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Somogyi effect: Nocturnal hypoglycemia can cause such a terrible blood sugar rebound!
For many diabetics, high blood sugar levels when they wake up in the morning are still a confusing situation. This phenomenon is called the Somogyi effect, or post-hypoglycemia and hyperglycemia, which refers to the sharp rise in blood sugar that occurs after hypoglycemia. This rebound effect is caused by physiological reactions in the body.
The Somogyi effect is named after Michael Somogyi, a Hungarian biochemistry professor who in 1922 provided the first insulin treatments to diabetic children in the United States.
When blood sugar falls below the normal range, the body responds by releasing glucagon and stress hormones such as adrenaline, cortisol, and growth hormone to quickly raise blood sugar levels. The release of these hormones can lead to short-term hyperglycemia, and subsequent insulin resistance may prolong the duration of this hyperglycemia state, leaving patients with the embarrassing situation of high blood sugar when they wake up in the morning.
Methods to detect Somogyi effect
To effectively prevent the Somogyi effect, continuous monitoring of blood sugar is key. Although continuous blood glucose monitoring technology is not yet popular, using traditional blood glucose testing equipment to detect blood glucose 8 to 10 times a day can help diabetic patients identify hypoglycemia early and avoid the rebound effect.
In addition, it is also important to test occasionally at night, especially when hyperglycemia occurs frequently. Adjusting the insulin dose based on the test results may reduce the chance of hyperglycemia.
Some patients may feel symptoms of hypoglycemia when they wake up in the morning, such as rapid heartbeat or night sweating. These may be caused by the complete impact of hormones. Unfortunately, most people with type 1 diabetes do not wake up during nighttime episodes of low blood sugar, leaving them often confused when they find high blood sugar in the morning.
How to avoid the Somogyi effect
The theoretical basis for avoiding the Somogyi effect is to prevent the occurrence of hyperinsulinemia. However, the actual situation is not easy, because diabetic patients often need to adjust their insulin dosage based on exercise, stress, and health conditions, making occasional hyperinsulinemia almost inevitable.
To effectively avoid the Somogyi effect, patients can take some practical actions, such as: frequent blood glucose monitoring, continuous blood glucose monitoring, recording and reviewing blood glucose data, looking for patterns of hypoglycemia, and making conservative adjustments to insulin doses.
In addition, patients should also be alert to signs of hypoglycemia and hyperglycemia, and choose the appropriate insulin type (such as long-acting or short-acting insulin) and dosage to better control blood sugar levels.
Controversy over the Somogyi effect
Although the Somogyi effect is well known in clinical medicine, there is insufficient scientific evidence to support this hypothesis. Research suggests that morning high blood sugar is more likely due to insufficient insulin from the night before lasting into the morning. If patients can be monitored continuously, the cause may be better traced.
A 2007 study noted that patients with type 1 diabetes who experience hypoglycemia at night are more likely to experience hypoglycemia in the morning rather than hyperglycemia caused by the Somogyi effect.
Therefore, Somogyi's hypothesis may not be completely correct, but further research is needed to reveal its truth. In real life, how can diabetic patients improve their blood sugar management under a complex background?
