OBJECTIVE: Continuous subcutaneous insulin infusion (CSII) programming for an early morning @entity101 is frequently recommended to counteract the rise in @entity413 prior to breakfast (dawn phenomenon). However, both the effectiveness and safety of this approach have not been tested in the ambulatory setting. Using continuous @entity413 monitoring, we investigated the safety and effectiveness of early morning CSII programming for management of the dawn phenomenon in subjects with type 1 @entity6 . METHODS: We conducted a controlled, observational, 8-month longitudinal study of type 1 @entity6 @entity1 (N = 40). Reproducibility of the dawn phenomenon was determined in subjects treated with multiple daily injections of insulin (n = 12) and those on CSII who did not program an early morning @entity101 (CSII nonprogrammers; n = 8). The effects of early morning CSII programming were determined by comparing rates of the dawn phenomenon and @entity4053 in CSII nonprogrammers versus CSII users who programmed an early morning @entity101 (CSII programmers; n = 20). RESULTS: The dawn phenomenon occurred in all tested subjects to a variable extent (median rate, 56% of nights). CSII programming was not associated with a reduction in the occurrence of the dawn phenomenon (42%) compared to nonprogrammers (48%) (P = .47) nor in the magnitude of the dawn phenomenon. @entity4053 occurred more frequently in the CSII programmers (37%) compared with nonprogrammers (18%) (P = .001). CONCLUSION: The dawn phenomenon occurs unpredictably; therefore, early morning CSII programming for a fixed increase in early morning insulin delivery is ineffective and may be hazardous to the @entity1 .

The effectiveness and risks of programming an insulin pump to counteract the dawn phenomenon in type 1 XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity101 :: ('MESH:D006973', 'Disease') :: ['increase in insulin delivery'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetic', 'diabetes'] @entity4053 :: ('MESH:D007003', 'Disease') :: ['hypoglycemia', 'Hypoglycemia'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity6 :: (MESH:D003920,Disease) :: ['diabetes']
