SOMOGYI EFFECT

Nicole2010 · Mar 24, 2009

"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"

this is straight from the pharm book

missjennmb · Mar 24, 2009

that sounds like another language lol

wonder what it means in English :)

allnurses Guide · Mar 24, 2009

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.

mRpeNa · Mar 24, 2009

thank you...so in the morning you would give a decrease in meds?

allnurses Guide · Mar 24, 2009

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.

Nicole2010 · Mar 24, 2009

Hyperglycemia in the morning is the Predawn Phenomenon

allnurses Guide · Mar 25, 2009

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.