This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Iatrogenic hypoglycemia, particularly nocturnal hypoglycemia, is the limiting factor in the glycemic management of diabetes (Cryer et al, Diabetes Care 26:1902, 2003). Using the nocturnal nadir plasma glucose concentration as the primary endpoint, we plan to contrast three bedtime treatments that have been reported to be effective - terbutaline, cornstarch, acarbose - with the standard treatment, a conventional bedtime snack, and no treatment in patients with type 1 diabetes who are managing their diabetes aggressively as evidenced by a HbA1c of <=8.0% and a goal of morning self-monitoring of blood glucose values <=120mg/dL. Patients will be sampled during five overnight GCRC stays with the bedtime treatments given in random sequence.
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