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Old 06-13-2010
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Pancreas Morning Hyperglycemia

It is mentioned in Kaplan IM lecture notes that both Somogyi effect and dawn effect cause hyperglycemia at morning. How can we distinguish amongst them in clinical case or exam question?
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Old 06-13-2010
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Quote:
Originally Posted by Dr. N Elham View Post
It is mentioned in Kap IM lecture notes that both Somogyi effect and dawn effect cause hyperglycemia at morning. How can we distinguish amongst them in clinical case or exam question?
The only way I know, is to measure blood sugar levels at 2 or 3 a.m
If it is low it is Somogyi whereas it is normal or high in Dawn

Why?

Since Somogyi mechanism is a result of counter-regulatory to high dose of insulin.This will increase glucose levels slowly

But Dawn mechanism is a result of inadequate evening insulin dose. So glucose would be high in a shorter time compared to Somogyi.
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Dr. N Elham (06-17-2010), Vomenti (06-13-2010)
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Old 06-13-2010
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Smile yep

yeah just like what good boy said,

You do a 3 AM glucose level, if it is low then what you have is Somogyi and you need to lower the insulin PM dose
if the glucose level were normal or high then what you have is dawn phenomenon and the management should be to increase the PM insulin dose.

By the way I heard that this is a very high yield in CK exam and the always ask about it.
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