Can exercise trigger the Somogyi effect?

There continues to be debate about the Somogyi effect (http://emedicine.medscape.com/article/125432-overview), but in either case, I’d suggest an alternate explanation for what you experienced. But, before I’d do that, I’d like to dispel the idea that the Somogyi caused your elevated blood sugar. The Somogyi effect is an overshoot of the counterregulatory effect and would have occurred in the period within a few hours of your snowshoing/skiing. A counterregulatory response will typically leave you in the 300s and feeling like a truck hit you. That did not occur, instead, the next day you simply had modestly elevated blood sugars.

Ok, so here is my explanation. You were “really active” by your own words. Were you by chance sore the next day? A particularly aggressive exercise session can increase hormones for literally days. It is common for cortisol to be elevated for a day or two and that alone could cause elevated fasting levels. Other hormones also come into play, such as Growth Hormone which is elevated overnight following exercise. I suspect that your blood sugar returned to normal after another day. A good source for information on the effect of exercise on the diabetic body is Sheri Colberg, she has some very good books and maintains a website with a good deal of useful information (http://shericolberg.com/).

I have a generally focused GP, well, he seems to be versed on diabetic treatment as one of his interests. He doubts the dawn phenomenon and Somogyi (why couldn’t he/she have a different name??). I show the evidence, BG at 3 am show a 95-105, bedtime can be anywhere from 105-115, and next morning, I wake up at 13X. Diet and exercise maintained.

What does he do? Puts me on Metformin at supper. Seems to work better, BG drops to 11X-12X. Suddenly, no change in behavior/eating, and it suddenly starts hitting 15X for mornings EVERY day. Same night time numbers. What does he do after me living this for several months? Doubles my metformin to lunch and supper. If anything, it makes it worse.

I’m moving that daggone dose around. Tried lunch, then my supper BG is real low (T2 version of low). Moved the met. to bedtime, still in the high 13X to 15X.

I’m snacking at bedtime, protein and fat, sometimes some light carbs.

Anyone else having Metformin adventures? Ideas?

One of the primary effects of metformin is to reduce the amount of blood sugar produced by your liver. Since DP is a production of glucose by your liver, metformin may actually help in reducing DP. You can try to take “all” of your metformin at bedtime and see if that addresses your DP. But the sad story is that if you are at all insulin deficient, your body will naturally “clear” insulin overnight, leaving you vulnerable to rises in blood sugar in the morning.

Don’t for a minute doubt that the DP is real, it affects many diabetics. Different people respond differently to attempts to help DP. In my case, exercise drives DP, don’t squat heavy. Some people find eating certain kinds of snacks help, it never helped me. I found drinking two glasses of red wine before sleeping helped, but although I enjoy red wine, I don’t like chugging two glasses while I brush my teeth. Search for DP and get a plethora of suggestions.