In what scenario should the Somogyi effect be suspected?

The Somogyi effect, also known as rebound hyperglycemia, occurs when blood glucose levels drop too low, typically due to excess insulin administration, often during the night. During this hypoglycemic episode, usually occurring between 2 a.m. and 3 a.m., the body responds by releasing counter-regulatory hormones such as glucagon and epinephrine, which elevate blood glucose levels.

In this context, the scenario that suggests the Somogyi effect is characterized by low blood sugar levels during the early morning hours, followed by a subsequent rise in fasting glucose levels throughout the day. Recognizing this pattern is essential for effective diabetes management, as it indicates a need to adjust insulin dosages or meal planning to prevent nocturnal hypoglycemia and its subsequent rebound.

The presence of consistently high blood sugar levels, elevated fasting glucose, or the absence of symptoms do not point toward the Somogyi effect. In those cases, different underlying causes of hyperglycemia or diabetes management issues should be considered.