What's the Best thing to do for a Somogyi effect episode?

Would like to know what is the best actions to take during a Somogyi effect episode? I've tried eating a small amount (little carbs high protein) numbers went up... i've tried shooting up with a few units of Humalog and numbers went up??? And exercising with numbers in the upper 200's low 300's
does not seem wise... so???
Have been T1D for 37 years now and i have this battle on occasion still and am at a loss to what to do... the Dawn Phenomena responds well with a few more units of Humalog and a walk but this Somogyi thing has me stumped.
Thanks for any in put y'all might have!
Peace LOVE and Light : )

What is the Somogyi effect for you? Can you describe the reaction in more detail?

"they" also call it "rebound" or "rebounding". It happens for me in the mornings and it has to do with too much insulin while sleeping. When blood glucose levels drop too low, the body sometimes reacts by releasing counterregulatory hormones such as glucagon and epinephrine. These hormones spur the liver to convert its stores of glycogen into glucose, raising blood glucose levels. This can cause a period of high blood sugar following an episode of hypoglycemia.
So when waking (6a.m.) @ 57mg/dl and then within half an hour after quickly walking the dog and throwing a flake of hay to the horse... the number rose to over 287mg/dl by 6:30a.m. then took a few units of Humalog to help and ate some (1/2 cup) oil and vinegar coleslaw to see if that would help but by 8 a.m. was 341 mg/dl...?
i know i should have acted quicker to counteract reaction before morning chores but as i sometimes do... made the incorrect call. And ,like i said, usually if it were the Dawn Phenomenon the insulin would have helped rather than elevate the number.?
But do you understand my confusion about what to do in the middle of the event? If there is too much insulin on board and it triggers this effect do i take more? because eating seems silly to stop the number from going higher too??? and exercise would make it worse too?
Thanks for the input.

I had an episode of this YEARS ago. about a year after I was diagnosed and still on animal insulins, damn near killed me. They switched me over to human insulin and thankful to say it's never been a problem since then. But what I recall, your blood sugars creep up around dinner and evening time, so you increase your evening dose, then you end up having wicked lows over night, but wake up in the AM at a normal level. At least that was what happened with me.

the best thing to do mateo is whatever correction it takes to get your bg back to the range you desire. When I have a rebound from a low it often takes more insulin because of the stress from the rebound. These are rare and from my experience are really a result of over treating a low. Exercise is not recommended as it will create another stress. I ignore IOB when I need to fix a problem. Also, when trying to fix high bg's I don't eat. Peace, love and light back at ya :)

Please be assured that in general the "Somogyi" effect does not exist for T1 diabetics. You might be the exception but I really doubt it. The point is that the Liver acts as a deposit for glucose. These deposits are very valuable thus the liver has developed strategies to preserve it. Here the insulin acts as an important signaling hormone for the liver. As long as there is excessive insulin present the liver will not release glucose in unusual amounts. In healthy people insulin is secreted for meals. Its presence does indicate that glucose has been absorbed into the blood stream increasing the level of BG. The beta cells will react to these small BG changes with insulin secretion. For the liver this means that glucose is already coming so nothing more needs to be added. In T1 diabetics excessive insulin is always present - bolus and basal. These levels will always prevent the liver to help us in case of going low. It can be said that the glucose dump mechanism is broken by design in insulin dependend diabetics. Again, your body might work differently but I really doubt it. I think your trouble is always the dawn phenomenon (DP). But your DP is not reliable thus the liver shows a very unpredictable behaviour. If this is the case then the drug Metformin has the potential to help you. This drug will regulate the glucose release of the liver down. As a result you will need less basal insulin and the DP spikes should be smaller. It is more and more common that small dosages of Metformin are used for T1 diabetics. Please ask your endo about it.

I think that the Somogyi effect has been discredited as the source of Darn Phenomenon, but it is present in T1. In practice, most T1s exhibit a rebound effect with a low blood sugar, but the signals (insulin and glucagon) which normally trigger a nice graceful counterregulation are messed up when you use external insulin. The extra insulin suppresses the liver from releasing glucose and when your body finally screams with a harsh hypo, your liver just totally dumps glucose causing a rebound high.

From what you wrote, you awoke, tested at 57 mg/dl and then walked and exercise by feeding your horse. I may well have been that this brought on a strong enough hypo to trigger a rebound effect. My suggestion would be that if you a prone to counterregulation, be diligent about treating any detected lows. Not treating the 57 mg/ml may have been a tactical error.

Thank you.

These wonderful posts don't need me adding my ideas, I guess. But since I'm here, let me add that a round the clock basal check sounds in order.

Best suggestion of all...basal is all too often overlooked as a cause of BG and insulin dosage challenges. Checking basal dosages, whether on MDI or a pump, pays off big time! I find that temp basals are a great way to see, in the short term, if the problem is there and adjustments are needed. It takes about three days for my basal changes to be fully impacting dosages,such as I:C ratio or post meal BGs.

For Somogyi effect you don't want to give yourself more fast acting insulin. But you do want to lower your basal isulin a tad. Somogyi happens when one goes low during sleep and then doesn't treat the low and wakes up with a rebound high. Beisides lowering your basal you can try eating something like ice cream before bed or toast and peanut butter or cheese, etc. The high amount of fat should help hold your blood sugars more steady through the night. The thing is you don't want to lower your basal a whole lot and you only need to do it long enough to avoid that low and then the rebound that happens from that untreated low. Of course if you know when the low happens you can always set your alarm to treat the low when it happens but I think you would rather not have the low and resulting rebound in the first place. I would head for doing a temporary of lowering the basal.

As I read more, your mistake was in not treating the low first of all then your exercise before eating, etc. caused your body to raise your blood sugar even more. Since you did not treat the low you got the all infamous rebound. Doing a temp basal to avoid those night time and early morning lows would help a great deal.

I never heard of Somogyi effect until I read this post. During my last visit with my Endo, I was describing why I was eating a little before I went to sleep and she said it may be Somogyi and I was able to understand what she meant,thanks to this post. Thank you
I was experiencing waking up with my hair and shirt soaked in sweat every morning, and originally thought it was because of the high BGs, usually well above 200. I woke up one morning a couple of hours early, sweating and feeling really low. BG was around 35, I ate something and went back to sleep, and my morning BG was at 90. That night I ate a bowl of cereal, slept all night, and woke up dry and BG was around 140. Now it is part of my routine, and most mornings my BG is below 150. My doc didn't like the idea too much eating before sleep, but it seems to work, and she reluctantly agreed. We did lower my early morning basal rate, but don't know how that is going to work just yet.

Brian BSC and karen provide some interesting excellent thoughts.

For me, I ALWAYS watch my BG and if I see it heading sub 100 to 80 I make sure I move to correct the low. once BG is sub 70, Liver/Brain swing into action and liver starts banging on the glucose. Due to faulty liver low insulin level signalling, my liver wants to throw the whole liver buffer at the problem and hammering my blood stream glucose vertical. The only times this does not happent is when liver buffer is drawn down or metformin in blood stream has liver by the throat.

this IS NOT a T1 issue versus T2 but simply liver operation mechanics. It may be true more likely seen in T2 but even a T1 this can probably happen.

THis discussion always amazes me.

There are a number of issues:

digestion is a 2 hour hiatus for the simple stuff and 6 hours for the tough stuff.

Going to sleep usually means digetsion action gets shut down and things dawdle along.

As masty old Type 2 and have watched my system intensely on CGMS, i do not eat snacks/ foods needing full digestion after dinner 5:00pm in the evening.

My goal is that by 11:30 pm all intestine work should be done and if blood glucose is high, I add small shot of humalog lispro at midnight and have metformin working the late night hours as well.

For me that seems to work out consistently.

Somogyi effect is triggered when you go low during the night. So the simple answer is don't go low during the night. It's totally different from the Dawn Phenomenon.

Digestion during sleep doesn't shut down. In certain stages of sleep it is slowed, but overall it continues as an autonomic process just like it does during your waking hours.