The Dawn Phenomenon: An Unpredictable Cause for Fasting Hyperglycemia

Abstract

Objective: The Dawn Phenomenon (an early morning rise in blood glucose) is a major cause of poor glucose control in diabetic patient's .Its variable occurrence precludes the automatic addition of extra insulin to counteract it.  Being able to predict its occurrence from easily obtained demographic and glycemic parameters would be of great benefit to diabetic patients. Our study examined the predictability of the Dawn Phenomenon in type 1 diabetic individuals.

Research design and methods: We studied 39 Type 1 diabetes volunteers on multiple nights (376) in order to quantitate and characterize the Dawn Phenomenon using Continuous Glucose Monitoring for a maximum of five continuous days per individual. We correlated the occurrence of the Dawn Phenomenon with 10 different variables obtained from both demographic and continuous glucose monitoring data. Regression analysis was used for continuous variables whereas an analysis of variance was used for categorical variables. Significance was set at p<0.05.

Results: The Dawn Phenomenon occurred on 46% of the monitored nights. In contrast to a previous report, we were unable to identify any parameters that demonstrated a clinically significant predictability of the occurrence of the Dawn Phenomenon.

Conclusion: Our data suggests that the Dawn Phenomenon is not predictable from commonly measured variables