somogyi versus sundown - zahrah

[ArchivalUser]

hyperglycemia---------------wat time
morning rebound
treatment

[ArchivalUser]

somogyi is a insulin related effect. due to too high insulin dose in the evening, the blood sugar drops in the night (hypoglycemic). as a reaction to this hypo, the body increases blood sugar, thus you have an increased blood sugar in the morning.
treatment is decrease evening dose of insulin.

dawn phenomen is an insulin-unrelated effect. as with somogyi effect, you have increased glucose in the morning, but the reason for this is an intrinsic, pyhsiologic production of growth hormone, which increases glucose.
in contrast to somogyi effect, you will have a normal/high night blood sugar. treatment is to increase evening insulin.

[ArchivalUser]

yup.........dawn is physiologic increase in hormones thus leading to insulin resistance vs somogyi is counter regulatory increase in same hormones (due to early morning 3 AM hypoglycemia)

both wud be diagnosed by measuring 3 AM glucose levels.........wud be normal in Dawns and low in somogyi

one more thing wud be waning of insulin....... in this the 3 AM glucose wud be high

rx........
somogyi.........dec night NPH or snack at bedtime
dawns......inc evening insulin
waning.......inc evening insulin

if all rx fails then use pump

[ArchivalUser]

somogyi - counterregulation of hypogylcemia causes hyperglycemia

sundown - low insulin causes hyperglycemia