Somogyi effect is characterized by what pattern and management?

• A. Too much insulin at night causes morning hyperglycemia; lower insulin at night
• B. Dawn phenomenon
• C. Insulin resistance
• D. Hypoglycemia at night

Answer: (A)

Somogyi effect happens when excess insulin at night leads to nocturnal hypoglycemia. In response, the body releases counterregulatory hormones such as glucagon, epinephrine, and cortisol, which drive morning hyperglycemia. The appropriate management is to lower the nighttime insulin dose (and/or add a bedtime snack to prevent overnight lows). To confirm the pattern, fasting checks or a glucose reading in the middle of the night (around 2–3 am) can reveal hypoglycemia preceding the morning rise. This distinguishes it from the dawn phenomenon, which is morning hyperglycemia due to an early morning rise in hormones without preceding nocturnal hypoglycemia.