Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

Which statement about the dawn phenomenon is NOT true?

1. It is a normal physiologic process.

2. The hormonal basis is related to overnight hormone secretion.

3. It usually elevates most morning glucose levels.

4. Insulin pump therapy is effective in controlling the dawn phenomenon.

The correct answer is: Insulin pump therapy is effective in controlling the dawn phenomenon.

The statement about insulin pump therapy being effective in controlling the dawn phenomenon is not true. The dawn phenomenon refers to the natural increase in blood glucose levels that occurs in the early morning hours, typically due to hormonal changes that increase insulin resistance. This phenomenon can result from the secretion of counter-regulatory hormones such as cortisol, glucagon, and epinephrine, which rise in the pre-dawn hours. Insulin pump therapy can provide basal insulin infusion that is adjustable, which is beneficial for individualized insulin management. However, despite these advantages, it may not specifically address the underlying hormonal mechanisms driving the dawn phenomenon. Many individuals may still experience elevated morning glucose levels despite using an insulin pump, indicating that simply adjusting insulin delivery may not be sufficient to counteract this physiological process. In contrast, the dawn phenomenon being a normal physiologic process is a true statement as it reflects typical biological rhythms in the body. The hormonal basis for this phenomenon is well-established, as it relates directly to changes in hormone secretion during the night. Moreover, because it usually elevates most morning glucose levels, this results in challenges in managing blood sugar levels overnight and upon waking.