| Diabetes is an illness that the patient must live with | | | | ketones causes the pH of the system to drop. If the |
| the rest of their lives. The key to living with diabetes | | | | pH of the body drops below 7.35, a state of Diabetic |
| successfully is tight glycemic control, or controlling | | | | Ketoacidosis occurs, which can cause a diabetic coma. |
| blood sugar levels. Blood sugar levels can vary from | | | | This rebound hyperglycemia known to occur in |
| time to time depending on several factors such as | | | | response to hypoglycemia in the early hours of the |
| stress levels, amount of food consumed, type of | | | | morning between two and four A.M., is called, the |
| food consumed, amount of insulin used or insufficient | | | | Somogyi Effect. A good way of detecting the |
| insulin coverage and the time of day. | | | | Somogyi Effect is to have the diabetic test their |
| The human being responds to Circadian Rhythms. | | | | blood sugar during those hours. If their blood sugar is |
| These are regular changes in mental and physical | | | | low, then they can correct it by eating a snack, |
| characteristics that occur in the course of a day. This | | | | before going back to sleep. |
| term may be more familiar as the, "biological clock". A | | | | The Somogyi Effect can occur at anytime during the |
| good example is that of someone working midnights | | | | day, but is most often equated with the early hours |
| for the first time. They find it very difficult to sleep | | | | of the morning. Symptoms include headache, |
| during the day and stay awake all through the night. | | | | nightmares and night sweats. The treatment of this |
| It is as if their body has a mind of its own. In fact, | | | | phenomenon usually involves lowering insulin dosage |
| there is some truth to that statement. Bears | | | | prior to sleep. |
| hibernate because of their biological clock. | | | | Another disorder similar to the Somogyi Effect is |
| Circadian Rhythms combined with the above | | | | known as the Dawn Phenomenon. Although most |
| mentioned factors can produce wide fluctuations in | | | | diabetics are affected by this disorder, it seems to |
| the blood glucose levels of diabetics while they sleep. | | | | occur more often in pubescent adolescents. |
| A diabetic's blood glucose level may be at 135 mg/dL | | | | Adolescents' blood sugar is affected adversely by |
| prior to bedtime and at two A.M. may drop to 40 mg | | | | their body releasing counter regulatory hormones. |
| dL, causing a severe state of hypoglycemia. The | | | | These counter regulatory hormones produce |
| body responds to such a drop by producing glucose | | | | precipitously high blood sugar levels. It is thought that |
| from alternate sources, since there is no source of | | | | the growth hormone has some impact in relation to |
| ingested food. The only sources of glucose come | | | | the production of counter regulatory hormones. |
| from the liver via gluconeogenesis, lipolysis (break | | | | Usually upon waking, the diabetic's blood sugar is |
| down of lipids) and glycogenolysis. | | | | excessively high. Correction of the Dawn |
| The body's hormones stimulate this cascading | | | | Phenomenon requires an increase in insulin coverage |
| response to dangerously low blood sugar. The results | | | | prior to bedtime. |
| of such a response, is that of high blood sugar. This | | | | It is easy to see how both of these disorders can be |
| rebound hyperglycemia can in turn causes ketosis. | | | | mistakenly diagnosed for the other. That is why it is |
| Ketosis occurs because the body is fooled into | | | | important for the diabetic to test their own sugar on |
| thinking that there is not enough glucose, since the | | | | several early morning intervals and present the |
| cells are starved, and the glucose is floating in the | | | | results to their doctor. Correct determination of |
| blood stream instead of being utilized within the cells. | | | | which disorder is occurring is crucial to continued |
| The body then begins to break down proteins which | | | | health of the diabetic. |
| in turn cause the release of ketones. The release of | | | | |