By Apollo 24/7, Published on - 29 April 2021
Normally, people diagnosed with type 2 diabetes, the more common type of diabetes, are prescribed oral anti-diabetic medications. However, if they are unable to manage their blood sugar levels with the help of medications, diet and lifestyle change, they need to take insulin. It has been reported that despite taking medications or insulin as per the doctor’s advice, some type-2 diabetics often experience a hike in their blood sugar levels early in the morning, which is known as the Somogyi effect.
The Somogyi effect, also known as the ‘chronic Somogyi rebound’ and ‘posthypoglycemic hyperglycemia’, was proposed by a Hungarian professor Dr Michael Somogyi in 1930. He discovered that when the blood sugar levels of the body drop too low in the late evening or at night while sleeping, there is an activation of counter-regulatory hormones which instigate gluconeogenesis (conversion of glycogen into glucose). This results in increased blood sugar levels (hyperglycemia) in the early morning.
The Somogyi effect is the response of the body’s defence mechanism to the long period of low blood sugar in a person suffering from type-2 diabetes. This can occur after vigorous exercise or if the person has taken more insulin than required, before going to bed.
Insulin is a hormone naturally produced by the pancreas, which helps in maintaining the levels of glucose (sugar) in the blood.
Due to the sudden drop in blood sugar levels, various hormones such as growth hormones, and stress hormones (cortisol and epinephrine) are released in the body, which trigger the release of glucagon, a hormone produced by the pancreas. Glucagon counteracts the action of insulin and promotes the production of glucose in the liver by converting glycogen (stored form of glucose) into glucose, resulting in increased blood sugar levels.
Simultaneously, the stress hormones keep the blood sugar levels high by not allowing the body cells to respond to insulin, resulting in insulin resistance.
The characteristics of the Somogyi effect include:
Another phenomenon known as the dawn phenomenon has been confused with the Somogyi effect since both of them result in blood sugar spikes in the morning. However, there are many differences between them which include:
Diabetics experiencing the Somogyi effect can manage their blood sugar levels in the morning by:
Apart from the Somogyi effect and the dawn phenomenon, other reasons that may cause a hike in the blood sugar levels in the morning include:
It is difficult to diagnose the Somogyi effect due to several reasons such as lack of awareness, varying symptoms, and the presence of other possible health conditions. Moreover, some studies have shown that patients having hyperglycemia early in the morning tend to have high blood glucose levels at night, rather than low.
Since there is a constant debate about the accuracy of Somogyi's theory, diabetics must stick to the diet, exercise, and medicine regime they’ve been prescribed. Any unusual spikes or patterns must be monitored and reported to the doctor.
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