Increased daytime glucose Rd ( 21.2 [ 19.4 , 23.9 ] vs 18.8 [ 18.3 , 21.7 ] mol/kg/min , P = .002 ) and decreased overnight Rd ( 10.4 [ 9.1 , 12.0 ] vs 11.8 [ 10.7 , 13.7 ] mol/kg/min , P = .005 ) were observed when the usual therapy was discontinued , whereas daytime peripheral insulin sensitivity was reduced ( 47.8 [ 24.8 , 66.1 ] vs 62.5 [ 34.8 , 75.8 ] nmol/kg/min per pmol/L , P = .034 ) .