{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:28:00Z","timestamp":1787740080304,"version":"build-2784847793"},"reference-count":23,"publisher":"American Diabetes Association","issue":"12","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":2845,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,12,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To assess the magnitude of the dawn phenomenon and its impact on the total glucose exposure in type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A total of 248 noninsulin-treated persons with type 2 diabetes who underwent continuous glucose monitoring were divided into three groups selected by treatments: diet alone (n = 53); insulin sensitizers alone (n = 82); and insulin secretagogues alone or in combination with insulin sensitizers (n = 113). The dawn phenomenon (\u2202 glucose, mg\/dL) was quantified by its absolute increment from nocturnal nadir to prebreakfast value. The participants were secondarily divided into two paired subsets after they had been separated by the presence\/absence of a dawn phenomenon based on a threshold of 20 mg\/dL and matched for glucose nadir. The impact of the dawn phenomenon was assessed on HbA1c and 24-h mean glucose.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The median of \u2202 glucose (interquartile range) was 16.0 (0\u201331.5 mg\/dL) in the 248 subjects, and no differences were observed across groups selected by HbA1c or treatments. In the overall population, the mean impacts on HbA1c and 24-h mean glucose were 4.3 \u00b1 1.3 mmol\/mol (0.39 \u00b1 0.12%) and 12.4 \u00b1 2.4 mg\/dL, respectively. The mean impact on 24-h mean glucose was not statistically different between those on diet alone (16.7 \u00b1 5.9 mg\/dL) compared with the two subsets treated with oral hypoglycemic agents (11.2 \u00b1 5.3 and 8.5 \u00b1 7.5 mg\/dL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The impact of the dawn phenomenon on overall glycemic control in type 2 diabetes, as depicted by the HbA1c level, was \u223c0.4% and not eliminated by any of the currently available armamentarium of oral antidiabetes agents.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc12-2127","type":"journal-article","created":{"date-parts":[[2013,10,30]],"date-time":"2013-10-30T02:53:21Z","timestamp":1383101601000},"page":"4057-4062","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":96,"title":["Magnitude of the Dawn Phenomenon and Its Impact on 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