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Somogyi Effect in Patient With Hypopituitarism
David L. Vesely, MD, PhD;
Albert Castro, PhD;
Gerald S. Levey, MD
Arch Intern Med. 1976;136(8):936-938.
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Insulin-induced posthypoglycemic hyperglycemia is an important cause of poorly controlled diabetes.1 This phenomenon, which is known as the Somogyi effect, is characterized by the following: (1) insulin-induced hypoglycemia and a rebound insulinresistant hyperglycemia; (2) negative urine tests for sugar and ketones, followed within several hours by substantial glycosuria and variable ketonuria; (3) wide daily fluctuations in blood glucose levels that are generally unrelated to dietary intake; (4) periods of mild hypothermia; and (5) nocturnal sweating and nightmares in patients with late-onset hypoglycemic effects. Although this clinical phenomenon was described initially by Somogyi and Kirstein,2 confirmed by numerous investigators,3-6 and thoroughly defined by Bloom et al,7 the basic mechanism underlying the compensatory insulin-resistant, hyperglycemia remains unexplained. A general consensus appears to have formed ascribing an important role for anterior hypophyseal hormones, particularly growth hormone, in the pathogenesis of the rebound hyperglycemia.1.8-10 This present case report demonstrates
. . . [Full Text PDF of this Article]
Author Affiliations
From the Division of Endrocrinology and Metabolism, Department of Medicine, University of Miami School of Medicine, Fla.
Footnotes
Received for publication Dec 17, 1975; accepted Dec 31.
Reprint requests to Division of Endocrinology and Metabolism, Department of Medicine, University of Miami School of Medicine, PO Box 520875, Biscayne Annex, Miami, FL 33152 (Dr Levey).
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