It is not unsual to observe that a diabetic patient excretes large amounts of sugar before breakfast whereas the urine is sugar-free or nearly so during the remainder of the day. It is well known that reactions to insulin are more common during the afternoon or evening than at other times of the day, provided the amounts of insulin taken before meals are similar. In order to keep diabetic patients sugar-free, particularly the ones with severe diabetes, it is often necessary to give more insulin in the morning than at noon or at night.
The curves for the blood sugar and the sugar excreted following the dextrose test meal suggest the use of insulin before each meal and lead one to expect similar results from like amounts of insulin regardless of time of day. The previously mentioned observations indicate that this expectation is not uniformly met. Apparently the postprandial rise
ROGERS FL. DAILY VARIATION OF SUGAR CONTENT OF BLOOD AND URINE DURING TREATMENT OF DIABETES MELLITUS. Arch Intern Med (Chic). 1936;57(5):1027-1031. doi:10.1001/archinte.1936.00170090192013