Family Nurse Practitioner Exam

What is the primary mechanism behind the elevated fasting blood glucose in the Somogyi phenomenon?

1. Increased glucagon production

2. Increased insulin resistance

3. Reduced sensitivity to glucose

4. Increased lordosis

The correct answer is: Increased glucagon production

In the Somogyi phenomenon, the primary mechanism behind elevated fasting blood glucose levels is the increased glucagon production. This phenomenon occurs when there is a rebound hyperglycemia after periods of hypoglycemia, often due to excessive insulin administration or insufficient carbohydrate intake. When blood glucose levels drop too low during the night, the body responds by increasing the production of glucagon, a hormone produced by the alpha cells of the pancreas. Glucagon plays a crucial role in raising blood glucose levels by promoting gluconeogenesis and glycogenolysis in the liver. This counter-regulatory response leads to elevated blood glucose levels upon waking after an episode of nocturnal hypoglycemia. Understanding this mechanism is essential for managing patients with diabetes, particularly in adjusting their insulin regimen to prevent cycles of hypoglycemia and subsequent hyperglycemia that can occur with the Somogyi effect.