58yo male, with DMI controlled with insulin, has blood glucose measurements in the morning of 205-272 mg/dL for the past week. He reports that his evening blood glucose measurements before bed range from 103-127 mg/dL. What are two potential causes of these findings?
There are two potential causes of early morning hyperglycemia in a diabetic patient on insulin.
- Dawn Phenomenon
- Due to the early morning rise of cortisol, patients can experience an early morning hyperglycemia as a result
- Somogyi Phenomenon
- (as covered by last week’s Ep-PAINE-nym) This was theorized to occur as undetectable hypoglycemia while the patient was asleep and the resultant hyperglycemia from instrinsic protective mechanisms.