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Somogyi Effect Nursing

Chronic Somogyi Rebound

Chronic Somogyi Rebound

The rebounding blood sugar following undetected diabetic hypoglycemia can easily become chronic when the high morning blood sugar data is misjudged to be due to insufficient nighttime insulin delivery. Chronic Somogyi rebound is a contested explanation of phenomena of elevated blood sugars in the morning. Also called the Somogyi effect and posthypoglycemic hyperglycemia, it is a rebounding high blood sugar that is a response to low blood sugar.[1] When managing the blood glucose level with insulin injections, this effect is counter-intuitive to insulin users who experience high blood sugar in the morning as a result of an overabundance of insulin at night. This theoretical phenomenon was named after Michael Somogyi, a Hungarian-born professor of biochemistry at the Washington University and Jewish Hospital of St. Louis, who prepared the first insulin treatment given to a child with diabetes in the USA in October 1922.[2] Somogyi showed that excessive insulin makes diabetes unstable and first published his findings in 1938.[3] Compare with the dawn phenomenon, which is a morning rise in blood sugar in response to waning insulin and a growth hormone surge (that further antagonizes insulin). Background[edit] A person with type 1 diabetes should balance insulin delivery to manage their blood glucose level. Occasionally, insufficient insulin can result in hyperglycemia. The appropriate response is to take a correction dose of insulin to reduce the blood sugar level and to consider adjusting the insulin regimen to deliver additional insulin in the future to prevent hyperglycemia. Conversely, excessive insulin delivery may result in hypoglycemia. The appropriate response is to treat the hypoglycemia and to consider adjusting the regimen to reduce insulin in the future. Somogyi Continue reading >>

Somogyi Effect Vs. Dawn Phenomenon: The Difference Explained

Somogyi Effect Vs. Dawn Phenomenon: The Difference Explained

For people who have diabetes , the Somogyi effect and the dawn phenomenon both cause higher blood sugar levels in the morning. The dawn phenomenon happens naturally, but the Somogyi effect usually happens because of problems with your diabetes management routine. Your body uses a form of sugar called glucose as its main source of energy. A hormone called insulin , which your pancreas makes, helps your body move glucose from your bloodstream to your cells. While you sleep , your body doesnt need as much energy. But when youre about to wake up, it gets ready to burn more fuel. It tells your liver to start releasing more glucose into your blood . That should trigger your body to release more insulin to handle more blood sugar . If you have diabetes, your body doesnt make enough insulin to do that. That leaves too much sugar in your blood, a problem called hyperglycemia . High blood sugar can cause serious health problems, so if you have diabetes, youll need help to bring those levels down. Diet and exercise help, and so can medications like insulin. If you have diabetes, your body doesnt release more insulin to match the early-morning rise in blood sugar. Its called the dawn phenomenon, since it usually happens between 3 a.m. and 8 a.m. The dawn phenomenon happens to nearly everyone with diabetes. But there are a few ways to prevent it, including: Dont eat carbohydrates before you go to bed. Take insulin before bedtime instead of earlier in the evening. Ask your doctor about adjusting your dose of insulin or other diabetes medicines. Continue reading >>

Differences Between Dawn Phenomenon Or Somogyi Effect

Differences Between Dawn Phenomenon Or Somogyi Effect

The dawn phenomenon and the Somogyi effect increase fasting (aka morning) blood glucose levels for people with diabetes, but for different reasons. Both occurrences have to do with hormones that tell the liver to release glucose into your blood stream while you sleep. The difference is why the hormones are released. Arandom elevated blood sugar could be a result of a variety of things: perhaps you ate too many carbohydrates the night before , you took less medicine than you're supposed to or you forgot to take it altogether . But,if you've noticed a pattern of elevated blood sugars in the morning, it could be a result of the dawn phenomenon or the Somogyi effect. Find out what causes this hormonal hyperglycemia and how you can prevent and can treat it. The dawn phenomenon is caused by a surge of hormones that the body puts out in the early morning hours. According to the American Diabetes Association, "everyone has the dawn phenomenon if they have diabetes or not. People with diabetes don't have normal insulin responses to adjust for it and that is why their blood sugars go up." This happens because: During the evening hours the body is making less insulin. Hormones trigger the liver to put out more glucose. Lack of insulin results in a blood sugar rise in the a.m. The Somogyi effect (or rebound hyperglycemia)results in morning high blood sugar ( hyperglycemia ) as a result very low bloodsugar (hypoglycemia) during the night. It's a very rare phenomenon and most often occurs in people with Type 1 diabetes. It occurs: More commonly in people who take night-time insulin , as a result of taking too much; Or if you are required to eat a snack before bed to keep your blood sugars stable and you skip it. The abundance of insulin in the blood and lack of glucose, causes the b Continue reading >>

Diabetes/hyperglycemia Nclex Questions

Diabetes/hyperglycemia Nclex Questions

The Somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The hypoglycemia at 2am is highly indicative. The Dawn phenomenon is similar but would not have the hypoglycemia at 2am. The nurse is caring for a patient whose blood glucose level is 55mg/dL. What is the likely nursing response? C. Administer 10-15 grams of a carbohydrate D. Give a small snack of high protein food C Administer 10-15 grams of a carbohydrate The client has low hypoglycemia. This is generally treated with a small snack. What insulin type can be given by IV? Select all that apply: The body's natural reaction to illness is to release glucose. As such, diabetics can expect to face increased hyperglycemia in addition to their illness. In educating a client about Type II Diabetes, what would be a proper explanation for poor wound healing? A. High blood glucose damages capillaries B. Swings in blood sugar prevent proper clotting C. The pancreas fails to secrete the proper chemicals High blood glucose damages capillaries which prevent proper healing. When does regular insulin generally have peak action after application? The exact details depend on various factors, but 2-3 hours for peak action of regular insulin is an accepted range. In educating a client with diabetes, what response would reveal need for further education? B. I should take good care of my toe nails C. I should not go more than 3 days without washing my feet D. I should avoid going barefoot and should wear clean socks C I should not go more than 3 days without washing my feet The recommended self-care routine is to wash feet on a daily basis without soaking and carefully cleaning. A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the he Continue reading >>

The Somogyi Effect : Ajn The American Journal Of Nursing

The Somogyi Effect : Ajn The American Journal Of Nursing

Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Thought you might appreciate this item(s) I saw at AJN The American Journal of Nursing. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Thought you might appreciate this item(s) I saw at AJN The American Journal of Nursing. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Thought you might appreciate this item(s) I saw at AJN The American Journal of Nursing. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Continue reading >>

Somogyi Effect: Causes And Prevention

Somogyi Effect: Causes And Prevention

The Somogyi effect, also known as the rebound effect, occurs in people with diabetes. Hypoglycemia or low blood glucose in the late evening causes a rebound effect in the body, leading to hyperglycemia or high blood glucose in the early morning. This phenomenon, known as the Somogyi effect, is widely reported but remains controversial due to a lack of scientific evidence. It is reported more by people with type 1 diabetes than by people with type 2 diabetes. Contents of this article: What is the Somogyi effect? Named after Michael Somogyi, a Hungarian-born researcher who first described it, the Somogyi effect is the body's defensive response to prolonged periods of low blood sugar. A dose of insulin before bed that is too high can be a cause. When insulin reduces the amount of glucose in the blood by too much, it causes hypoglycemia. In turn, hypoglycemia makes the body stressed, triggering the release of the stress hormones epinephrine (adrenaline), cortisol, and growth hormone. The endocrine hormone glucagon is also released. Glucagon triggers the liver to convert stores of glycogen into glucose, which can send blood glucose levels into a rebound high. The stress hormones keep the blood glucose levels raised by making the cells less responsive to insulin. This is known as insulin resistance. Controversy The Somogyi effect is widely cited among doctors and people with diabetes, but there is little scientific evidence for the theory. For example, one small study found that hyperglycemia upon waking is likely to be caused by not enough insulin before bed. Researchers also found that participants who appeared to have rebound hyperglycemia did not have higher levels of growth hormone, cortisol, or glucagon than others. A 2007 study of 88 people with type 1 diabetes using c Continue reading >>

Somogyi Effect | Allnurses

Somogyi Effect | Allnurses

Can someone please explain the somogyi effect? "response tp excessive dose of insulin. is a hypoglycemic condition that usually occurs in the predawn hrs of 2-4am. there is a rapid decrease in blood glucose which stimulates a release of hormones (eg cortisol, glucagon, epinephrine) to increase blood glucose by lipolysis, gluconeogenesis, & glycogenolysis. blood sugars must be monitored between 2-4 am & reduce the bedtime insulin level" Basically means rebound hyperglycemia. Your blood glucose level drops too low overnight, and to compensate the body over-reacts by releasing a whole bunch of chemicals which result in elevated blood sugar in the morning. Way to avoid the rebound is to avoid the hypo - may mean timing or dosing the night time insulin differently. thank you...so in the morning you would give a decrease in meds? No. You need to avoid the overnight hypoglycemia - either give less insulin at night, or change diet etc. so the overnight drop doesn't happen, because that is what causes the rebound hyperglycemia. You will still need to treat the high blood sugar in the morning if it happens. Hyperglycemia in the morning is the Predawn Phenomenon Not necessarily, by my understanding. It's somogyi if the hyperglycemia follows a hypo at 2-3am. If it's just morning hyperglycemia, it's dawn/pre-dawn phenomenon. Somogyi is related to too much insulin causing the rebound hyper, while dawn phenomenon is caused by not enough circulating insulin to control blood sugar. That's my understanding, but I'm not a diabetes expert. Continue reading >>

Somogyi Phenomenon: Overview, Pathophysiology, Patient History

Somogyi Phenomenon: Overview, Pathophysiology, Patient History

Author: Michael Cooperman, MD; Chief Editor: George T Griffing, MD more... 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 . The ability to suppress insulin release is an important physiologic response that people with insulin-requiring diabetes cannot carry out, as displayed in the image below. Defense against hypoglycemia involves counterregulatory hormones, which stimulate glucone Continue reading >>

Diabetes Mellitus Nclex Review Notes Medications & Nursing Management

Diabetes Mellitus Nclex Review Notes Medications & Nursing Management

Below are review notes for Diabetes Mellitus to help you study for the NCLEX exam or your nursing lecture exams. As the nurse taking care of the diabetic patient, you must know how to properly care for them, especially newly diagnosed diabetics. The nurses role include educating, assessing, planning, administering medications, and evaluating treatment. These NCLEX review notes will cover: Diet Exercise Oral Diabetic Medications Insulin Mnemonics After reviewing these notes, don’t forget to take the Diabetes NCLEX quiz. Lecture on Diabetes Mellitus for NCLEX Review Diabetes Nursing Management Nurse’s role: educating, monitoring, and administering (medications) Teach patient to follow the Triangle of Diabetes Management **Diet, medications, and exercise all work together while monitoring blood glucose Example: Patient wants to make sure their diet is balanced with their medication (insulin/oral meds) and they use exercise to manage glucose levels (doing all this while monitoring blood glucose). As the nurse you will be educating the diabetic…so for the NCLEX know education pieces like: Diet, exercising, oral medications, giving insulin (peak times), drugs that increase blood glucose and lower glucose etc. DIET: Diets are individualized due to physical activity and medication therapy (they always need tweaking)…recommend following American Diabetic Association Diet (ADA) Limitation of the following: Carbs (45-60%) grains, vegetables with starches potatoes, corn, sweets…cookies, soda, dried beans, milk) Fats (<20 %)….limit unhealthy fats saturated, trans fats, cholesterol: lard, gravies, whole milk, bologna, hot dogs, sausage, processed foods hydrogenated oils…concentrate on mono & polyunsaturated avocadoes, olives, peanuts, nuts Proteins (15-20%) meats don’ Continue reading >>

Dawn Phenomenon And The Somogyi Effect

Dawn Phenomenon And The Somogyi Effect

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 >>

Somogyi Vs Dawn Phenomenon

Somogyi Vs Dawn Phenomenon

I need help please. Can someone please explain the difference between somogyi phenomenon & dawn phenomenon & which insulin doses would need to be adjusted for each to avoid these? TIA!! Somogyi is morning hyperglycemia as a result of hypoglycemia during the night and is the result of too high of a dose of insulin at night. Dawn phenomenon is morning hyperglycermia without hypoglycemia during the night and is a result of normal cycles within the body. Here is a website that explains it more: Dawn Phenomenon results from reduced tissue sensitivity to insulin that develops between 5 and 8 am (dawn). Prebreakfast hyperglycemia occurs. So you'll wake up hyper at dawn. Tx: Administer an evening dose of intermediate-acting insulin at 10 pm. Somogyi's phenomenon hypoglycemia occurs at 2 to 3 am. By 7 am the blood glucose rebounds significantly to the hyperglycemic range. I remember this with (I have a brother named Yogi who's a musician), the club closes at 2-3 in the morning, Yogi is low so off to breakfast he goes. Tx: Decrease the evening (predinner or bedtime) dose of intermediate-acting insulin or increase the bedtime snack. Continue reading >>

The Somogyi Effect (2018)

The Somogyi Effect (2018)

The Somogyi effect can be one of those trickier subjects to learn in nursing school. Lets be realits a tough word to even say! In this video well break down what the Somogyi effect is, and how the Somogyi effect relates to diabetes. So if youre a nursing student struggling to understand the Somogyi effect in nursing school, this video is for you! Want even more med-surg videos, courses, cheat sheets and study guides? #HeckYes! In this video Im going to teach you the easiest way to remember the Somogyi Effect. Hey there friend, Im Christina Rafano and today we are diving into one of those more confusion nursing school topics: the Somogyi effect. I seriously remember taking one of my nursing school exams and starring down at that word Somogyi trying SO hard to remember what it was, like starring at it would make me remember right? Can you relate? Oh, that is frustrating. So in this video were going to break down the Somogyi effect really simple for you, so you can get those questions right on your nursing school exams. So Somogyi effect, of Somogyi phenomenon, is a problem thats associated with diabetes, either type 1 or type 2, and its caused by the body trying to balance glucose in the blood. So heres what happens: when your blood glucose levels decrease, so theres less sugar in the blood, the liver breaks down glycogen into glucose for your body to use for energy. I like to think of glycogen as a piggy bank, and pennies as glucose. So the liver takes all of the pennies, or sugar molecules, and puts them in a piggy bank, and that piggy bank represents glycogen. So the pennies are glucose, and all of those pennies together inside of the piggy bank, make glycogen. And your liver is keeping this piggy bank for a rainy day, when the body needs more pennies, or more glucose Continue reading >>

The Somogyi Effect | Dawn Phenomenon | What Do They Mean | Diabetes

The Somogyi Effect | Dawn Phenomenon | What Do They Mean | Diabetes

Somogyi effect and the Dawn phenomenon: hyperglycemia on wake up hours omogyi effect and the Dawn phenomenon are conditions related todiabetes and blood sugar fluctuations.Somogyi effectinvolves hyperglycemia when you wake up,even though you might have increased insulin before going to sleep. This is sometimes called rebound hyperglycemia and it is counter intuitive since increased insulin would most likely result in low blood sugar and not high. A low around at 07:00 AM is usually followed by previous high at around 02:00 AM. The idea behindSomogyi is that too much insulin can cause low blood sugar during the night and asubsequent high in the morning hours; according to Somogyi this may becaused by an insulin atagonistic action created bysome hormones, such ashypothalmic-pituitary adrenal axis. The risk involved inthis condition is an increased by NPHinsulin use which reaches peak concentration in 4-5 hours after injection.You should suspect you have Somogyi effect if glucose levels are increasingly higher in the morning after increasing insulin units prior to going to bed. Also if you check you blood glucose at around 03:00 AM and it is low it could mean you might be having Somogyi effect by early morning. The Somogyi effect is more likely to happen with type I diabetics and less common with type II. The name Dawn is a simple reference to the time of the day this phenomena occurs. The main difference between Dawn phenomenon and Somogyi effect is that the down happens to everyone whether you have diabetes or not. Down is a spike in glucose due to hormonal responses in your body preparing you for the day. When we are sleeping, regulatory hormones such as growth hormone, cortisol and catecholamines are released in order to repair cells and that can increase your glucose Continue reading >>

Somogyi Effect

Somogyi Effect

The tendency of the body to react to extremely low blood sugar (hypoglycemia) by overcompensating, resulting in high blood sugar. The Somogyi effect, also known as the “rebound” effect, was named after Michael Somogyi, the researcher who first described it. When blood glucose levels drop too low, the body sometimes reacts by releasing counterregulatory hormones such as glucagon and epinephrine. These hormones spur the liver to convert its stores of glycogen into glucose, raising blood glucose levels. This can cause a period of high blood sugar following an episode of hypoglycemia. The Somogyi effect is most likely to occur following an episode of untreated nighttime hypoglycemia, resulting in high blood sugar levels in the morning. People who wake up with high blood sugar may need to check their blood glucose levels in the middle of the night (for example, around 3 AM). If their blood sugar level is falling or low at that time, they should speak with their health-care team about increasing their food intake or lowering their insulin dose in the evening. The only way to prevent the Somogyi effect is to avoid developing hypoglycemia in the first place. Continue reading >>

The Dawn Phenomenon: What Can You Do?

The Dawn Phenomenon: What Can You Do?

What is the dawn phenomenon that some people with diabetes experience? Can anything be done about it? Answers from M. Regina Castro, M.D. The dawn phenomenon, also called the dawn effect, is the term used to describe an abnormal early-morning increase in blood sugar (glucose) — usually between 2 a.m. and 8 a.m. — in people with diabetes. Some researchers believe the natural overnight release of the so-called counter-regulatory hormones — including growth hormone, cortisol, glucagon and epinephrine — increases insulin resistance, causing blood sugar to rise. High morning blood sugar may also be caused by insufficient insulin the night before, insufficient anti-diabetic medication dosages or carbohydrate snack consumption at bedtime. If you have persistently elevated blood sugar in the morning, checking your blood sugar once during the night — around 2 a.m. or 3 a.m. — for several nights in a row will help you and your doctor determine if you have the dawn phenomenon or if there's another reason for an elevated morning blood sugar reading. What you can do Your doctor may recommend a number of options to help you prevent or correct high blood sugar levels in the morning: Avoid carbohydrates at bedtime. Adjust your dose of medication or insulin. Switch to a different medication. Change the time when you take your medication or insulin from dinnertime to bedtime. Use an insulin pump to administer extra insulin during early-morning hours. Continue reading >>

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