Monitoring of Blood Glucose to Assess Dawn Phenomenon in Chinese People with Type 2 Diabetes Mellitus

Huang

Qiu

et al. 2017

International Journal of Endocrinology

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Aims. We investigated whether self-monitoring of blood glucose could be used to assess dawn phenomenon in Chinese people with type 2 diabetes mellitus (T2DM). Methods. A total of 306 people with T2DM underwent continuous glucose monitoring and self-monitoring of blood glucose for 72 h. A linear model was used to fit the optimal linear formula of the magnitude of dawn phenomenon (ΔDawn) and self-monitoring of blood glucose values. Results. The prevalence of dawn phenomenon was similar within different oral antidiabetic drug groups (42.5%, 31.5%, and 40.9%, P = 0.216). Multiple variable linear regression showed that prebreakfast, prelunch, and predinner glucose measurements were independently and significantly correlated with ΔDawn. The linear formula between ΔDawn and blood glucose was as follows: ΔDawn (mg/dL) = 0.557 × prebreakfast − 0.065 × prelunch − 0.164 × predinner − 20.894 (mg/dL) (adjusted R2 = 0.302, P = 0.000). Conclusions. Dawn phenomenon could be partly assessed by blood glucose self-monitoring in Chinese people with T2DM using the abovementioned formula. The incidence of dawn phenomenon was similar among patients in different oral antidiabetic drug groups.

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Frequency of the Dawn Phenomenon in Type 2 Diabetes: Implications for Diabetes Therapy

Cited by 27 publications

References 32 publications

Spontaneous and transient predinner hyperglycemia in some patients with diabetes

Spontaneous and transient predinner hyperglycemia in some patients with diabetes

Frequency and Severity of the Dawn Phenomenon in Type 2 Diabetes

Self-Monitoring of Blood Glucose to Assess Dawn Phenomenon in Chinese People with Type 2 Diabetes Mellitus

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