IS THE SOMOGYI PHENOMENON REAL?

For 50 years, physicians have been told that nocturnal hypoglycemia can result in a "rebound" hyperglycemia that produces paradoxically high fasting-blood-sugar levels the next morning -- an effect known as the Somogyi phenomenon. If such an effect does occur, the appropriate response would be to decrease the insulin dose, particularly if an injection were given in the evening.

Ten patients with insulin-dependent diabetes mellitus taking their usual therapeutic regimens and engaging in their usual activities, were studied on three nights. The patients either received no treatment, were kept euglycemic, or were made hypoglycemic during the night. The next morning, rebound fasting hyperglycemia was not observed in the patients made hypoglycemi…