Glucose Ra increased during the day ( 21.4 [ 19.5 , 23.5 ] vs 18.6 [ 17.0 , 21.6 ) mol/kg/min , P = .019 ) and decreased overnight ( 9.7 [ 8.5 , 11.4 ] vs 11.6 [ 10.3 , 12.9 ] mol/kg/min , P = .004 ) when the usual therapy was discontinued and replaced with insulin .