A 17-year-old boy with type 1 diabetes mellitus on insulin therapy presents with fasting morning glucose levels of 280 mg/dL. His endocrinologist requests 3 AM glucose checks, which consistently show levels of 60 mg/dL. Vital signs are stable: BP 118/76, HR 82, RR 16, temp 37°C, SpO2 98%. HbA1c is 9.2%. He denies nocturnal sweating or seizures. Which of the following best explains his morning hyperglycemia?
- A)Somogyi effect due to nocturnal hypoglycemia triggering counterregulatory hormonesGABARITO
- B)Progressive beta cell failure from type 2 diabetes
- C)Inappropriate ADH secretion overnight
- D)Dawn phenomenon due to increased growth hormone without overnight hypoglycemia
- E)Excess calcitonin secretion
Explicação
The Somogyi effect is rebound morning hyperglycemia after nocturnal hypoglycemia triggers counterregulatory hormones. Low glucose at 3 AM is the distinguishing feature. Ver explicação completa e trilha adaptativa →