{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T01:41:40Z","timestamp":1794620500141,"version":"4.9.1"},"reference-count":50,"publisher":"American Diabetes Association","issue":"10","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.diabetesjournals.org\/journals\/pages\/license"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n                  <jats:title\/>\n                  <jats:p>The aim of this study was to establish the contribution of insulin resistance to the morning (a.m.) versus afternoon (p.m.) lower glucose tolerance of people with type 2 diabetes (T2D). Eleven subjects with T2D (mean [SD] diabetes duration 0.79 [0.23] years, BMI 28.3 [1.8] kg\/m2, A1C 6.6% [0.26%] [48.9 (2.9) mmol\/mol]), treatment lifestyle modification only) and 11 matched control subjects without diabetes were monitored between 5:00 and 8:00 a.m. and p.m. (in random order) on one occasion (study 1), and on a subsequent occasion, they underwent an isoglycemic clamp (a.m. and p.m., both between 5:00 and 8:00, insulin infusion rate 10 mU\/m2\/min) (study 2). In study 1, plasma glucose, insulin, C-peptide, and glucagon were higher and insulin clearance lower in subjects with T2D a.m. versus p.m. and versus control subjects (P &amp;lt; 0.05), whereas free fatty acid, glycerol, and \u03b2-hydroxybutyrate were lower a.m. versus p.m. However, in study 2 at identical hyperinsulinemia a.m. and p.m. (\u223c150 pmol\/L), glucose Ra and glycerol Ra were both less suppressed a.m. versus p.m. (P &amp;lt; 0.05) in subjects with T2D. In contrast, in control subjects, glucose Ra was more suppressed a.m. versus p.m. Leucine turnover was no different a.m. versus p.m. In conclusion, in subjects with T2D, insulin sensitivity for glucose (liver) and lipid metabolism has diurnal cycles (nadir a.m.) opposite that of control subjects without diabetes already at an early stage, suggesting a marker of T2D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Article Highlights<\/jats:title>\n                  <jats:p>In people with type 2 diabetes (T2D), fasting hyperglycemia is greater in the morning (a.m.) versus the afternoon (p.m.), and insulin sensitivity for glucose and lipid metabolism is lower a.m. versus p.m. This pattern is the reverse of the physiological diurnal cycle of people without diabetes who are more insulin sensitive a.m. versus p.m. These new findings have been observed in the present study in people without obesity but with recent-onset T2D, with good glycemic control, and in the absence of confounding pharmacological treatment. It is likely that the findings represent a specific marker of T2D, possibly present even in prediabetes before biochemical and clinical manifestations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/db22-0721","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T19:09:05Z","timestamp":1689275345000},"page":"1364-1373","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":11,"title":["Diurnal Cycling of Insulin Sensitivity in Type 2 Diabetes: Evidence for Deviation From Physiology at an Early Stage"],"prefix":"10.2337","volume":"72","author":[{"given":"Paola","family":"Lucidi","sequence":"first","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Perriello","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9291-6734","authenticated-orcid":false,"given":"Francesca","family":"Porcellati","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Pampanelli","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelantonio","family":"De Fano","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3466-5900","authenticated-orcid":false,"given":"Andrea","family":"Tura","sequence":"additional","affiliation":[{"name":"2CNR Institute of Neuroscience, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-4003","authenticated-orcid":false,"given":"Geremia B.","family":"Bolli","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-158X","authenticated-orcid":false,"given":"Carmine G.","family":"Fanelli","sequence":"additional","affiliation":[{"name":"1Section of Endocrinology and Metabolism, Department of Medicine and Surgery, University of Perugia Medical School, Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"2023092018510821700_B1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.mce.2015.01.024","article-title":"Circadian rhythms in glucose and lipid metabolism in nocturnal and diurnal mammals","volume":"418","author":"Kumar Jha","year":"2015","journal-title":"Mol Cell Endocrinol"},{"key":"2023092018510821700_B2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.metabol.2017.11.017","article-title":"Circadian regulation of glucose, lipid, and energy metabolism in 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