The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
The “Dawn-Phenomenon” – a common occurrence in both non-insulin-dependent and insulin-dependent diabetes mellitus
Abstract
The dawn phenomenon is a condition recently described in patients with insulin-dependent diabetes mellitus (IDDM) that is characterized by abrupt increases in fasting levels of plasma glucose or insulin requirements or both between 5 and 9 a.m., in the absence of antecedent hypoglycemia. To determine its potential clinical relevance, we assessed its frequency and reproducibility in 20 patients with IDDM and in 13 patients with non-insulin-dependent diabetes mellitus (NIDDM) during overnight closed-loop (feedback-controlled) intravenous insulin infusion. After 6 a.m., plasma glucose levels increased similarly in NIDDM (89 +/- 2 mg per deciliter, midnight to 6 a.m., vs. 98 +/- 2 mg per deciliter, 6 to 9 a.m.; P less than 0.01). Insulin requirements increased at least 50 per cent for 1 1/2 hours in 77 per cent of patients with NIDDM and in 75 per cent of patients with IDDM. In five patients with IDDM who were studied on four occasions, the phenomenon occurred during 17 of the 20 observation periods, with insulin requirements after 6 a.m. increasing 225 +/- 34 per cent; coefficients of variation in individual patients ranged from 4 to 25 per cent. Thus, the dawn phenomenon occurs commonly in both NIDDM and IDDM, but its potential variability must be taken into consideration when one is attempting to adjust insulin doses.
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“A similar situation occurs in humans; before waking, glucose production and glucose concentrations are increased while at the same time glucose utilization is high [61].”
From Circadian control of glucose metabolism (2014) · cites this paper as [61]
Citations
Cites
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Cited by
Sorted by citations
Roles of Circadian Rhythmicity and Sleep in Human Glucose Regulation
Cauter, E. V., Polonsky, K. S., & Scheen, A. J. (1997) · Endocrine Reviews · doi:10.1210/edrv.18.5.0317 · Cited by 632
Circadian clock control of endocrine factors
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Monnier, L., Colette, C., Dunseath, G. J., & Owens, D. R. (2007) · Diabetes Care · doi:10.2337/dc06-1612 · Cited by 490
A Daily Rhythm in Glucose Tolerance
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Metadata
- Authors
- Bolli, G. B., & Gerich, J. E.
- Affiliations
- Mayo Clinic (US)
- ORCID
- Bolli, Geremia B.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1984-03-22
- Volume
- 310
- Issue
- 12
- Pages
- 746-750
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2317353168
- Cited by
- 235
- References
- 21
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 9 · 2015: 7 · 2014: 16 · 2013: 7 · 2012: 6
- FWCI
- 10.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pancreatic function and diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- dawn phenomenon, type 1 diabetes, type 2 diabetes, insulin requirement, fasting blood glucose, nocturnal glucose, insulin dose adjustment
- MeSH terms
- Adult, Blood Glucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Insulin, Insulin Infusion Systems, Male, Middle Aged, Time
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