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Roles of Circadian Rhythmicity and Sleep in Human Glucose Regulation¹

Department of Medicine, University of Chicago, Chicago, Illinois 60637; and Division of Diabetes, Nutrition and Metabolic Disorders, University of Liège, Liège, Belgium B-4000

I. Introduction

II. Characteristics and Causal Mechanisms of 24-h Rhythms of Glucose Regulation in Normal Young Subjects

A. 24-h variations in glucose tolerance

B. Causal mechanisms

III. Alterations of 24-h Rhythms of Glucose Regulation in Normal Aging

A. Daytime variations in glucose tolerance

B. Nighttime variations in glucose tolerance

C. Respective roles of sleep and time of day

D. Significance and clinical implications

IV. Diurnal Variations of Glucose Regulation in Obesity

A. Daytime variations in glucose tolerance

B. Nighttime variations in glucose tolerance

C. Significance and clinical implications

V. Alterations in 24-h Rhythmicity of Glucose Regulation in Non-Insulin-Dependent Diabetes Mellitus (NIDDM)

A. Alterations in daytime variations in glucose tolerance

B. Alterations in nighttime variations in glucose levels during fasting

C. Significance and clinical implications

VI. Alterations in 24-h Rhythmicity of Glucose Regulation in Insulin-Dependent Diabetes Mellitus (IDDM)

A. Alterations in daytime variations in glucose tolerance

B. Alterations in nighttime variations in glucose tolerance

C. Significance and clinical implications

VII. Conclusions