Somogyi effect vs Dawn effect in diabtes: what's the difference?
Started by Knicks
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Dawn is when the patient doesnt get enough insulin at night so they get hyperglycemic throughout the night. Somogyi is when they get too much insulin at night so they become hypoglycemic over night. Then the body has a reflex sympathetic response and releases catecholamines to compensate. The result is reflex hyperglycemia in the morning. Somogyi will have sympathetic symptoms overnight while dawn will not.
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The IMPORTANCE here is the management...because if you dont get the correct diagnosis and believe the patient requires MORE insulin at bedtime because they are hyperglycemic in the morning, you can actually bottom them out if they were actually hypoglycemic in the first place.
Yes..typically what happens is that your patient will present to your office for follow-up and they give you their sugar readings for the past few months. You will notice that all the morning readings are high..say above 200. So is this dawn effect or somogyi? You tell them to check their sugar at 3 AM. If it is low, tell them to decrease their insulin...if it is high...then it is safe to assume that they need to increase their bedtime insulin.
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