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what is the tx of dawn penomenon in DM.

it occurse because of a less dose of insulin at night----so early in morning at 3am ur glucose is increased because of sympathetic responsis by cortisol and ephinephrerine...

so u have to increase the dose of insulin or u take it later at night.

ohter modalites are:

Not eating a carbohydrate snack at bedtime
Adjusting your dosage of medication or insulin
Switching to a different medication
Using an insulin pump to administer extra insulin during early-morning hours

increase the dose of insulin ..

how about glargine insulin... it gives long stable action for 24 hrs?...

hi i thnk dawn phenomenon is hyperglycemia early in the morning(both at at 3 am and 7 am due to the effect of growth hormone
3am hypoglycemia and 7am hyperglycemia is due to epinephrine and glucagon effect this called somoglyi effect source kaplan
not sure about treatment
correct me if iam wrong

ALERT: CORRECTION

Dawn effect: Patient is taking less insulin and at 3am level will be hyperglycemic and 7am hyperglycemic.

rx: increase the dose of insulin or take it at later time

Somygi effect: Patient is taking more insulin than needed so at 3am gets hypoglycemia--and body responds by secrecting glucagon and cortisol and thus causing a rise in glucose in the morning so 7am glucose will be raised.Patient will encouter sympathetic symptoms---sweatnig, palpitaions, tachycardia, anxiety, restlessness, etc.

Objective:

Dawns: 3am glucose level--high 7am--high

Somygi: 3am gluose level--low 7am--high (along with symptoms)

Thanks for reading


....s4ck......

if any mistakes do give ur input...

Next step in diagnosis question in this------>get 3am glucose levels

next step in management question---------->Dawn: decrease the dose of insulin, or take it earlier (around 8pm)
------------------------------------------------------>Somygyi: increase dose of insulin, or take it later (around 10pm).

...s4ck.....

CORRECTION TO ABOVE:

Next step in diagnosis question in this------>get 3am glucose levels

next step in management question---------->Dawn: INCREASSE the dose of insulin, or take it LATER (around 10PM)
------------------------------------------------------>Somygyi: DECREASE dose of insulin, or take it EARLIER (around 8PM).

...s4ck.....

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