Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: 2/1/2008
Publication Date: 4/10/2008
Citation: Young, M.E. 2008. Case 26: Somogyi effect. In: Toy, E.C., Seifert, W.E., Strobel, H.W., Harms, K.P. editors. Case Files Biochemistry. 2nd edition. New York, NY: McGraw-Hill Medical. p. 234-241. Interpretive Summary:
Technical Abstract: This individual has a classic manifestation of the Somogyi effect, which is fasting morning hyperglycemia in response to hypoglycemia in the early morning and late night hours. The danger is that if night-time blood glucose levels are not measured, the physician may interpret the patient as having hyperglycemia and require even higher doses of insulin. This would be exactly the wrong treatment, since the hypoglycemia is leading to counter-regulatory hormone reaction, and a very low sugar level bound to the high level in the morning. The diagnosis is established by measuring a 2 AM glucose level, and when confirmed, then the bedtime NPH insulin (intermediate to long acting) needs to be decreased.