from the sequence of events observed , we conclude that the dawn phenomenon in iddm begins earlier than is currently thought ( approximately 3:30 am ) , that it is due to both accelerated glucose production and impaired glucose utilization , and that nocturnal increases in sympathetic nervous system activity and/or growth hormone secretion , but not changes in secretion of cortisol , adrenaline and glucagon or changes in insulin clearance , may be of pathogenetic importance .
C0011854
iddm
C0021641
insulin