Dawn Phenomenon Somogyi Effect

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Somogyi Effect

Ads by Google Fasting can elevate cortisol levels, which in turn raises blood sugar. So, for someone with blood sugar regulation issues such as diabetes, fasting may make their blood glucose worse. What is Somogyi effect? Somogyi phenomenon is due to your body’s reaction to midnight hypoglycemia. Since the patient is sleeping, they don’t feel the hypoglycemic symptoms such as tiredness, shakiness, tremors, or confusion. This low blood sugar is undesirable. Thus your body reacts to this with an overshoot of counterregulatory hormones such as glucagon, epinephrine, growth hormone, and cortisol. It makes the liver to dump hepatic glucose, which raises morning blood glucose level even up to 300s. Additionally, counter-regulatory hormones may cause insulin resistance for about 12 to 48 hours. Fasting blood sugar level is elevated in reaction to the preceding low. Thus Somogyi effect is also called as rebound hyperglycemia. The patient is succumbed to increase the insulin dose still more; this leads to further more hypoglycemic episodes. A vicious circle leads to increase, and increased insulin doses occur with extremely unstable and brittle diabetes. High dose insulin / Missed meals Continue reading >>

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Popular Questions

  1. scottish_beekeeper

    I've been diabetic for 25 years, but in the last 5 or so years have had problems with both of the above. I started out waking up very high, and increased my overnight basal as a result, only for it to get higher! Eventually, with CGMS, we discovered that my sugar was dropping to a hypo level around 1am, staying there til 5 or 6, then bouncing back to between 13 and 20 by 8am - the Somogyi effect.
    A combination of changes in insulin (from lantus/novorapid to levemir/apidra) and closer monitoring has got me away from the night-time lows, but I now have extremely erratic morning levels - a 'good' morning is to be around 10-12mmol/l (180-220) but most mornings it can be 15 (270) or more - the Dawn Phenomenon.
    Either way, it keeps on rising over the morning, and I'm taking a large dose of insulin over and above my breakfast dose to try to keep it level, and it leaves me feeling rough for the rest of the day til late afternoon usually.
    I've tried changes in insulin doses, diet, and even trying to wake up earlier and get my morning insulin in 'sooner' but without much luck (with support from my diabetic health team). I'm interested to know if anyone else has experienced the same situation, and if they've had any luck with any particular approaches?

  2. Wdc331

    Is a pump possible? I had horrible Issues work DP, and the pump cured it. Had to spend a couple of months to find the appropriate overnight basal rates, but I did and I now generally wake up under 130.

  3. scottish_beekeeper

    I'm looking into it - I think I can get on a scheme for one, but there'll be a waiting list...

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