Frequency and Severity of the Dawn Phenomenon in Type 2 Diabetes

Monnier, L.; Colette, C; Sardinoux, Mathieu; Baptista, Grégory; Regnier-Zerbib, Alyne; Owens, David R.

doi:10.2337/dc12-0385

Cited by 51 publications

(56 citation statements)

References 12 publications

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“…This is especially the case in those who exhibit the "dawn phenomenon", a spontaneous early-morning rise in blood glucose [18][19][20]. In diabetics being treated with insulin, any pharmacological treatment should be carefully selected and titrated according to both the patient's eating patterns and the physician's own clinical practices.…”

Section: Is Dietary Intake a Major Problem During Ramadan?mentioning

confidence: 99%

New insights on glucose homoeostasis during Ramadan

Monnier¹,

Bonnet²,

Colette³

2015

Diabetes & Metabolism

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Section: Is Dietary Intake a Major Problem During Ramadan?mentioning

confidence: 99%

New insights on glucose homoeostasis during Ramadan

Monnier¹,

Bonnet²,

Colette³

2015

Diabetes & Metabolism

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“…Dawn phenomenon mostly affects children and youth with type 1 diabetes, although it is not rare in subjects with type 2 diabetes (as high as 40%, reported by Monnier et al) [2]. By using a continuous glucose monitoring system, dawn phenomenon could be determined by the difference between nocturnal nadir and prebreakfast glucose levels [2].…”

Section: Introductionmentioning

confidence: 99%

Poor Sleep Quality Is Associated with Dawn Phenomenon and Impaired Circadian Clock Gene Expression in Subjects with Type 2 Diabetes Mellitus

Huang

Wang

et al. 2017

International Journal of Endocrinology

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Aims. We investigated whether poor sleep quality is associated with both dawn phenomenon and impaired circadian clock gene expression in subjects with diabetes. Methods. 81 subjects with diabetes on continuous glucose monitoring were divided into two groups according to the Pittsburgh Sleep Quality Index. The magnitude of dawn phenomenon was quantified by its increment from nocturnal nadir to prebreakfast. Peripheral leucocytes were sampled from 81 subjects with diabetes and 28 normal controls at 09:00. Transcript levels of circadian clock genes (BMAL1, PER1, PER2, and PER3) were determined by real-time quantitative polymerase chain reaction. Results. The levels of HbA1c and fasting glucose and the magnitude of dawn phenomenon were significantly higher in the diabetes group with poor sleep quality than that with good sleep quality. Peripheral leucocytes from subjects with poor sleep quality expressed significantly lower transcript levels of BMAL1 and PER1 compared with those with good sleep quality. Poor sleep quality was significantly correlated with magnitude of dawn phenomenon. Multiple linear regression showed that sleep quality and PER1 were significantly independently correlated with dawn phenomenon. Conclusions. Dawn phenomenon is associated with sleep quality. Furthermore, mRNA expression of circadian clock genes is dampened in peripheral leucocytes of subjects with poor sleep quality.

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“…The glucose level after the first meal (breakfast) (2), and sometimes the Somogyi phenomenon (3) and the dawn phenomenon (4) are the main causes of increased morning glucose levels. In the case of the Somogyi phenomenon, the cause is nocturnal hypoglycemia.…”

Section: Introductionmentioning

confidence: 99%

Investigating the Relationship between Morning Glycemic Variability and Patient Characteristics Using Continuous Glucose Monitoring Data in Patients with Type 2 Diabetes

Takeishi¹,

Mori²,

Kawai³

et al. 2017

Intern. Med.

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Objective To investigate the relationship between patient characteristics and morning glycemic variability. Methods We retrospectively evaluated 106 patients with type 2 diabetes who underwent continuous glucose monitoring during admission. The highest postprandial glucose level (within 3 hours after breakfast; ‘highest level’), the time from the start of breakfast to the highest postprandial glucose level (‘highest time’), the difference between the pre-breakfast and highest postprandial breakfast glucose level (‘increase’), the area under the curve (AUC; ≥180 mg/dL) for the glycemic variability within 3 hours after breakfast (‘morning AUC’), and the post-breakfast glucose gradient (‘gradient’) were calculated. We analyzed the associations between these factors and nocturnal hypoglycemia and the patients’ characteristics by using a regression analysis. Results After stepwise multivariate adjustment, significant independent associations were found between ‘highest level’ and high age, low BMI, and high HbA1c; ‘highest time’ and high HbA1c, low C-peptide immunoreactivity (CPR), and low fasting plasma glucose (FPG); the ‘increase’ and high age, low BMI, high HbA1c, low FPG and hypoglycemia; ‘morning AUC’ and high age, high HbA1c and hypoglycemia; and ‘gradient’ and long duration of diabetes and low BMI. Conclusion Higher age and lower BMI are associated with higher ‘highest’ and ‘increase’ levels. Higher HbA1c levels were linked to a longer ‘highest time’, and longer durations of the diabetes, while lower BMI values were related to a higher ‘gradient’.

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Frequency and Severity of the Dawn Phenomenon in Type 2 Diabetes

Cited by 51 publications

References 12 publications

New insights on glucose homoeostasis during Ramadan

New insights on glucose homoeostasis during Ramadan

Poor Sleep Quality Is Associated with Dawn Phenomenon and Impaired Circadian Clock Gene Expression in Subjects with Type 2 Diabetes Mellitus

Investigating the Relationship between Morning Glycemic Variability and Patient Characteristics Using Continuous Glucose Monitoring Data in Patients with Type 2 Diabetes

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