The nurse is assessing the blood glucose levels of a diabetic patient getting long acting insulin at night every four hours. The nurse finds 75 mg/dL at 11:00 pm, 30 mg/dL of blood glucose at 3:00 a.m., and 170 mg/dL at 7:00 a.m. Which mechanism that you learned in your reading is at work here?

Question

Group of answer choices

Prediabetes

Dawn phenomenon

Presence of an insulin secreting tumor.

Somogyi effect

Answer 1

The scenario described in your question indicates that the patient experiences low blood glucose levels at night (30 mg/dL at 3:00 a.m.) followed by high levels in the morning (170 mg/dL at 7:00 a.m.). This pattern is suggestive of the Somogyi effect.

The Somogyi effect, also known as rebound hyperglycemia, occurs when a patient's blood glucose levels drop too low during the night, prompting a counter-regulatory response in the body that leads to high blood glucose levels in the morning. This can happen due to excessive doses of insulin or inadequate nighttime carbohydrate intake.

In contrast:

• Dawn phenomenon is characterized by increased blood glucose levels in the early morning due to normal hormonal fluctuations in the body.
• Prediabetes is a condition that precedes diabetes in which blood glucose levels are higher than normal but not yet high enough for a diabetes diagnosis.
• Insulin-secreting tumors (such as insulinomas) would typically lead to persistent hypoglycemia rather than the cyclical pattern shown here.

Thus, the correct answer is the Somogyi effect.