How to identify hypoglycaemiainduced hyperglycaemia somogyi effect linda fleeman bvsc phd manzcvs animal diabetes australia, melbourne, vic hypoglycaemiainduced hyperglycaemia somogyi effect is a wellknown phenomenon that may occur when. The somogyi effect is related to the dawn phenomenon but is a bit differentthe somogyi effect is a rebound hyperglycemia when blood sugars bounce too high in response to low blood sugar in the evening. So if we are not sure if the morning hyperglycemia is due to the dawn or somogyi effect, what do we do. Dawn effect requires an adjustment of medication, so there is enough insulin or other hypoglycemic to cover the dawn glucose release. Dawn phenomenon and the somogyi effect metro health. Consequently, the tendency for blood glucose levels to rise before breakfast dawn phenomenon may be aggravated by a waning insulin effect before breakfast andor by counterregulatory hormones secreted in response to a fall in blood glucose levels during sleep, resulting in posthypoglycemic hyperglycemia somogyi phenomenon. The difference between the somogyi effect and dawn. Some common reasons include taking the wrong dose of a medication or eating foods such as carbohydrates before bedtime. The dawn phenomenon is more common than the somogyi effect. The somogyi effect occurs mainly in type 1 diabetes.
The somogyi effect is most likely to occur following an episode of untreated nighttime hypoglycemia, resulting in high blood sugar levels in the morning. Dawn phenomenon and the somogyi effect michigan medicine. By contrast, the somogyi effect is usually associated with the nighttime. 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. Home blog amy campbell the dawn phenomenon and somogyi effect. The somogyi effect is comparable to the dawn effect, also known as the dawn phenomenon, in that the patient affected with either condition wakes up with high blood sugar. The difference between the somogyi effect and the dawn phenomenon is that the somogyi effect is a response to low blood sugar during the night. This is the form of insulin resistance due to chronic overdosage, described by somogyi in 1959.
The dawn phenomenon and the somogyi effect via medica journals. You see, when your blood glucose drops during the night, hormones are released which trigger the liver to release stored glucose. Morning hyperglycemia in patients with type 1 diabetes t1d may be caused by the dawn phenomenon, the somogyi effect or poor glycemic. Morning hyperglycemia in diabetic subjects may be caused by the dawn phenomenon, or the somogyi effect, or poor glycemic control. The difference between the somogyi effect and dawn phenomenon the somogyi effect first discovered my dr. The cumulative effect of increased nocturnal growth hormone. The dawn phenomenon is a normal rise in blood sugar as a persons body prepares to wake up. Download citation the dawn phenomenon and the somogyi effect two phenomena of morning hyperglycaemia morning hyperglycaemia in diabetic subjects may be caused by the dawn phenomenon, or the. But it usually happens when you take too much or too little insulin. Definition of somogyi effect in the legal dictionary by free online english dictionary and encyclopedia. Dawn phenomenon and the somogyi effect healthlink bc.
Glucophage, glumetza is a medication used primarily for diabetes. If the glucose is increased in the am, it was dawn phenomenon. When managing the blood glucose level with insulin injections, this effect is counterintuitive to people who experience high blood sugar in the. The somogyi effect is present in the case of excessive amounts of exogenous insulin. This normally results in a highfasting glucose reading. B, somogyi effect the somogyi effect is when blood sugar drops too low in the morning causing rebound hyperglycemia in the morning. The only way to test if it is the somogyi effect or the dawn phenomenon that is making your morning glucose levels high is to wake up sometime in between 2 and 3 am for several nights in a row and check your blood sugar reading. The difference is that dawn phenomenon is not caused by hypoglycemia, but by a random release of the triggering hormones. This results from two distinctly different processes.
It is similar to the dawn phenomenon in that both lead to high morning blood glucose readings as a result of a hormone release that causes the liver to release glucose into the blood. It is different from chronic somogyi rebound in that dawn phenomenon is not associated with nocturnal hypoglycemia. Somogyi effect represents an excessive response to hypoglycaemia. The best way to know for sure whether youre experiencing the dawn phenomenon or the somogyi effect is to test your blood sugar in the middle of the night. The dawn phenomenon is similar but would not have the hypoglycemia at 2am. Dawn phenomenon one of the most frustrating things that diabetics deal with is an unexpected rise in blood glucose overnight. 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. The wellknown somogyi effect in insulin treatment of diabetes mellitus is frequently overlooked. In insulindependent diabetic patients, an increase in glucose levels andor. Heres a simple way to remember what is happening with insulin in these two causes of elevated fasting morning glucose level. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Szkol e nie p o dyp lo m o we dawn phenomenon definition and pathogenesis recurring abnormally high plasma glucose levels in the morning before breakfast are commonly called the dawn phenomenon. The dawn phenomenon occurs when endogenous insulin secretion decreases or when the effect of the exogenous insulin administered to the patient the day.
The dawn phenomenon and the somogyi effect cause high blood sugar levels, especially in the morning before breakfast, in people who have diabetes. You will notice that all the morning readings are highsay above 200. The dawn phenomenon and the somogyi effect two phenomena. The best way to stop the somogyi effect in its tracks is to prevent it in the first place.
The dawn phenomenon, sometimes called the dawn effect, is an earlymorning usually between 2 a. To diagnose these phenomena, it is useful to measure plasma glucose levels for several nights between 3 a. Since the two causes of the dawn phenomenon have two different solutions we need to find out which is occurring first. Dawn phenomenon, and its associated increase in insulin resistance, is the reason most diabetics are far more sensitive to carbs in the morning. Morning hyperglycemia in patients with type 1 diabetes t1d may be caused by the dawn phenomenon, the somogyi effect or poor glycemic control, diagnoses that lead to different clinical management in each case. The dawn effect or dawn phenomenon is a morning rise in blood sugar which occurs as a response to waning levels of insulin and a surge in growth hormones.
Prior to the use of cgm, such determinations were more technically difficult i. Somogyi effect definition of somogyi effect by medical. Somogyi phenomenon synonyms, somogyi phenomenon pronunciation, somogyi phenomenon translation, english dictionary definition of somogyi phenomenon. The dawn effect can actually take place anytime between 2 a. There are several reasons for a high fasting blood glucose reading in the morning. Dawn phenomenon and somogyi effect in iddm diabetes care. It lowers blood sugar levels in type 2 diabetics by facilitating the entrance of glucose in the tissues and reducing the amount made by the liver. Somogyi effect as the most common cause of fasting hyperglycemia. If you dont know why your morning blood sugar readings are high in diabetes, you need to learn about the dawn phenomenon and somogi effect. Somogyi effect in treatment of diabetes jama jama network. Michael somogyi is caused by nighttime hypoglycemia, which leads to a rebound hyperglycemia in the early morning hours. Somogyi effect 2018 the somogyi effect can be one of those trickier subjects to learn in nursing school. The dawn phenomenon is a normal rise in blood sugar as a persons.
Also called the somogyi effect and posthypoglycemic hyperglycemia, it is a rebounding high blood sugar that is a response to low blood sugar. Dawn phenomenon and the somogyi effect peacehealth. Somogyi theorised that prolonged levels of untreated hypoglycemia could lead to stress due to low blood sugar and a high blood sugar levels rebound. Dawn phenomenon and the somogyi effect diabetes daily post. Both the somogyi effect and the dawn phenomenon can make blood sugar levels too high when you wake up. What you should know about diabetes and the dawn phenomenon. According to the daily insulin secretion profile set out in figure 2 9, the dawn phe. The somogyi effect can occur any time you or your child has extra insulin in the body. Can anyone explain in laymans terms the somogyi effect. Pdf the dawn phenomenon and the somogyi effect two. Somogyi effect as the most common cause of fasting. Somogyi phenomenon definition of somogyi phenomenon by. 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.
Pdf somogyi effect in a patient of type 2 diabetes mellitus. The somogyi effect should be handled with a prebedtime snack, preferably high in protein to keep the bg from falling too low over the night. Download fulltext pdf dawn phenomenon and somogyi effect in iddm article pdf available in diabetes care 124. The somogyi effect also causes high levels of blood sugar in the early morning. The dawn phenomenon and the somogyi effect malwina rybicka et al. Michael somogyi is caused by nighttime hypoglycemia, which leads to a rebound hyperglycemia in the. It does not happen overnight as in the dawn phenomenon and it usually happens when medication or insulin is too high.
The term dawn phenomenon describes a rise in blood glucose that occurs. The somogyi effect is a rebound hyperglycemia cause by too much insulin. Yestypically what happens is that your patient will present to your office for followup and they give you their sugar readings for the past few months. Due to repeated insulin overdosage, recurrent insulin reactions occur. It is also a preferred basal insulin in person who require two basal injections, i. How to prevent or lessen the effect of the dawn phenomenon. Prelipcean, md on september 7, 2018 written by anna schaefer and justin sarachik.