What phenomenon occurs when a patient's morning blood glucose levels increase after an increase in their evening insulin dose?

The phenomenon described in the scenario is known as the Somogyi effect. This occurs when a patient experiences rebound hyperglycemia in the morning as a result of nocturnal hypoglycemia that can be triggered by too much insulin administered in the evening. When the insulin dose is increased in the evening, it can lead to a drop in blood glucose levels during the night. In response to this hypoglycemic episode, the body releases counter-regulatory hormones such as glucagon, epinephrine, and cortisol to raise blood glucose levels back to normal. This rebound effect results in elevated blood glucose levels in the morning, leading to the observation of higher morning glucose levels after an increase in evening insulin.

Understanding the Somogyi effect is crucial when managing diabetes, particularly in individuals who may be experiencing swings in blood glucose levels due to insulin dosing. Recognizing this pattern can inform appropriate adjustments in insulin therapy and improve overall glycemic control.