Somogyi effect vs Dawn effect in diabtes: what's the difference?

[Knicks]

They both result in hyperglycemia during sleep, right?

I tried reading the exact difference, but I need some clarification.


Thanks in advance.

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[WDeagle]

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.

 

[Knicks]

^^ Perfect.

Thanks.

 

[Pansit]

They both result in hyperglycemia during sleep, right?

I tried reading the exact difference, but I need some clarification.


Thanks in advance.

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.

 

[Knicks]

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.

So in the Dawning pt, give more insulin.

In the Somogyi pt, withhold insulin?

 

[Pansit]

So in the Dawning pt, give more insulin.

In the Somogyi pt, withhold insulin?

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.

 

[Knicks]

^^ great, thanks for the clarifications