The Circadian Study:
The Get-Up Phenomenon in Type 1 Diabetes
- Guido Freckmann, MD1,
- Lois Jovanovic, MD2,
- Annette Baumstark, PHD1,
- Cornelia Haug, MD1 and
- Wim van der Helm, MD3
- 1Institute for Diabetes Technology at the University of Ulm, Ulm, Germany
- 2Sansum Diabetes Research Institute, Santa Barbara, California
- 3Disetronic Medical Systems AG, Burgdorf, Switzerland
- Corresponding author: Guido Freckmann, guido.freckmann{at}uni-ulm.de
Continuous subcutaneous insulin infusion (CSII) is the most advanced form of insulin administration in patients with type 1 diabetes. CSII can be initiated by one basal rate, providing the same amount of insulin every hour for the whole day, or by multiple basal rates providing a circadian variation of basal insulin with an increased infusion rate in the morning and evening hours (1). A circadian basal rate is considered to be closer to physiology and therefore to result in better glycemic control. Improved glycemia is thought to result mainly from an increase in insulin delivery in the early morning hours to antagonize the dawn phenomenon (2–4).
Individual adaptation of basal rates is time-consuming and frequently …
