The dawn phenomenon in type 2 diabetes: its association with glucose excursions and changes after oral glucose-lowering drugs

doi:10.1177/20406223211033674

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24056

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24056

Title:	The dawn phenomenon in type 2 diabetes: its association with glucose excursions and changes after oral glucose-lowering drugs
Authors:	Wang, JS;Lee, IT;Lee, WJ;Lin, SD;Su, SL;Tu, ST;Lin, SY;Sheu, WHH
Keywords:	continuous glucose monitoring;dawn phenomenon;glucose excursions;type 2 diabetes
Date:	2021
Issue Date:	2022-08-05T09:47:07Z (UTC)
Publisher:	SAGE PUBLICATIONS LTD
ISSN:	2040-6223
Abstract:	Background: We investigated the association between glucose excursions and the dawn phenomenon, and the effects of oral-glucose lowering drugs on the dawn phenomenon in patients with type 2 diabetes (T2D). Methods: We conducted a post hoc analysis using data from a previous randomized trial. Patients with T2D on metformin monotherapy were randomized to receive add-on acarbose or glibenclamide for 16 weeks. Ambulatory continuous glucose monitoring (CGM) was conducted before randomization and at the end of the study. Using the CGM data, we assessed glucose excursions as indicated by mean amplitude of glycemic excursions (MAGE). The magnitude of the dawn phenomenon was calculated as the difference between the nocturnal nadir (0:00 to 6:00 a.m.) and prebreakfast glucose level. Results: A total of 50 patients with T2D [mean age 53.5 +/- 8.2 years, mean glycated hemoglobin (HbA1c) 8.4 +/- 1.2%] were analyzed. There was an independent association between MAGE and the dawn phenomenon [beta coefficient 0.199, 95% confidence interval (CI) 0.074-0.325, p = 0.003]. HbA1c improved significantly after treatment with acarbose or glibenclamide. However, only treatment with acarbose significantly improved glucose excursions. The dawn phenomenon decreased significantly only in patients treated with acarbose (from 35.9 +/- 15.7-28.3 +/- 16.5 mg/dl, p = 0.037), but not in those treated with glibenclamide (from 35.9 +/- 20.6-34.6 +/- 17.0 mg/dl, p = 0.776). Conclusion: Glucose excursions were independently associated with the dawn phenomenon in patients with T2D on metformin monotherapy. Both glucose excursions and the dawn phenomenon improved after treatment with acarbose, but not after treatment with glibenclamide.
URI:	http://dx.doi.org/10.1177/20406223211033674 https://www.webofscience.com/wos/woscc/full-record/WOS:000694880700001 https://ir.csmu.edu.tw:8080/handle/310902500/24056
Relation:	THERAPEUTIC ADVANCES IN CHRONIC DISEASE ,2021,v12
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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