American Board of Internal Medicine (ABIM) Certification Practice Exam

What physiological response is linked to the Somogyi effect?

1. Extreme fatigue

2. Rebound hyperglycemia following hypoglycemia

3. Persistent hyperglycemia throughout the day

4. Increased urine output

The correct answer is: Rebound hyperglycemia following hypoglycemia

The Somogyi effect, also known as rebound hyperglycemia, occurs when there is a drop in blood glucose levels (hypoglycemia), often due to insulin administration or other factors, which then triggers a physiological counter-regulatory response. The body reacts to the hypoglycemia by releasing hormones such as glucagon and epinephrine, which stimulate gluconeogenesis and glycogenolysis. This results in an overproduction of glucose, leading to high blood sugar levels following the initial drop. Thus, the essence of the Somogyi effect is the sequence of hypoglycemia followed by a compensatory hyperglycemic state. Recognizing this is crucial for management, especially in individuals with diabetes who may be adjusting their insulin dosage and need to monitor for fluctuations in their blood sugar levels closely. Understanding this physiological mechanism is vital for effective treatment and management strategies to prevent such swings in blood glucose.