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Somogyi Effect Vs Dawn Phenomenon Usmle

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Somogyi Effect And Dawn Phenomenon In Diabetes

So I read a lot of interesting things today and I'm formulating questions based on it. A person took too much insulin at night and went to sleep. He checks his morning blood sugar levels and it's elevated. Why? It's because stress hormones were released while he was asleep which caused the hyperglycemia. (This is called Somogyi effect!) Now, a person took his appropriate dose of insulin at night and went to sleep. He checks his morning blood sugar levels and it's elevated. What happened this time? There is a normal hormone surge at 7 am (Growth hormone, cortisol, glucagon and epinephrine) which caused the hyperglycaemia. This is called dawn phenomenon. How will you differentiate Somogyi effect from dawn phenomenon? Why is this clinically relevant? I guess the person with Somogyi effect will have certain signs and symptoms related to hypoglycemia. For instance, night terrors. Right? People with hypoglycemia don't wake up but have nightmares. The 3 am glucose levels to be precise. It is low in Somogyi effect and maybe normal or high in dawn phenomenon. You'll decrease NPH insulin at night in the former and increase the NPH insulin dose in the latter. NPH is an intermediate acting ins Continue reading >>

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Popular Questions

  1. bangbong2000

    I guess they have to give us tips in the question like in case of somogyi pt morning hyperglycemia not improving with restriction of carbohydrate food before bed... Anyone can give me more idea?

  2. sonu.agarwall

    i read abt it somewer man....not sure wer....sum wer in my final year texts.....will post as soon as i find it....somogyi is sumthing in middle of night due to medications n dawn phenomenon is in early mrng related to counter regulatory hormones...sumthing like that

  3. docnas

    somogyi = rebound hyperglycemia due to hypoglycemia because of too much insulin given before sleeping
    dawn phenom is due to homones being released according to circadian rhythm main hormone noted is GH. this causes a hyperglycemic state.

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