What is an example of the Somogyi effect?
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.
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.
How do you prevent the Somogyi effect?
Somogyi Effect. 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.
What is the difference between the Somogyi effect and dawn phenomenon?
The Somogyi phenomenon states that early morning hyperglycemia occurs due to a rebound effect from late-night hypoglycemia. However, the dawn phenomenon does not include hypoglycemic episodes to be a factor.
What causes 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.
What does the Somogyi effect feel like?
Symptoms of the Somogyi effect start with high blood glucose levels upon waking that do not respond to increased insulin doses. The symptoms also include low blood glucose levels at 2:00 a.m. or 3:00 a.m. as well as the following, which are symptoms of low blood sugar: night sweats. a rapid heart rate.
How do you stop the Somogyi effect?
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.
Why do diabetics wake up at 3am?
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.
Why is my fasting blood sugar always high in the morning?
What causes high morning blood sugars? Two main culprits prompt morning highs: the dawn phenomenon and waning insulin. A third, much rarer cause, known as the Somogyi effect, may also be to blame.
Why do diabetics wake up in the middle of the night?
Low blood glucose at night When blood glucose levels fall below 70 mg/dl while sleeping at night, the person experiences a condition called nocturnal hypoglycemia. Studies suggest that almost half of all episodes of low blood glucose — and more than half of all severe episodes — occur at night during sleep.
How can I stabilize my blood sugar overnight?
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...
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 drink lowers blood sugar?
Drinking water regularly may rehydrate the blood, lower blood sugar levels, and reduce diabetes risk ( 20 , 21 ). Keep in mind that water and other zero-calorie drinks are best.
What time should diabetics stop eating at night?
Try to fast at night Try to go 10 to 12 hours each night without eating, Sheth advises. For instance, if you eat breakfast at 8:30 a.m. every morning, that means capping your nighttime meals and snacks between 8:30 and 10:30 p.m. each night.
What 10 foods should diabetics avoid?
10 foods to avoid if you have diabetesProcessed meats. ... Full-fat dairy products. ... Packaged snacks and processed baked goods. ... White carbohydrates. ... Sweetened breakfast cereals. ... Dried fruits. ... French fries. ... Higher-fat cuts of meat.More items...•
When does the Somogyi effect occur?
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 causes skyrocket blood sugar?
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.
Is Somogyi effect normal?
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.
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 common cause of morning hyperglycemia in type 1 diabetes?
In 27.1% it resulted from poor glucose control. In 12.9% it resulted from the dawn phenomenon. They concluded that the Somogyi effect was the most common cause of morning hyperglycemia in people with type 1 diabetes who did not manage their blood sugar effectively.
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 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 is my blood sugar high in the morning?
If a person notices high blood glucose levels in the morning, the Somogyi effect may be responsible, but the rise could have resulted from a similar effect, called the dawn phenomenon. Many people know about the Somogyi effect, but it remains controversial due to a lack of scientific evidence. People with type 1 diabetes are more likely ...
What is the dawn phenomenon?
The dawn phenomenon or “dawn effect” is similar to the Somogyi effect, in that people experience hyperglycemia in the morning, but the reasons differ.
Why is my blood sugar low at 3:00?
Blood sugar that is low at 3:00 a.m. indicates the Somogyi effect, while high or normal levels at that time suggest that the dawn phenomenon is causing high morning blood sugar.
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 is the Somogyi Effect?
The Somogyi effect may also be called “chronic Somogyi rebound” or “rebound hyperglycemia.”
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.
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 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 happens when blood sugar levels drop?
When blood sugar levels become low, hormones will kick in that raise your blood sugar. The rebound of blood sugar can leave a person with diabetes with hyperglycemia. This event is known as the Somogyi effect. This phenomenon can be a complex one, so this post will work through those complexities and simplify what the Somogyi effect is ...
How to prevent high glucose?
The first step in preventing this event is to monitor blood sugar often. If you are using a CGM (Continuous Glucose Monitor), then this will make life a little easier for you. A CGM will monitor your glucose throughout the night, so you can see what your glucose trend looks like throughout the entire day. Some CGM’s will even send notifications to your device to warn you of high or low glucose. If you monitor your glucose through finger sticks, then it is recommended that you check around 8-10 times daily. This may even mean setting an alarm around 2 a.m to check your glucose to prevent severe low or high glucose readings.
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.
What is the Somogyi Effect?
The Somogyi Effect is when you experience a severe low blood sugar followed by a significant spike — that you don’t notice until you wake up — during your sleep.
What does a CGM do?
A CGM can immediately provide life-saving insight into blood sugar mysteries like this.
How long does the Somogyi effect last?
Keep in mind that rapid-acting insulin stays in your body for about 4 hours, which means the insulin you took at 9 p.m.
How to check blood sugar at night?
Secondly, set an alarm for a few nights to wake up once or twice in the middle of the night and check your blood sugar. Thirdly, share your blood sugar results with your healthcare team to pinpoint any evidence of the Somogyi Effect.
How to prevent recurring rise in blood sugar?
Talk to your healthcare team about making adjustments in your basal/background insulin to prevent this recurring rise in your blood sugar levels.
What is the blood sugar level of a person who is waking up with a high blood sugar?
What you’ll notice as the person experiencing it is simply going to bed with a blood sugar that isn’t low, and waking up with a very high blood sugar — generally above 250 mg/dL — without any clear explanation for the spike.
Can insulin spike blood sugar?
For example, while you may take enough insulin to technically cover the carbohydrates and fat in the pizza you ate last night at 8 p.m., the long-term effect of insulin resistance from high-fat foods can easily lead to a spike in your blood sugar the next morning when your big meal boluses wear off.
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 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. ...
What happens if blood glucose levels drop in the evening?
The National Center for Biotechnology Information ( NCBI) explains that if blood glucose levels drop in the evening, the body may respond by producing hormones that lead to the increased production of glucose. The Somogyi effect is more common among people with type 1 diabetes than type 2 diabetes.
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 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 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
Why do people with diabetes have dawn?
People with both type 1 and type 2 diabetes can experience the dawn phenomenon, because their body is either unable to produce insulin ...
Why do people wake up with high blood sugar?
The dawn phenomenon and the Somogyi effect are two possible reasons for why people with diabetes may wake up with high blood sugar levels. In this article, we explain the differences between the two phenomena and the available options for treatment and prevention.
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 >>
What happens if you take insulin too high?
An insulin dose that is too high may bring about the Somogyi effect or rebound hyperglycaemia. This can also be produced if blood glucose concentrations fall too rapidly. The body attempts to counteract the decline in the blood glucose concentration through a chain of reactions: The blood glucose concentration falls rapidly or approaches hypoglycaemia (blood glucose concentrations of less than 5 mmol/l (90 mg/dl)) following the injection of insulin. The animal becomes hungry and either restless or lethargic. In response to a declining blood glucose concentration in the CNS, adrenaline and subsequently cortisol, glucagon and growth hormone are released. These hormones bring about an increase in the blood glucose concentration (through gluconeogenesis, release of glucose from hepatic glycogen and increased peripheral resistance to insulin). The resultant hyperglycaemia produces polyuria and polydipsia. This can easily be misinterpreted as a result of an inadequate insulin dose. If the morning polyuria is thought to be the result of an insufficient insulin dose and a higher dose is given, the problem will be aggravated. An even more pronounced Somogyi effect will follow. Eventually the counter-regulatory mechanisms become exhausted resulting in severe hypoglycaemia. Hyperglycaemia due to a Somogyi effect can sometimes persist for as long as 3 days after a single hypoglycaemic episode. As a result blood glucose concentrations do not always normalise within a few days of lowering the insulin dose. If the Somogyi effect is suspected, an alternative approach is to decrease the dose by 20% and closely observe the clinical signs. If signs of polyuria or polydipsia worsen a few days following the dose adjustment, it is unlikely that the Somogyi effect was the cause of the regulat Continue reading >>
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 causes a rise in blood glucose in the morning?
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 >>
How to wake up with high blood sugar?
Waking up with a high blood sugar reading is not exactly the way you want to start off your day. Besides rushing to get ready for work or getting the kids off to school (or both), you now have to decide if and how you’ll deal with that reading on your meter. Maybe you decide to skip breakfast. If you take mealtime insulin, perhaps you inject a few extra units. Or you put in some additional time during your workout. Another option is to shrug it off and hope that your blood sugar comes down in a few hours. You might also ponder the reason your blood sugar is high. Could it be that you ate dinner later than usual last night? Or you ate too much carb at dinner? Or maybe it was your snack? While it’s normal to have high blood sugars when you have diabetes, it’s time to pay attention when the highs become the norm. Morning hyperglycemia (high blood sugar) is frustrating for many people; figuring out the cause is the first step in dealing with (and preventing) it. Dawn phenomenon: hormones that wreak havoc It’s easy to blame your morning high on the plate of pasta last night. But while that could certainly be a factor, chances are, your “highs” are a result of hormones. An imbalance of insulin, amylin (a hormone released by the pancreas), and incretins (hormones released by the gut) is the likely culprit. Other hormones get in on the act, too, including glucagon, growth hormone, cortisol, and adrenaline. Why? Overnight, the body gets this idea that it needs fuel (glucose). The witching hour seems to be around 3 AM or so. At this time, the liver and muscles obligingly respond to the signal for fuel and release glucose into the bloodstream. In someone without diabetes, insulin and its other hormone pals kick in to keep blood sugar levels on an even keel. In the case Continue reading >>
What is rebounding blood sugar?
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 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 >>
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.
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…