Treatment And Prevention Of The Somogyi Effect
- lowering the dose of insulin taken before bed,
- timing the insulin administration well,
- changing the type (brand) of insulin being used,
- altering lifestyle factors (exercise, stress) and
- eating a snack while you administer the evening insulin dosage.
What is the Somogyi effect and how can you avoid it?
Also known as the Somogyi phenomenon, the Somogyi effect happens when you take insulin before bed and wake up with high blood sugar levels. When insulin lowers your blood sugar too much, it can trigger a release of hormones that send your blood sugar levels into a rebound high.
What is the Somogyi effect when you take insulin?
When you use insulin therapy to control your diabetes, you need to measure your blood sugar levels several times a day. Depending on the results, you might take insulin to lower your blood sugar levels or have a snack to raise them. The Somogyi effect or phenomenon happens when you take insulin before bed and wake up with high blood sugar levels.
What is the Somogyi effect or dawn phenomenon?
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.
What is Somogyi theory of hypoglycemia (low blood sugar)?
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 ]
How is dawn phenomenon and Somogyi effect treated?
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.
How long does the Somogyi effect last?
Eventually the counter-regulatory mechanisms may become exhausted resulting in severe hypoglycemia. Hyperglycemia due to a Somogyi effect can sometimes persist for as long as 3 days after a single hypoglycemic episode.
What is the most likely cause of the Somogyi effect?
The causes of Somogyi phenomenon include excess or ill-timed insulin, missed meals or snacks, and inadvertent insulin administration. Unrecognized posthypoglycemic hyperglycemia can lead to declining metabolic control and hypoglycemic complications.
Does Metformin help with the Somogyi effect?
Metformin, an oral diabetes medication commonly prescribed for people with type 2 diabetes, can help slow down the release of glucose from the liver and prevent the dawn phenomenon.
What time of day does the Somogyi phenomenon occur?
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.
How do you test for Somogyi phenomenon?
Your doctor will want to find out why you're waking up with high blood sugar before they tell you how to treat it. This means they'll ask you to test your blood sugar in the middle of the night -- around 2 or 3 a.m. -- for several nights. If your levels are always low during that time, it's probably the Somogyi effect.
How can we stop morning phenomenon?
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.More items...
How common is Somogyi effect?
nights 2 (P=0.001) and 3 (P<0.001). Fasting hyperglycemia was observed in 82.4% of patients. Silent nocturnal hypoglycemia was observed in 61.2% of patients. The main cause of elevated morning glucose levels was Somogyi effect (60%), followed by poor glycemic control (27.1%) and dawn phenomenon (12.9%).
Why do I wake up at 3am blood sugar?
These early morning wake-up calls often are simply one of many low blood sugar symptoms. Sleeping through the night represents a long period without food when blood sugar can drop too low. This is bad news for the brain, which depends on glucose for energy.
How can you tell the difference between dawn phenomenon and Somogyi effect?
How can you tell the difference?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.
Why does my blood sugar go up without eating?
Physical or emotional stress triggers the release of hormones that can cause high blood sugar levels. Menstrual periods and menopause also cause changes in the hormones that affect blood sugar levels. Regular blood sugar testing can uncover patterns. This can help you and your health care team control your diabetes.
How do I stop my liver from dumping glucose?
They may suggest one of the following to help stabilise your morning blood sugar levels:Adjusting insulin dosage.Adjusting medication dosage.Switching to different medication.Switching to an insulin with a different profile of activity.Not eating carbohydrate snacks before bed.More items...
How many hours does dawn phenomenon last?
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.
How can we stop morning phenomenon?
Eat a breakfast a lower in carbohydrates since blood glucose is high and you have greater insulin resistance in the morning. Don't wait too long to eat breakfast when you wake up. Eating food early in the morning can help release insulin which can lower blood glucose.
Why do diabetics wake up at 3am?
What gives? These early morning wake-up calls often are simply one of many low blood sugar symptoms. Sleeping through the night represents a long period without food when blood sugar can drop too low. This is bad news for the brain, which depends on glucose for energy.
How do you treat dawn phenomenon naturally?
How to manage dawn phenomenonTake medication or insulin at bedtime instead of at dinnertime.Eat dinner earlier in the evening.Get some exercise after dinner.Avoid snacks that contain carbohydrates at bedtime.
What Is The Somogyi Effect?
This sort of blood sugar troubleshooting can be thrown off when something like the Somogyi effect comes into play. Also known as the Somogyi phenomenon, the Somogyi effect happens when you take insulin before bed and wake up with high blood sugar levels. When insulin lowers your blood sugar too much, it can trigger a release of hormones that send your blood sugar levels into a rebound high. The Somogyi effect is rare. It’s more common in people with type 1 diabetes than type 2 diabetes. If you notice inconsistencies or large changes in your blood sugar levels, speak with your doctor. If you wake up with high blood sugar levels in the morning, and you don’t know why, you may be experiencing the Somogyi effect. Night sweats may be a symptom of this phenomenon. If you have diabetes, you may use insulin injections to manage your blood sugar levels. When you inject too much insulin, or you inject insulin and go to bed without eating enough, it lowers your blood sugar levels too much. This is called hypoglycemia. Your body responds to hypoglycemia by releasing hormones, such as glucagon and epinephrine. In turn, this raises your blood sugar levels. This is why the Somogyi effect is sometimes referred to as the “rebound effect.” Although the Somogyi effect is widely reported, there’s little scientific evidence to confirm its existence. Somogyi Effect vs. Dawn Phenomenon The dawn phenomenon is similar to the Somogyi effect, but the causes are different. Everyone experiences the dawn phenomenon to some extent. It’s your body’s natural r Continue reading >>
Why does somogyi happen at night?
The difference is why the hormones are released. The Somogyi effect is caused by having too much insulin in the blood during the night.
Why do cats have somogyi?
It happens more often with pets than with humans, since humans check their own blood sugar more often and have a better idea of the right insulin dose. Because of the variability in a cat's response to insulin and that an individual cat's insulin needs can change greatly when not on a low-carb diet , they are more prone to having Somogyi episodes [1]. It's confusing but true: Too little insulin means pre-shot blood tests are too high; too much insulin often also means pre-shots are too high. This effect is often noted by those who test their pets' blood glucose at home. It means that even when blood glucose levels are too high, simply raising insulin dosage can make things worse instead of better. The blood sugar readings may go from a lowish number very suddenly to a high number, with a 'checkmark' shaped curve (see graph below). If overdose goes on for a few days, you may see few or no low readings, and just lots of very high and unpredictable readings that don't seem to correlate with feeding. Once in a while, a very low reading or even a symptomatic hypo may ensue. The reason: Anytime the glucose level drops too far or too fast, the cat or dog may defensively dump glucose into the blood by breaking down glycogen from the liver. Hormones epinephrine and cortisol, as well as growth hormone and glucagon, [2] causing temporary insulin-resistance, will also be released into the bloodstream [3]. (If these are insufficient, hypoglycemia ensues!) ( See the nice tutorial on the insulin/glucagon equilibrium at the link below.) [4] Even Continue reading >>
Why is the Somogyi phenomenon important?
The Somogyi phenomenon had been considered in the past; an essential consideration for the proper diagnosis and management of blood glucose levels is vital for the body’s metabolic demands. The post-hypoglycemic hyperglycemia raises to question whether or not a patient’s insulin levels should be adjusted in the evening to prevent hyperglycemia in the mornings. As this is something ideally avoided, the Somogyi phenomenon occurs too infrequently to make this standardized practice. The importance of avoiding both hypoglycemia and hyperglycemia and why the Somogyi phenomenon is clinically significant can be reasoned with when describing the different side effects of abnormal blood glucose levels.
Who was the first person to describe the Somogyi effect?
The Somogyi effect, also known as the "chronic Somogyi rebound," or "posthypoglycemic hyperglycemia," was a theory proposed in the 1930s by Dr. Michael Somogyi, who was an Hungarian-born professor at Washington University, St. Louis, MO, United States.[1] He described the paradoxical tendency of the body to react to hypoglycemia by producing hyperglycemia. Somogyi proposed, that when blood glucose levels drop too low during the late evening, activation of counterregulatory hormones such as adrenaline, corticosteroids, growth hormone, and glucagon may be observed, leading to activation of gluconeogenesis and resultant hyperglycemia in the early morning.[2]
How to coordinate care for a patient with hypoglycemia?
It is essential to coordinate care by involving the patient in discussions regarding proper glucose management. Lifestyle modifications and being aware of the symptoms for hypoglycemia or hyperglycemia requires discussion in great detail with the patient. It will allow them to make well-informed decisions regarding their food choices, lifestyle habits, and activity levels.
Is the Somogyi phenomenon a risk factor?
Theoretically, the risks of adjusting a patient’s insulin in case they undergo the Somogyi phenomenon could risk the potential consequence of increasing a patient’s chance of becoming severely hypoglycemic. Although the risk of the Somogyi phenomenon in clinical practice has not shown to have significance.
How to prevent Somogyi effect?
The only way to prevent the Somogyi effect is to keep blood sugar levels stable through effective glucose management. Anyone who finds it hard to manage fluctuations in blood sugar levels should speak to a doctor, who will help adjust their treatment plan.
What does the Somogyi effect do to glucose levels?
The Somogyi effect leads to high glucose levels in the morning.
Why do doctors recommend CGM?
A doctor may recommend CGM for the long-term management of diabetes and the Somogyi effect. A CGM system can alert people when their blood sugar dips too high or low.
How long does it take to take blood glucose readings for Somogyi?
Before a doctor can diagnose the Somogyi effect, a person will need to take blood glucose readings over several nights.
Is Somogyi effect scientifically proven?
Doctors and people with diabetes often refer to the Somogyi effect, but there is little scientific evidence for the theory.
Can diabetes help with Somogyi?
Outlook. Adjusting the diabetes treatment plan to better manage blood sugar levels can help resolve the Somogyi effect. Anyone experiencing fluctuations in glucose levels and high blood sugar in the morning should discuss this with a doctor before making any changes to their insulin treatment.
What is the Somogyi effect?
The Somogyi effect is 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.
Somogyi effect treatment
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).
How to treat Somogyi?
Treatment And Prevention Of The Somogyi Effect 1 lowering the dose of insulin taken before bed, 2 timing the insulin administration well, 3 changing the type (brand) of insulin being used, 4 altering lifestyle factors (exercise, stress) and 5 eating a snack while you administer the evening insulin dosage.
How to prevent the Somogyi effect?
Avoiding the development of hypoglycemia is the best (and the only) way to prevent the Somogyi effect.
What Is The Somogyi Effect?
In this, people who have low blood sugars during late evenings tend to show a rebound effect in the body that causes high glucose levels in the early morning.
How does CGM work?
The CGM system works by alerting the patient of hypoglycemia or hyperglycemia with the use of alarms [13] .
Why do people get somogyi?
Causes Of The Somogyi Effect. Most of the people who have diabetes, use insulin injections to keep their blood glucose levels under control. However, problems could occur if the dosage of insulin injected is not correct or suitable for one's health conditions.
Is Somogyi effect good for diabetics?
The outlook for diabetic patients is excellent if the Somogyi effect is identified on time and managed well. Alongside insulin management, it is also essential that such patients manage their lifestyle well, taking into consideration factors such as diet and exercise. View Article References.
How to Prevent and Treat the Somogyi Effect?
The simple answer to this is to become an expert on your personal diabetes management. This means knowing how certain foods and drinks affect your blood sugars, as well as becoming aware of any trends you see with your blood sugar readings. Such as, are you noticing that your glucose levels are high or low before you go to bed? Are your glucose levels typically high in the morning and difficult to bring back down to normal? Are you experiencing low blood sugar symptoms during the night? Knowing these aspects of your diabetes management is crucial for you to prevent the Somogyi effect, as well as just feel better all around. Discuss these trends with your doctor and what steps should be taken.
What is the Somogyi Effect?
The Somogyi effect may also be called “chronic Somogyi rebound” or “rebound hyperglycemia.”
What to eat if you have Somogyi?
If you are suffering from the Somogyi effect often, then you may want to try having a light snack before going to bed. You want to check your blood sugar before doing this. If your glucose is on the lower end of your target range, then having a light snack such as a serving of nuts, a few crackers, or a serving of peanut butter could prove to be beneficial. A serving of fruit is always a viable option also. Regardless, what you are eating should be low in carbs and high in protein and fiber.
What is the Somogyi effect vs dawn phenomenon?
Somogyi Effect vs. Dawn Phenomenon. The dawn phenomenon , as mentioned above, is naturally occurring. Meaning, this takes place within everyone, not just diabetics. However, those with diabetes are the ones that will notice it and may have to take action to prevent it.
What are the symptoms of the Somogyi effect?
You may not experience all of them, but experiencing a few could mean that you are suffering from the Somogyi effect. Night Sweats. Rapid Heart Rate.
Can you have a somogyi effect without eating?
The second is if you have gone without eating for a while and do not have some sort of nutritional intake before heading to bed. This has the potential to lead to lower glucose levels, which in turn can trigger the Somogyi effect.
Insulin, Blood Sugar, and Sleep
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.
The Dawn Phenomenon
If you have diabetes, your body doesn’t release more insulin to match the early-morning rise in blood sugar. It’s called the dawn phenomenon, since it usually happens between 3 a.m. and 8 a.m.
The Somogyi Effect
The Somogyi effect also causes high levels of blood sugar in the early morning. But it usually happens when you take too much or too little insulin before bed, or when you skip your nighttime snack.
How Do You Know Which One You Have?
Your doctor will want to find out why you’re waking up with high blood sugar before they tell you how to treat it. This means they’ll ask you to test your blood sugar in the middle of the night -- around 2 or 3 a.m. -- for several nights.
