So Apparently I Have Textbook Somogyi Rebound Effect....

[notorious_bob]

For which there is no current treatment.

Anybody in the same boat and get a different story from their healthcare provider or endo?

 

[EllieM]

For which there is no current treatment.

Anybody in the same boat and get a different story from their healthcare provider or endo?

Just googled it. So it's rebound high blood sugar in response to too low at night? I thought that went with the T1 territory. And surely you treat it by not going too low at night????

 

[EllieM]

Just googled it. So it's rebound high blood sugar in response to too low at night? I thought that went with the T1 territory. And surely you treat it by not going too low at night????

Ah, just realised you may be T2. Easier said than done, then. What medications are you on?

 

[Jollymon]

If you go lo, Symogi Effect will pop you back up. It’s a life saving reaction that the body can do all by itself. The problem with it is the uncontrolled high that it creates. To fix it, you need to correct your insulin dose-you’re PROBABLY taking too much insulin. An insulin driven low will create a Symogi driven high.

When I bounce off the bottom it usually takes about 36 hours to regain bs control. So I try really hard not to let Symogi Effect go to work.

 

[notorious_bob]

If you go lo, Symogi Effect will pop you back up. It’s a life saving reaction that the body can do all by itself. The problem with it is the uncontrolled high that it creates. To fix it, you need to correct your insulin dose-you’re PROBABLY taking too much insulin. An insulin driven low will create a Symogi driven high.

When I bounce off the bottom it usually takes about 36 hours to regain bs control. So I try really hard not to let Symogi Effect go to work.

Only problem is that I'm not on Insulin!

I was briefly, when no one could even work out what was going on and my fasting blood sugar was my highest reading. Putting me on insulin, initially last thing at night almost killed me. Causing hypos in the middle of the night. My fasting i.e. 1st thing in the morning Bg averaged 50 points higher on insulin than off.

My normal body without any drugs is experiencing the Somogyi Effect. Apparently once my Bg hits a particular level at night then my Glucogon spikes and my liver dumps glucose in response. The longer I wait before eating, the higher my Bg goes.

So, if I eat early and sleep in late, my fasting Bg can be crazy!

If I eat more or later and then get up early then my Bg is lower.

Quite bonkers.

Round 2 with my new endo on Friday!! Now idea what Plan F will be!

 

[notorious_bob]

Ah, just realised you may be T2. Easier said than done, then. What medications are you on?

No meds, they've tried a bunch but most just make things worse. Doctor mentioned that I might be T1.5 before the Somogyi doodah became the prime suspect.

 

[Jollymon]

Insulin or no insulin, if your body feels threatened by how it feels for bs levels, it may launch a Symogi Effect.

If you’re trying to gain better control, do it gradually. False hypo can trigger Symogi Effect in people who have become accustom to being high.

 

[notorious_bob]

Insulin or no insulin, if your body feels threatened by how it feels for bs levels, it may launch a Symogi Effect.

If you’re trying to gain better control, do it gradually. False hypo can trigger Symogi Effect in people who have become accustom to being high.

Seems like my body has been doing this for a long time - years, not months.

My previous doctor thought my liver would "run out of sugar" - it hasn't.

"Control" is something I seem destined not to have

 

[EllieM]

Well, the cure is possibly worse than the disease, but have you considered setting your alarm for 2am and having a snack....?

Edited to add - have you looked at the reactive hypoglycaemia forum to see how they cope? It seems like you may have a similar issue....

 

[Jollymon]

Then you should call it “fatty liver”. Which will have an endless supply of glucagon. I don’t know how to fix that.

 

[kitedoc]

Hi @notorious_bob,
Some people with T2ds or pre-diabetes can go hypo about 3 to 3 1/2 + hours after a biggish meal.
The person's own insulin rise in these people lags behind the blood glucose rise, so that this mistiming leads to late surge in insulin.
The BSL peaks at 2 hours or so, then dips as the late insulin surge pushes it down to sometimes hypo levels at 3 - 31/2 + hours.
If hypo blood sugar level is low enough a release of liver-derived glucose can push the blood sugar up. = Somogyi.
So no extraneous insulin required !!
If you think about it the above is like a Glucose Tolerance Test (GTT - this is not the abbreviation for a sports car !!), except that in a GTT they usually stop the test at the 2 hour mark.
No doubt your endo will be able to help you.

 

[Alison54321]

A late night snack of blackberries might help you out here. Super high in vitamins E and C, low carb berries, low GI. But anyway...........

 

[kitedoc]

Maybe a low carb (with low GI carbs) and some protein to stretch out and keep the blood sugar rise flat will produce less insulin surge, less risk of hypo, less risk of rebound.

 

[Engineer88]

Seems like my body has been doing this for a long time - years, not months.

My previous doctor thought my liver would "run out of sugar" - it hasn't.

"Control" is something I seem destined not to have

Sounds like a dawn phenomenon - what time are hypos and when do the rises start?

 

[GyCix]

I am exeriencing something similar, I go to bed with a reading of 5.9 (2 hours after eating) and upon waking have a reading of 6.5 -7.0 After explaining this to a diabetic nurse at health centre she could not expalin. I too do not take insulin or any other drugs to control Diabetes. I was diagnosed in March 2018 and decided to do the 800 calorie a day diet, and lost 12.7 KG in 8 weeks I now weigh 90 KG. In my retest in June i was reading as pre-diabetic with a HbA1c of 42 down from 67. I plan to loose another 6KG in October this year with a month of 800 calorie a day. Do you think this will help?
I have been regulary exercising for the last 6 years ( and most of my adult life) squash once a week and 1 or 2 Gym sessions and some occasional running/cycling.

 

[derry60]

Dare I say it...How about before going to sleep. Have a glass of red wine and a slice of cheese. I find this keeps my fasting BS lower

 

[Lamont D]

For which there is no current treatment.

Anybody in the same boat and get a different story from their healthcare provider or endo?

Well, the cure is possibly worse than the disease, but have you considered setting your alarm for 2am and having a snack....?

Edited to add - have you looked at the reactive hypoglycaemia forum to see how they cope? It seems like you may have a similar issue....

Hi and welcome to the forum.
I have Reactive Hypoglycaemia.
What the symogi effect does is the other extreme to RH.
With RH you have an overshoot of insulin after digestion due to a hyper level of blood sugar. The pancreas produces too much insulin and you hypo. This mainly happens because of carbs during day time in the norm, but it can happen at night.
I believe the symogi effect is because your liver overshoots glucose during the night due to low or quick dropping blood sugar levels or too much insulin circulating.
My treatment to avoid my condition is avoiding the foods that trigger the hyper, if I don't hyper then I don't go hypo.
My advice is to find out by testing and experimentation what foods, drinks and lifestyle that causes the liver to produce too much glucose.
I get a rebound effect if I don't eat very low carb, because I have to deal with yo-yo fluctuations in blood glucose levels. It's like a rollercoaster ride, up and down.

Just one question, what is causing the hypos during the night, but not through the day?
Some type twos have to eat regularly even though the night to try and offset the dawn phenomenon..
As I found out, you have to find a way to stop the triggers.
No trigger, no hypo, no hyper. It's not easy, but well worth avoiding the foods that do cause these types of conditions.

Best wishes

 

[Bluetit1802]

I am exeriencing something similar, I go to bed with a reading of 5.9 (2 hours after eating) and upon waking have a reading of 6.5 -7.0 After explaining this to a diabetic nurse at health centre she could not expalin. I too do not take insulin or any other drugs to control Diabetes. I was diagnosed in March 2018 and decided to do the 800 calorie a day diet, and lost 12.7 KG in 8 weeks I now weigh 90 KG. In my retest in June i was reading as pre-diabetic with a HbA1c of 42 down from 67. I plan to loose another 6KG in October this year with a month of 800 calorie a day. Do you think this will help?
I have been regulary exercising for the last 6 years ( and most of my adult life) squash once a week and 1 or 2 Gym sessions and some occasional running/cycling.

That sounds more like common or garden dawn phenomenon to me. The Somogi effect is not the same thing.

https://www.dietdoctor.com/the-dawn-phenomenon

 

[notorious_bob]

Well, the cure is possibly worse than the disease, but have you considered setting your alarm for 2am and having a snack....?

Edited to add - have you looked at the reactive hypoglycaemia forum to see how they cope? It seems like you may have a similar issue....

Setting my alarm for 2 am would make for a horrendous lifestyle. I'm a single father with a 7yr old. Added to that I find it near impossible to go back to sleep once I've woken up. I'd be a zombie!

 

[notorious_bob]

Maybe a low carb (with low GI carbs) and some protein to stretch out and keep the blood sugar rise flat will produce less insulin surge, less risk of hypo, less risk of rebound.

Yeah, a late night snack and early start does help. e.g. snack at midnight and then up at 6 am. For each hour past 6 am my Bg rises 10-20 points