COUNTER REGULATORY MECHANISMS IN DIABETES MELLITUS

Question 1

What are the counter regulatory mechanisms?

Answer 1

Somogyi (SO MUch insulin) Effect & Dawn (down insulin) Phenomenon

Question 2

What is the Somogyi effect characterized by?

Answer 2

Insulin induced hypoglycaemia followed by rebound hyperglycaemia
- the hypoglycaemic state stimulates glucose CRH (catecholamines, glucagon, cortisol, GH) as a part of compensatory mechanism
- these hormones cause hyperglycemia to produce insulin resistance
- the cycle occurs when hyperglycaemia and insulin resistance is treated with larger insulin doses

Question 3

Management to prevent hypoglycaemia and subsequent CRM activation includes?

Answer 3

Redistributing dietary carbs and altering insulin dose or time of admin

Question 4

Does the Somogyi effect occur in T1 or T2 diabetes?

Answer 4

Usually occurs in T1, but can occur in T2D if insulin is prescribed