Copyright © 2006 American Medical Association. All rights reserved. From: Assessing Glycemia in Diabetes Using Self-monitoring Blood Glucose and Hemoglobin A1c JAMA. 2006;295(14):1688-1697. doi:10.1001/jama.295.14.1688 Figure Legend: Sample data downloaded from blood glucose meters over the 90 days prior to the visit. In panel A, the patient clearly has good glycemic control during the day but levels are high between about 5 and 7 AM. This illustrates the “dawn phenomenon,” in which hyperglycemia occurs in the dawn hours. In panel B, the patient tests regularly 3 times daily and has much better, more stable glucose levels in the morning than at noon or at 5 PM, when the level is higher and more variable. Regimen adjustment could include more daytime insulin or oral agent coverage or modification of dietary intake. Date of download: 10/27/2017 Copyright © 2006 American Medical Association. All rights reserved.

Copyright © 2006 American Medical Association. All rights reserved. From: Assessing Glycemia in Diabetes Using Self-monitoring Blood Glucose and Hemoglobin A1c JAMA. 2006;295(14):1688-1697. doi:10.1001/jama.295.14.1688 Figure Legend: Glycemic control is clearly worse throughout the month of March. The patient started a better nutritional plan in April and the results are evident. Discussion with the patient could include lessening antidiabetic treatment to avoid hypoglycemia. Date of download: 10/27/2017 Copyright © 2006 American Medical Association. All rights reserved.