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.