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Break the Tradition! Why Nighttime Blood Sugar Instability May Be the Real Cause of Your High Blood Sugar
For people with diabetes, high blood sugar levels in the morning can often be confusing. In this condition, many people experience a phenomenon known as "Somogyi rebound" or the "Somogyi effect," a rise in blood sugar triggered by low blood sugar. This phenomenon seems counterintuitive when it comes to managing blood sugar, and it raises many questions, especially when we notice high blood sugars after taking insulin at night.
The concept of the Somogyi effect originates from the research of Hungarian biochemist Michael Somogyi, who first suggested that excess insulin could destabilize diabetes.
This theory dates back to the 1930s, when Somogyi discovered that long-term low blood sugar levels, if not properly treated, would cause rebound high blood sugar levels due to the release of stress hormones in the body. Specifically, when blood sugar levels drop below normal, the body releases glucagon and stress hormones (such as adrenaline, cortisol, and growth hormone), which prompt the liver to release glucose, thereby raising blood sugar levels.
Detection of the Somogyi Effect
The first step to prevent Somogyi rebound is to test your blood sugar. Although continuous blood glucose monitoring technology is more ideal, many people still rely on traditional blood glucose meters for multiple daily testing. It is also crucial to perform occasional blood sugar testing during the night when experiencing high morning blood sugars.
Frequent blood sugar testing at night can help diabetic patients detect hypoglycemia in advance and avoid the occurrence of Somogyi rebound.
Strategies to avoid the Somogyi effect
In theory, the key to avoiding Somogyi rebound is to prevent overdosing of insulin. For people with diabetes, keeping track of blood sugar levels and adjusting insulin doses appropriately can be challenging. Frequent blood sugar testing, recording blood sugar data, and timely adjustment of insulin dosage can help reduce the risk of Somogyi rebound.
Observing the body's signals of hypoglycemia or hyperglycemia and choosing the appropriate type of insulin to adjust the dosage is an important strategy for diabetes management.
Controversy over the Somogyi effect
Although the Somogyi effect is well known clinically, the scientific evidence for it is relatively weak. For many studies, high fasting blood glucose in the morning is more likely to be caused by insufficient insulin dosing the previous day, and its association with Somogyi rebound has not been fully demonstrated.
Some research suggests that nighttime hypoglycemia may be associated with lower blood sugar levels in the morning, rather than higher blood sugar levels.
