Somogyi phenomenon

It refers to the hyperglycemia that occurs by counter regulatory hormones in response to hypoglycemia induced by insulin. This is most commonly observed as morning hyperglycemia.
The problem with this phenomenon is that we will have a tendency to increase the evening dose of insulin to try to decrease the morning hyperglycemia but in doing so we will induce more severe hypoglycemia at night and it will be detrimental for the patient.
The counter regulatory hormones include:
1) Glucagon
2) Epinephrine
3) Cortisol
4) Growth hormone.
Another cause of morning hyperglycemia is hypoinsulinemia resulting from the dawn's phenomenon.

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