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 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 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.
Which blood glucose curves are suggestive of the Somogyi effect?
Any of the following blood glucose curves can be suggestive of the Somogyi effect: Hypoglycemia (low nadir) followed by rebound hyperglycemia. A rapid decrease in glycemia with an adequate nadir followed by rebound hyperglycemia.
What causes 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.
How do you stop Somogyi?
For Somogyi effect:Decreasing the dose of diabetes medications that are causing overnight lows.Adding a bedtime snack that includes carbs.Doing evening exercise earlier.If you take insulin, switching to an insulin pump and programming it to release less insulin overnight.
Can you have Somogyi effect and not be diabetic?
In an individual that does not have diabetes, the blood glucose and insulin concentrations stay flat and constant throughout the night, with a transient increase in insulin just before dawn to prevent hepatic glucose production through gluconeogenesis and prevent hyperglycemia.
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.
Why is blood sugar high in the morning before breakfast?
The dawn phenomenon In the early hours of the morning, hormones, including cortisol and growth hormone, signal the liver to boost the production of glucose, which provides energy that helps you wake up. This triggers beta cells in the pancreas to release insulin in order to keep blood glucose levels in check.
How is Somogyi effect diagnosed?
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.
What foods keep your blood sugar stable at night?
Try one the following healthful snacks before bed to help manage blood sugar levels and satisfy nighttime hunger:A handful of nuts. ... A hard-boiled egg. ... Low-fat cheese and whole-wheat crackers. ... Baby carrots, cherry tomatoes, or cucumber slices. ... Celery sticks with hummus. ... Air-popped popcorn. ... Roasted chickpeas.More items...
Can Apple cider vinegar lower blood sugar immediately?
On a short-term basis, groups taking apple cider vinegar saw significant improvement in blood glucose levels 30 minutes after consuming the vinegar.
How can I stabilize my blood sugar overnight?
Check your blood sugar (or CGM) before bed. Avoid eating lots of food close to bedtime. For diaTribe writer Adam Brown, the key to staying in range overnight is low-carb, early dinners, with no snacking after dinner. Consider eating less food at night and taking more basal insulin to cover your evening meal.
How can rebound hypoglycemia be prevented?
Avoiding sugary foods and processed simple carbohydrates, such as white bread or white pasta, especially on an empty stomach. Eating food when drinking alcohol, if you drink. Eating several small meals and snacks throughout the day, about three hours apart during waking hours.
Does metformin help with dawn phenomenon?
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 should my blood sugar be when I wake up?
What should your blood sugar be when you wake up? Whenever possible, aim to keep your glucose levels in range between 70 and 130 mg/dL in the morning before you eat breakfast, and between 70 and 180 mg/dL at other times.
What is the Somogyi effect?
The Somogyi effect is named after Michael Somogyi, a Hungarian American researcher, who first described it. It happens when the body’s defenses respond to long periods of low blood sugar. This can occur when a person exercises a lot, goes a long time without a snack, or takes more insulin before bed than they need.
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.
Why do you need 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. A person may need to adjust their insulin dosage, and taking a higher dosage at night can increase the risk of the Somogyi effect.
What is the difference between dawn and somogyi?
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. Testing blood sugar levels at 3:00 a.m. and again in the morning can help distinguish between the types of changes.
What is the dawn effect?
The dawn effect involves a rise in early morning blood sugar levels. This results from declining levels of insulin and an increase in growth hormones. Everyone experiences higher blood sugar levels in the morning, whether they have diabetes or not.
When to check blood sugar for Somogyi?
They should check their blood sugar levels: before bed. at 3:00 a.m. when they wake up.
Does Somogyi affect blood sugar?
Doctors and people with diabetes often refer to the Somogyi effect, but there is little scientific evidence for the theory. For example, one small study. Trusted Source. found that hyperglycemia — high blood sugar — upon waking is likely to happen if a person does not take enough insulin before bed.
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).
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.
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 is the Somogyi rebound?
The Somogyi effect may also be called “chronic Somogyi rebound” or “rebound hyperglycemia.”. The Somogyi effect is when either an excess of insulin or lack of carbohydrates causes blood glucose levels to drop, causing hypoglycemia. This occurs during the night when the individual is sleeping, typically around 2 or 3 in the morning.
Why does cortisol spike in the morning?
Cortisol levels start to spike in the early morning to prepare you for the morning. The cortisol signals the liver to start releasing glucose to give the body energy.
Combating an Incorrect Insulin Dose
An insulin dose that is too high may bring about the Somogyi effect or rebound hyperglycemia. This is produced because blood glucose concentrations fall too rapidly. The moment that the Somogyi effect is triggered is very individual—it is a life-saving response.
Help Your Practice Manage Diabetes Mellitus
View and download resources and tools that will assist your hospital, inform your team, and help with clients.
Read More About Monitoring & Controlling Canine Diabetes
Vetsulin ® should not be used in dogs known to have a systemic allergy to pork or pork products. Vetsulin is contraindicated during periods of hypoglycemia. Keep out of reach of children.
How to avoid Somogyi effect?
Practical ways to avoid Somogyi effect include regular blood glucose monitoring, logging blood glucose values, conservatively increasing insulin, being aware of hypoglycemia and how your insulin influences it, and using the most suitable insulin for your circumstances .
What is the Somogyi rebound?
The Somogyi phenomenon (also known as post-hypoglycemic hyperglycemia, chronic Somogyi rebound) describes a rebound high blood glucose level in response to low blood glucose. Amongst those people with diabetes who manage their blood glucose using insulin injections, this may take the form ...
Is Somogyi rebound a challenge?
Somogyi rebound can be a challenge to avoid. The need to keep blood sugar levels stable whilst still adjusting insulin to take account of a complex lifestyle involving stress and exercise can be really difficult.
Is the Somogyi effect scientifically proven?
At this stage, although the Somogyi Effect is widely reported and well- known amongst healthcare professionals, there is little scientific evidence to prove its existence. Clinical studies indicate that high fasting glucose is down to insulin running out during the night.
Does Somogyi occur at night?
Does the Somogyi phenomena only occur during the night? Sometimes the Somogyi rebound will occur when the person with diabetes is awake. They may notice initial symptoms of low blood sugar or a rebound. Waking up during the night is a clear symptom of 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.
What is the Somogyi effect?
Also known as rebound hyperglycemia, the Somogyi (suh-MOH-jee) effect occurs when the body responds to an instance of hypoglycemia (low blood sugar) with hyperglycemia (high blood sugar). The Somogyi effect was theorized by Dr. Michael Somogyi, who believed that prolonged levels of untreated hypoglycemia could result in stress ...
How are dawn and somogyi similar?
The dawn phenomenon and Somogyi effect may seem very similar, as both involve the production of hormones in the body which stimulates the production and release of glucose. However, there are stark differences. According to NCBI, the Somogyi effect is dependent on a late night hypoglycemic episode in which the response is an early morning increase ...
What are the symptoms of dawn phenomenon?
Symptoms. The symptoms that are associated with the dawn phenomenon and Somogyi effect will vary greatly, and will depend on how long a person has had diabetes. A person who has had type 1 diabetes for a long period of time may have hypoglycemia unawareness, which means they do not experience any symptoms when they have low blood sugar. ...
How to treat dawn phenomenon?
NCBI notes that the dawn phenomenon has been found to occur more often than the Somogyi effect. A healthcare professional may recommend some of these common treatment methods for the dawn phenomenon: 1 Avoiding carbohydrates at bedtime 2 Adjusting medication and/or insulin doses 3 Switching to different medications 4 Using an insulin pump
Is the dawn phenomenon more frequent than the Somogyi effect?
Controversy Around the Somogyi Effect. As we noted, the dawn phenomenon is found to occur more frequently than the Somogyi effect. Diabetes.co.uk reports that even though the Somogyi effect is well-known throughout the healthcare industry, there is little scientific evidence that proves it exists.
Does the dawn phenomenon occur without a hypoglycemic episode?
The dawn phenomenon can occur without the body experiencing a hypoglycemic episode.
Is Somogyi more common in type 1 diabetes than type 2 diabetes?
The Somogyi effect is more common among people with type 1 diabetes than type 2 diabetes. People who manage their diabetes with insulin injections may experience the Somogyi effect as a result of an excess amount of insulin at night. If you have type 2 diabetes and take metformin, you are not at risk for the Somogyi effect.
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 >>
What is the Somogyi rebound?
Amongst those people with diabetes who manage their blood glucose using insulin injections, this may take the form of high blood sugar in the morning due to an excess amount of insulin during the night. The Somogyi effect is controversial despite being widely reported. Why is rebound hyperglycemia called The Somogyi effect? The Somogyi phenomenon was named after a Hungarian-born professor called Dr. Michael Somogyi. He prepared the first insulin treatment given to a child with diabetes in the USA, and also showed that too much insulin would make diabetes management unstable and more difficult. Is Somogyi Phenomenon the same as Dawn Phenomenon? No, although they are often confused by healthcare professionals. 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. How does Somogyi Phenomenon occur? Somogyi theorised that prolonged levels of untreated hypoglycemia could lead to stress (due to low blood sugar) and a high blood sugar levels rebound. This is a defensive response by the body as it released endocrine hormone glucagon, backed up by the stress hormones cortisol and epinephrine. This means an instant increase in blood glucose, and stress hormones cause insulin resistance for several hours, and this in turn leads to elevated blood sugar. How do I avoid Somogyi rebound? Somogyi phenomenom is avoidable in several ways. Firstly, intense blood glucose testing allows the individual experiencing Somogyi effect to detect and then prevent the circumstances leading to it. Testing blood sugar regu Continue reading >>
What Is The Somogyi Effect?
Who It affects?
- This phenomenon affects those who have diabetes, especially those with type 1 diabetes. If you have type 2 diabetes and are insulin-dependent, then there is a chance that you could be affected. This is due to it not being a normal event such as the dawn phenomenon (this will briefly be explained farther down), but rather the mismanagement of diabetes.
What Causes It?
- One of two things can cause you to suffer from this event. The first is taking too much insulin at night. So, if you are eating dinner or having a dessert, be very cautious with how much insulin you are taking. Count your carbs and follow the insulin to carb ratio prescribed by your doctor. The second is if you have gone without eating for a while and do not have some sort of nutritional int…
Symptoms of The Somogyi Effect
- If you are waking up with high blood sugar in the morning, then consider these symptoms. You may not experience all of them, but experiencing a few could mean that you are suffering from the Somogyi effect. 1. Night Sweats 2. Rapid Heart Rate 3. Headache 4. Blurred Vision 5. Confusion 6. Dizziness 7. Fatigue 8. Increased Appetite
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 …
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. Essentially, what takes place with the dawn phenomenon, is your body is trying to wake you up and get you ready for the day. With this event…
to Close
- We hope this has given you a greater understanding of the Somogyi effect. If you are waking up in the middle of the night with low blood sugars or continually experiencing high blood sugars in the morning, then consult your doctor. Discuss what course of action needs to be taken to prevent these events that could be detrimental to your health. If you are having trouble affording your pr…