August 1976

Somogyi Effect in Patient With Hypopituitarism

Author Affiliations

From the Division of Endrocrinology and Metabolism, Department of Medicine, University of Miami School of Medicine, Fla.

Arch Intern Med. 1976;136(8):936-938. doi:10.1001/archinte.1976.03630080070021

Insulin-induced posthypoglycemic hyperglycemia is an important cause of poorly controlled diabetes.1 This phenomenon, which is known as the Somogyi effect, is characterized by the following: (1) insulin-induced hypoglycemia and a rebound insulinresistant hyperglycemia; (2) negative urine tests for sugar and ketones, followed within several hours by substantial glycosuria and variable ketonuria; (3) wide daily fluctuations in blood glucose levels that are generally unrelated to dietary intake; (4) periods of mild hypothermia; and (5) nocturnal sweating and nightmares in patients with late-onset hypoglycemic effects. Although this clinical phenomenon was described initially by Somogyi and Kirstein,2 confirmed by numerous investigators,3-6 and thoroughly defined by Bloom et al,7 the basic mechanism underlying the compensatory insulin-resistant, hyperglycemia remains unexplained. A general consensus appears to have formed ascribing an important role for anterior hypophyseal hormones, particularly growth hormone, in the pathogenesis of the rebound hyperglycemia.1.8-10 This present case report demonstrates

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