The Somogyi Phenomenon

Richard K. Bernstein, MD
Arch Intern Med. 1985;145(3):575. doi:10.1001/archinte.1985.00360030227050.
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To the Editor.  —Dr Raskin's1 recent contribution is possibly the first article to critically survey the literature relating to blood glucose (BG) overshoot. Hopefully it will open the eyes of the medical community to a myth that has served for years as one of the excuses for accepting as "physiologic" the roller coaster BG levels prevalent in insulin-dependent diabetes mellitus (IDDM).When I first became diabetic in the mid-1940s, we were taught not to overeat for attacks of hypoglycemia, and, above all, to consume the most rapidly acting carbohydrate we could find. In those days, unfortunately, pure glucose was not readily available to patients and we had to make do with packets of the slower-acting disaccharide—sucrose (table sugar). Then in the 1950s, Somogyi's crude studies began to influence the medical community and, in time, the Somogyi effect gained widespread usage as one of the several excuses for the "impossibility"


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