Re: Somogyi
- From: "Just Me" <pstevenoops@xxxxxxx>
- Date: Mon, 4 Sep 2006 19:48:53 -0400
<shoppa@xxxxxxxxxxxxxxxxx> wrote in message
news:1157412759.625093.297210@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
Just Me wrote:
Anyone here dealing with Somogyi - the rebound phenomenon? My endo
believes only Type 1's get this and very rarely (I am type 2). Yet my
symptoms fit perfectly and have for years. Tested a few times at 3 am
and
yep, lower than my bedtime, yet when I wake up it is skyhigh! One night
it
went from 92 at bedtime to 390 the next morning. All I ate at bedtime
was
2 pices of cheese. So what do any of you do the help this? I have
tried
protein with no effect, carbs with no effect, nothing with no effect,
switch
my Lantus from morning to night with no change. I am on Lantus in the
evening 30 units and Humalog at mealtimes.
Have been a diabetic for 20 years - would like to straigthen these out.
Can achieve good control during the day most of the time - after I get
the
high mornings down.
Do you have normal hypoglycemic awareness? Recently as opposed to the
past? 20 years is a commonly named point where hypoglycemic unawareness
tends to begin especially under tight control.
I experienced several episodes earlier this summer where I had no warning
that a low was coming on. One of them landed me in the ER because I became
basically comatose with a BG of 26. Gave me an IV and I popped back.
All episodes resulted in extreme reactions where I know I lost touch with
everything for a while. One of them did occur overnight. I woke up at my
computer, moaning and had no idea how I even got there.
I think they were mostly to blame from the Lantus - I know the ER one was as
I had not had humalog for over 6 hours. The ER doctor felt I was on way
too much Lantus.
Any recent hypoglycemic episodes during the day? Different than the
usual patterns? Caught from symptoms first or from low bg's?
I average a low - under 65 - once a day. But since the Lantus has been
cut in half, I feel them coming on again.
Somogyi effect pretty much requires hypoglycemia at some point to get
the rebound from. It is difficult to diagnose it for sure unless you
get the rebound. The rebound itself can be pretty nasty and leave you
feeling pretty bad in the morning. Of course just having high bg's by
themselves leaves me feeling nasty in the morning.
Especially if you're getting no hypo symptoms it will be hard to point
at Symogyi. Although you're using insulin so clearly it is a
possibility.
I set an alarm and tested every 3am for about 10 days. All resulted in 3
am results 30-100 points or more lower than my bedtime BG, and then a
resulting higher FBG, though not usually as severe as the one I mentioned.
I read somewhere that it doesn't have to be a true hypo, just the large drop
can trigger the somogyi effect.
Alternative explanation is the truism: "The most common cause of
morning hyperglycemia is hypoinsulinemia" (e.g. not enough insulin).
I am finding that since the Lantus was cut in half, the daytime BGs are
easier to control. I was on a real roller coaster before that and found
myself eating to control the insulin, instead of taking insulin to control
what I eat.
I have found over the years that the summer-to-fall transistion
(shorter days, different activities) can require largish changes in
insulin therapy even though I'm trying to keep everything constant.
Tim.
.
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