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How Do You Assess For Somogyi Phenomenon?

Szkolenie Podyplomowe/postgraduate Education

Szkolenie Podyplomowe/postgraduate Education

Endokrynologia Polska/Polish Journal of Endocrinology Tom/Volume 62; Numer/Number 3/2011 ISSN 0423–104X The dawn phenomenon and the Somogyi effect — two phenomena of morning hyperglycaemia Zjawisko brzasku i efekt Somogyi — dwa zjawiska porannej hiperglikemii Malwina Rybicka, Robert Krysiak, Bogusław Okopień Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland Abstract Morning hyperglycaemia in diabetic subjects may be caused by the dawn phenomenon, or the Somogyi effect, or poor glycaemic control. The dawn phenomenon occurs when endogenous insulin secretion decreases or when the effect of the exogenous insulin administered to the patient the day before disappears, together with a physiological increase in insulin-antagonistic hormones. The Somogyi effect is present in the case of excessive amounts of exogenous insulin. The dawn phenomenon is more common than the Somogyi effect. To diagnose these phenomena, it is useful to measure plasma glucose levels for several nights between 3 a.m. and 5 a.m. or use a continuous glucose monitoring system. Although their treatment differs, the best way of preventing both the dawn phenomenon and the Somogyi effect is an optimal diabetes control with insulin therapy. (Pol J Endocrinol 2011; 62 (3): 276–283) Key words: morning hyperglycaemia, dawn phenomenon, Somogyi effect Streszczenie Poranna hiperglikemia wśród pacjentów z cukrzycą może być spowodowana zjawiskiem brzasku, efektem Somogyi lub złą kontrolą glikemii. Zjawisko brzasku pojawia się, gdy zmniejsza się wydzielanie endogennej insuliny lub gdy skończy się działanie podanej pa- cjentowi egzogennej insuliny łącznie z fizjologiczny Continue reading >>

The Somogyi Effect - Rebound Hyperglycemia

The Somogyi Effect - Rebound Hyperglycemia

If there were a diabetes spelling bee, one of the real stumpers would be "Somogyi." At some point in learning about diabetes care you're likely to come across this word in reference to the Somogyi effect, sometimes known as "rebound hyperglycemia." Named for the Hungarian physician who first described it in 1938, the Somogyi effect occurs when blood sugar (glucose) levels drop too low during the night, causing the body to overcompensate, resulting in a blood sugar spike in the morning. What Causes the Somogyi Effect? The Somogyi "rebound" effect is usually triggered either by an excessive dose of insulin at night or neglecting to eat a pre-bedtime snack. Both of these oversights can cause blood sugar to drop too low in the middle of the night, usually without symptoms. In fact, it is possible to sleep right through such an episode of hypoglycemia. During sleep, the body reacts to the low blood sugar levels by releasing hormones that prompt the liver to release glucose into the bloodstream. These hormones then prevent the glucose from being absorbed and blood sugar levels stay high. Morning hormones also drive higher levels of glucose -- this is known as the dawn phenomenon. Within a very short period of time, the body has gone from hypoglycemia to hyperglycemia -- all while sleeping. Note that most morning hyperglycemia is the result of overnight hypoinsulinemia (abnormally low insulin) and most people will therefore need additional insulin. The Somogyi effect is not without controversy. Research finds that it is rarer than it is generally thought to be, and there is dispute about what its causes may be. Low fasting blood glucose happens more often after silent nocturnal hypoglycemia, according to a paper published in 2013. The cases where the blood sugar level was high Continue reading >>

Acute Complications Of Diabetes Mellitus

Acute Complications Of Diabetes Mellitus

1. Acute Complications of Diabetes -Reshma Ann Mathew 2. DIABETES It is a GROUP of metabolic disease characterised by chronic hyperglycemia with DISTURBANCE in the carbohydrate, fat & protein metabolism resulting from DEFECTS in insulin secretion, insulin action or both . 3. Pancreas beta cells Insulin actions Glucose entry and utilization (oxidation, storage) Glucose entry and oxidation TG synthesis Normal glucose and fat metabolism 4. Pancreas beta cells Insulin actions Glucose entry and utilization (oxidation, storage) Glucose entry and oxidation TG synthesis Metabolic consequences of insulin deficiency/resistance 5. Clinical Features of DM due to insulin lack Polyphagia (decr. leptin?) Starvation in the midst of plenty Hyperosmolar hyperglycemic syndrome (HHS) Lactic acidosis Lactic acidosis Muscle protein breakdown Acetoacetate,0H-butyrate, acetone 6. • Insulin level increases when? a) Glucose administered by mouth (food intake) b) Glucose given by IV (glucose infusion) c) No difference 7.  CLASSIFICATION 1) Type 1 2) Type 2 3) Other specific types 4) Gestational diabetes 8. DIABETIC KETOACIDOSIS • It is a MEDICAL emergency • PRINCIPALLY seen in type 1 diabetes • Mortality- • CHILDREN & ADOLESCENTS- cerebral edema • ADULTS- hypokalemia, acute respiratory distress syndrome & co-morbid conditions 9.  PATHOPHYSIOLOGY Insulin Counterregulatory hormones Glucagon, Epinephrine, Cortisol, Growth hormone NORMAL 10. EXCESS counterregulatory hormones Insulin DEFICIENCY DKA 11. Insulin Deficiency Glucose uptake Proteolysis Lipolysis Amino Acids Glycerol Free Fatty Acids Gluconeogenesis Glycogenolysis Hyperglycemia Hepatic Ketogenesis Metabolic Acidosis Osmotic diuresis Dehydration & electrolyte loss Excess counterregulatory hormones Forces H+ ions into cells Continue reading >>

Diabetic Complications

Diabetic Complications

Diabetes mellitus is a disease of glucose dysregulation secondary to relative insulin resistance (non-insulin dependent diabetes mellitus) or an absolute insulin deficiency (insulin dependent diabetes mellitus). The pathophysiology and management of uncomplicated diabetes mellitus is too involved to describe here. Most veterinarians feel comfortable diagnosing diabetes mellitus in dogs and cats, and the diagnostics are straightforward and easy to interpret. Currently the options for long acting insulin include glargine, humulin N, detemir, porcine zinc (Vetsulin™) and protamine zinc (ProZinc™). Most of these products are human recombinant insulins. No insulin type has been definitively shown to be better than another in a single species. Several small studies within the last 4 years have suggested, however, that glargine and detemir may achieve better glycemic control and remission rates in cats when compared to humulin N and protamine zinc insulins. Several excellent resources to turn to for more information include Feline Internal Medicine (August JR 2010), Textbook of Veterinary Internal Medicine (Ettinger SJ, Feldman EC 2010), Current Veterinary Therapy XIII, XIV (Bonagura JD, Twedt DC 2009). Table 1 compares the most commonly used long acting insulins in dogs and cats. Table 1. Comparison of different types of insulin most commonly used in dogs and cats. Insulin Syringe Source Dose Humulin N u-100 Human recombinant Dogs and cats 0.1-0.2 u/kg q 12 hr Protamine Zinc, ProZinc™ u-40 Human recombinant Cats only 0.2 – 0.7 u/kg q 12 hr Glargine, Lantus ™ u-100 Synthetic 0.25 – 0.5 u/kg q12 hr Detemir , Levemir ™ u-100 Human recombinant Cats 0.25 – 0.5 u/kg q 12hr Dogs 0.1 – 0.2 u/kg q 12 hr Porcine Zinc, Vetsulin ™ u-40 Porcine Cats 1 – 2 u/kg q 12hr Continue reading >>

Nclex-rn: Medicalsurgical Nursing

Nclex-rn: Medicalsurgical Nursing

MedicalSurgical Nursing: Endocrine System MedicalSurgical Nursing: Pancreas Disorders MedicalSurgical Nursing: Diabetes Mellitus (Types 1 and 2) Definition: A group of disorders that have a variety of genetic causes, but have glucose intolerance as a common thread. Type 1insulin-dependent diabetes mellitus with beta cell destruction or defect in function affects about 5% of all diabetics. a. Immune mediatedpresence of islet cell or insulin antibodies that identify the autoimmune process leading to beta cell destruction. b. Idiopathicno evidence of autoimmunity. Type 2noninsulin-dependent diabetes mellitus is the most common. Results when body produces insufficient insulin or there is insulin resistance with relative insulin deficiency. Affects 90% of all diabetics. Twenty-one million Americans have type 2 and 41 million are prediabetic. a. Type 2 accounts for half of all cases in young people. b. Incidence in young has risen dramatically last 10 years. Type 3Gestational (GDM)increased blood glucose levels during pregnancy. Type 4Other specific typesgenetic defects of beta-cell function or insulin action, pancreatic diseases, endocrinopathies, or drug- or chemical-induced diabetes. a. Rapid onsetrequires insulin due to absence of circulating insulin. c. Presence of anti-islet cell antibodies. Type 2 (noninsulin-dependent), formerly adult-onset type. a. Gradual onsetmay be controlled by diet. b. Ninety percent of diabetes cases are this type. c. Impaired beta-cell response to glucose (client usually nonobese). d. Tissues insensitive to insulin (client usually obese). (2) Normal or high levels of circulating insulin. C. Somogyi phenomenon. Hypoglycemia usually at night followed by compensatory rebound hyperglycemia in the morning (lasts 1272 hours). Usually caused by too Continue reading >>

Dawn Phenomenon And The Somogyi Effect - Overview

Dawn Phenomenon And The Somogyi Effect - Overview

The dawn phenomenon and the Somogyi effect cause high blood sugar levels, especially in the morning before breakfast, in people who have diabetes. The dawn phenomenon is a normal rise in blood sugar as a person's body prepares to wake up. In the early morning hours, hormones (growth hormone, cortisol, and catecholamines) cause the liver to release large amounts of sugar into the bloodstream. For most people, the body produces insulin to control the rise in blood sugar. If the body doesn't produce enough insulin, blood sugar levels can rise. This may cause high blood sugar in the morning (before eating). If the blood sugar level drops too low in the early morning hours, hormones (such as growth hormone, cortisol, and catecholamines) are released. These help reverse the low blood sugar level but may lead to blood sugar levels that are higher than normal in the morning. An example of the Somogyi effect is: A person who takes insulin doesn't eat a regular bedtime snack, and the person's blood sugar level drops during the night. The person's body responds to the low blood sugar by releasing hormones that raise the blood sugar level. This may cause a high blood sugar level in the early morning. The Somogyi effect can occur any time you or your child has extra insulin in the body. To sort out whether an early morning high blood sugar level is caused by the dawn phenomenon or Somogyi effect, check blood sugar levels at bedtime, around 2 a.m. to 3 a.m., and at your normal wake-up time for several nights. A continuous glucose monitor could also be used throughout the night. If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect. If the blood sugar level is normal or high at 2 a.m. to 3 a.m., it's likely the dawn phenomenon. Continue reading >>

Pubpdf - Find Full Text Journal Articles About Somogyi Phenomenon

Pubpdf - Find Full Text Journal Articles About Somogyi Phenomenon

Orv Hetil 2017 Aug;158(34):1323-1330 Jnos Szabad Cells feel good and carry on perfect functions when they contain the right types of proteins in the right concentration, at the right time and sites. There are mechanisms that ensure the right level of gene expression in the different cell types: the formation of protein molecules based on the DNA-encoded genetic information. Gene expression can also be regulated through the compactness of chromatin, i. View Full Text PDF Listings View primary source full text article PDFs. J Feline Med Surg 2016 Aug 4;18(8):587-96. Epub 2015 Jun 4. Kirsten Roomp , Jacquie Rand Rebound hyperglycaemia (also termed Somogyi effect) is defined as hyperglycaemia caused by the release of counter-regulatory hormones in response to insulin-induced hypoglycaemia, and is widely believed to be common in diabetic cats. However, studies in human diabetic patients over the past quarter century have rejected the common occurrence of this phenomenon. Therefore, we evaluated the occurrence and prevalence of rebound hyperglycaemia in diabetic cats. View Full Text PDF Listings View primary source full text article PDFs. PLoS One 2014 18;9(3):e91541. Epub 2014 Mar 18. Tams Juhsz , Csaba Matta , va Katona , Csilla Somogyi , Roland Takcs , Pl Gergely , Lszl Csernoch , Gyorgy Panyi , Gbor Tth , Dra Regldi , Andrea Tams , Rza Zkny Pituitary adenylate cyclase activating polypeptide (PACAP) is an important neurotrophic factor influencing differentiation of neuronal elements and exerting protecting role during traumatic injuries or inflammatory processes of the central nervous system. Although increasing evidence is available on its presence and protecting function in various peripheral tissues, little is known about the role of PACAP in formation of skeletal comp Continue reading >>

Somogyi Phenomenon

Somogyi Phenomenon

Overview In the 1930s, Dr. Michael Somogyi speculated that hypoglycemia during the late evening induced by insulin could cause a counterregulatory hormone response (see the image below) that produces hyperglycemia in the early morning. [1] This phenomenon is actually less common than the dawn phenomenon, which is an abnormal early morning increase in the blood glucose level because of natural changes in hormone levels. [2, 3, 4] Debate continues in the scientific community as to the actual presence of this reaction to hypoglycemia. Shanik et al, for example, suggested that the hyperglycemia attributed to the Somogyi phenomenon actually is caused by an insulin-induced insulin resistance. [5] The causes of Somogyi phenomenon include excess or ill-timed insulin, missed meals or snacks, and inadvertent insulin administration. [6, 7, 8] Unrecognized posthypoglycemic hyperglycemia can lead to declining metabolic control and hypoglycemic complications. Although no data on frequency are available, Somogyi phenomenon is probably rare. It occurs in diabetes mellitus type 1 and is less common in diabetes mellitus type 2. With proper identification and management, the prognosis for Somogyi phenomenon is excellent, and there is no evidence of long-term sequelae. Instruct patients in proper identification of symptoms of hypoglycemia, insulin dose, timing of meals, and insulin administration. For patient education information, see Insulin Reaction. Practice Essentials Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. See the image below. See Clinical Findings in Diabetes Mellitus, a Critical Imag Continue reading >>

Dictionary (what Does That Mean?!) - She Sugar

Dictionary (what Does That Mean?!) - She Sugar

Acanthosis Nigricans is the browning or darkening of the skin in the folds of the neck, back, chest and groin area. This can occur in healthy people but is associated with certain disease processes, namely diabetes. Most commonly acanthosis nigricans occurs in people with hyperinsulinemia (high insulin levels). [Read more...] Whoa. Not so fast, increase nighttime insulin because you or your child wake up with high Think again, first wake yourself and get a early morning blood sugar to see whats going on. As a person living with Type 1 for 29 years I have heard of this and experienced it first hand throughout my life. I have always wondered where this unique name originated though. With a little research I found the answer to this inane question- Dr. Michael Somogyi, of course. Sounds a little star treky, I know. [Read more...] January 25, 2012 By jewels Leave a Comment When you picture a Honeymoon this is not where your mind initially goes, right? However, it is THE best and longest honeymoon ever when you are speaking about the honeymoon period after diagnosis with Type 1 Diabetes. [Read more...] Feeling like you just didnt fit the mold? Many people talk about their struggle prior to diagnosis with Type 1.5 Diabetes. Most people have heard of Type 1 and Type 2 Diabetes, while others are in the dark on this form of Diabetes. Type 1 Diabetes has more than a few names: T1D, Juvenile Diabetes, Insulin Dependent Diabetes Mellitus (IDDM), and Type 1 Diabetes Mellitus. T1D is an autoimmune disease, which is very different contextually from Type 2 diabetes. The body basically begins an all out warfare against its beta cells in the pancreas better known as the insulin producers. Its a rather quick process and essentially ends with little to no insulin production. Type 1 diabet Continue reading >>

Nocturnal Hypoglycaemias Intype 1diabetic Patients: What Can We Learn With Continuous Glucose Monitoring? - Em|consulte

Nocturnal Hypoglycaemias Intype 1diabetic Patients: What Can We Learn With Continuous Glucose Monitoring? - Em|consulte

Received:22 septembre 2006; accepted:27 mars 2007 Nocturnal hypoglycaemias intype 1diabetic patients: what can we learn with continuous glucose monitoring? Hypoglycmies nocturnes chezlespatients diabtiques detype 1 : que pouvons-nous apprendre delamesure delaglycmie encontinu ? L. Guillod, S. Comte-Perret, D. Monbaron, R.C. Gaillard, J. Ruiz Service ofendocrinology, diabetology andmetabolism, centre hospitalier universitaire Vaudois, 1011 Lausanne, Switzerland Les hypoglycmies nocturnes sont une complication majeure du traitement des patients diabtiques de type 1; des autocontrles de la glycmie capillaire sont donc recommands pour les dtecter. Cependant, la majorit des hypoglycmies nocturnes ne sont pas dceles par un autocontrle glycmique durant la nuit. La mesure de la glycmie en continu (CGMS) est une alternative intressante. Les buts de cette tude rtrospective taient d'valuer la vritable incidence des hypoglycmies nocturnes chez des patients diabtiques de type 1, la meilleure priode pour effectuer un autocontrle qui permet de prdire une hypoglycmie nocturne, la relation entre les hyperglycmies matinales et les hypoglycmies nocturnes (phnomne de Somogyi) ainsi que l'utilit du CGMS pour rduire les hypoglycmies nocturnes. Quatre-vingt-huit patients diabtiques de type 1 qui avaient bnfici d'un CGMS ont t inclus. Les indications au CGMS, les hypoglycmies nocturnes et diurnes ainsi que la corrlation entre les hypoglycmies nocturnes et les hyperglycmies matinales durant le CGMS ont t enregistres. L'efficacit du CGMS pour rduire les hypoglycmies nocturnes a t value six neuf mois aprs. La prvalence des hypoglycmies nocturnes tait de 67 % (32 % non suspectes). La sensibilit d'une hypoglycmie prdire une hypoglycmie nocturne tait de 37 % (OR = 2,37, P = 0,001) lorsqu'elle survi Continue reading >>

Crne Review

Crne Review

Which of the following hormones maintains adequate levels of glucose in the blood between meals? The client received NPH (Novolin ge) insulin at 0730. Based on an understanding of peak time, the nurse should assess the client for hypoglycemia at which of the following times? The client is scheduled to receive 5 units of Humalog and 25 units of glargine (Lantus) insulin prior to bedtime for a blood sugar of 14 mmol/L. What nursing intervention is most appropriate for this client? Make sure the client's snack is ready to eat before administering this insulin. Offer the client a high-carbohydrate snack in six hours. Hold the insulin if the blood glucose level is <100 mg/dl. Administer the medications in two separate syringes. During the assessment, the client states, "My blood glucose levels range between 4.5-5.5 mmol/L, but my early-morning blood glucose levels are 11 mmol/L." This phenomenon is best known as _________. The nurse is initiating discharge teaching with the newly diagnosed diabetic. Which of the following statements indicates that the client needs additional teaching? "If I am experiencing hypoglycemia, I should drink half a cup of apple juice." "My insulin needs might increase when I have an infection." "I must draw the NPH insulin first if I am mixing it with regular insulin." 'If my blood glucose levels are greater than 300mg/dl, I must check my urine for ketones." Which of the following medications prescribed for a type 2 diabetic client is needed to optimize the secretion of insulin, slows glucose absorption, and decreases action of glucagons? The client is newly admitted with clinical manifestations of type 1 diabetes ketoacidosis. Which of the following medications would the nurse anticipate administering to this client via IV access immediately? The Continue reading >>

The Somogyi Phenomenon Revisited Using Continuous Glucose Monitoring In Daily Life

The Somogyi Phenomenon Revisited Using Continuous Glucose Monitoring In Daily Life

, Volume 48, Issue11 , pp 24372438 | Cite as The Somogyi phenomenon revisited using continuous glucose monitoring in daily life Blood Glucose ConcentrationContinuous Glucose MonitoringNocturnal HypoglycaemiaContinuous Glucose Monitoring SystemBlood Glucose Profile These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves. To the Editor: In 1959, Michael Somogyi reported that hypoglycaemia during the night was often followed by heavy glycosuria next morning [ 1 ]. Moreover, a high morning fasting blood glucose value was later attributed to nocturnal hypoglycaemia and the need to reduce the evening or bedtime dose of insulin. The Somogyi phenomenonhypoglycaemia begetting hyperglycaemiais believed to be due to the release of counterregulatory hormones in response to (nocturnal) insulin-induced hypoglycaemia. Despite the fact that experimental studies have rejected the existence of the Somogyi phenomenon [ 2 , 3 , 4 ], it is, in our experience, still widely believed to exist by health care professionals. Previous experimental research has been based on hospitalised patients using nocturnal blood glucose profiles or real life data with a single nocturnal blood glucose measurement. The sensitivity of the latter method for the detection of nocturnal hypoglycaemia is low [ 3 , 5 ], which may explain some of the reluctance to accept that the phenomenon does not exist. The recent development of continuous glucose monitoring systems has made it possible to monitor patients with type 1 diabetes in daily life. Using this technology, we tested the existence of the Somogyi phenomenon in daily life in a large cohort of type 1 diabetic subjects. All 262 patients with type 1 diabetes from Continue reading >>

Somygi Phenomenon

Somygi Phenomenon

in Pets with Diabetes Mellitus. There was a very good article that was found at this link which seems to not be working at this time so here is the page that was originally found there. Somogyi Below is a blood glucose curve depicting the Somogyi phenomenon. In this scenario, the positive urine glucoses prompted continued escalation in the insulin dose administered. The subsequent insulin toxicity (and concomitant hypoglycemia –or low blood glucose) resulted in initiation of protective compensatory mechanisms which caused massive transient rises in blood sugar. In this case, urine dipsticks for glucose were checked twice daily and were always positive, prompting the owners to incrementally increase the insulin dose. This graph depicts in days what usually happens over weeks when well-meaning concerned pet owners try to use urine dipsticks to determine insulin dosing. Fortunately, the body is able to release several hormones which increase the amount of circulating glucose and which “shield” the tissues from the effects of insulin. Over time, even as the body is experiencing dramatic fluctuations in blood sugar levels, the tissues develop a resistance to insulin which may require weeks of insulin withdrawal to resolve. The best way to avoid Somogyi is to base insulin dose adjustments on blood, not urine glucose levels. Your veterinarian can do this by using a glucometer with just a drop of blood acquired every 2-3 hours for 12-24 hours, depending on how often insulin is administered. From the Pet Diabetes Dictionary Somogyi effect: A condition in which the blood glucose level increases if too much insulin is given. It occurs when insulin causes the blood glucose level to go so low it stimulates the production of other hormones in the body such as epinephrine which Continue reading >>

High Fasting Levels

High Fasting Levels

High fasting levels are a huge problem for many ladies. Fasting blood sugar levels, levels taken first thing in the morning when you wake up, are the hardest thing to control with gestational diabetes. But why is that? When we're sleeping we are not eating and drinking and we are not active and so the body is left to it's own devices with regards to controlling blood sugar levels. Impacts on fasting blood sugar levels Many things can impact fasting levels: what you've eaten earlier in the evening when you last ate hydration levels how well you've slept the dawn phenomenon the Somogyi effect What you ate earlier in the evening Bearing in mind how much of each food group converts to glucose in the bloodstream and the time taken, your fasting levels may be impacted by this. Too much carbohydrate in your evening meal or as a snack before bed can contribute to high fasting levels, as your body can only produce or use so much insulin, so if you raise your blood sugars too high by eating too much carbohydrate, your body can spend the night battling to try to lower your blood sugar levels. A high fat meal such as takeaway food can also cause higher blood sugar levels and so eating a well paired evening meal is important. When you last ate The key to stabilising blood sugar levels is to eat small amounts, often. We obviously cannot do this throughout the night, but if you eat your evening meal early and do not eat again until breakfast the following day, it can be an extremely long time to go without eating. Likewise, if you eat a large meal just before going to bed, this too can have a detrimental effect on your fasting levels. Hydration levels Dehydration will cause higher blood sugar levels. Water helps to flush excess sugar from the body and so it is important to stay well h Continue reading >>

Canine And Feline Diabetes - The Somogyi Effect

Canine And Feline Diabetes - The Somogyi Effect

Canine and feline diabetes is a disease that results in an abnormal increase in blood glucose levels. When treated with insulin, the blood glucose levels are decreased and, hopefully, kept within the normal range. Insulin overdose, however, is possible and can lead to a phenomenon known as the Somogyi effect. What Is the Somogyi Effect and How Does It Affect a Diabetic Dog or Cat? The Somogyi effect occurs when an overdose of insulin occurs. The insulin acts to lower the blood glucose (blood sugar) level. However, because of the fact that too much insulin was given, the blood glucose level may fall lower than the normal range. When the blood glucose becomes too low (a condition known as hypoglycemia), the body has defense mechanisms that go into effect to force the glucose to increase again. However, the dog or cat may not be able to control how high the blood glucose goes and it may rebound to an abnormally high level. This is known as the Somogyi effect. This effect may actually become circular in its effect if the insulin overdosage is ongoing. When the insulin dose is given, the blood glucose level first falls to below normal then rebounds to an abnormally high level. The insulin dose is repeated, which again leads to first an abnormally low glucose level and then a rebound to an abnormally high level. And the circle goes on and on. How Is the Somogyi Effect Diagnosed in Dogs and Cats with Diabetes? A blood glucose curve will be necessary to diagnose this phenomenon. The blood glucose curve is a series of blood glucose measurements taken at regular intervals after the administration of insulin. When evaluating a blood glucose curve for a dog or cat that is experiencing the Somogyi effect, it will be possible to see the blood glucose value drop first to an abnormally Continue reading >>

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