The Somogyi Effect is also known as hypoglycemic rebound, and is frequently seen in type 1 diabetes. The main causes of this phenomenon is the low blood sugar level in midnight, which causes the counter-regulatory hormone (e.g. growth hormone, cortisol, glucagon and epinephrine, etc.) stimulates gluconeogenesis and glycogenolysis, which elevates the blood sugar levels to counter the low blood sugar. Since type 1 diabetic patients lack endogenous insulin, they are more sensitive to the actions of these hormones: a slight decrease in the midnight blood sugar level will often result in rapid increase of blood sugar in the early morning of next day.

Patients with the Somogyi effects often have normal blood sugar levels before sleep, which then drop to lowest during midnight, and the rebound occurs in early morning to elevate the blood sugar. Therefore, patients will sometimes decrease their insulin dosage before dinner or sleep to prevent midnight low blood sugar level.

How do I deal with Somogyi Effect?

Routine monitoring and life event records are the same as Dawn Phenomenon, the only difference being the adjustment to the insulin dosage, which is usually lowered to prevent midnight low blood sugar level. Patients may sometimes be encouraged to eat snacks before sleep so that their blood sugar level is not decreased during the night. However, patients are recommended to discuss the issue with their physicians first before adjusting the insulin dosage. The following tips can be handy for diabetic patients:

1.Measurement of blood sugar levels before sleep, in the middle of the night (3-4 am), and in the morning.

2.Detailed record of life events, such as diets, exercise, medicine usage and disease records.

3.Discuss with the physician over the blood sugar levels and life record to determine whether the Somogyi Effect has occurred.

4.Follow the physician’s order to properly adjust the medicine dosage, do not attempt to adjust the dosage by yourself.

5.Eat snacks before sleeping.