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Question 14: A 33-year-old woman was reviewed in the insulin pump clinic. She had had type 1 diabetesmellitus for 10 years. She had been treated with a continuous subcutaneous insulin infusion 3 years
previously, because of frequent hypoglycaemic episodes. She had recently undergone continuous
glucose monitoring (see image).
Investigations:
haemoglobin A1c43 mmol/mol (20-42)
What is the most likely cause of the blood glucose trace seen between 08.00 h and 10.00 h?
A. blocked infusion set
B. dawn phenomenon
C. inadequate basal insulin rate
D. inadequate mealtime insulin bolus
E. overcorrection of hypoglycaemia
Correct Answer: D
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