Dawn Phenomenon

00:00 With dawn effect, the counter-regulatory hormones often peak around dawn.

00:05 We know that already, for example, cortisol; cortisol is highest.

00:09 Remember the diurnal pattern.

00:10 It will be highest in the morning… cortisol is.

00:14 Therefore, leading to high blood sugars, a little bit different from somogyi... somogyi is a-is a story, meaning to say that you had decreased blood glucose around two to three and so, therefore, the counter-regulatory hormones kicked in therefore resulting in high blood sugar in the morning.

00:32 With the dawn effect, you wake up, you have those high levels of counter-regulatory hormones such as cortisol resulting in high blood sugar, minimized by using long-acting insulin that provides steady levels such as glargine.

00:45 Remember glargine? Not only could it cover you for a day, maybe a little bit more or by insulin pump, different from somogyi.

00:53 If you’re confused between the two, what it basically means is that the dawn phenomenon is the fact that you’re trying to control how much counter-regulatory hormone is being released in the morning resulting in that spike of glucose perhaps and somogyi would mean that you need a bedtime snack so that you do not drop your glucose levels and become hypoglycemic in the middle of the night.

01:18 Other strategies for type I diabetes… insulin pump, continuous subcutaneous insulin infusion CSII.

01:28 Used buffered regular insulin and perhaps islet cell transplantation, if at all possible… a lot of research on that particular method.