somogyi effect: hypoglycemia at night , followed by rebound hyperglycemia in the morning , hypoglycemia due to so much insulin trigger release of counter regulatory hormones(epinephrine , glucagon,GH,cortisol ,all of them promote hepatic secretion of glucose and induce transient insulin resistance)
Treatment : decrease insulin(evening dose) dose or change time of administration
dawn phenomenon : early morning hyperglycemia and there is no hypoglycemia at night , appears to be the effect of growth hormones , increased liver glucose production , decrease peripheral tissue use
Treatment :increase insulin dose (increase basal insulin ) or adjust timing to improve control
the most important !
how to differentiate :
check blood glucose at middle of night , high or normal indicate dawn , low sugar indicate somogyi
Mnemonic :
somogyi : so much insulin
dawon : down insulin(low insulin)