Studi Kasus : Fenomena Fajar dan Efek Somogyi pada Pasien Diabetes di Lihat dari Kadar Gula Darah dan Masalah Keperawatan yang Muncul di Filipina

Abstract

Early morning hyperglycaemia in diabetics can be caused by the dawn phenomenon, the Somogyi effect, or poor glycaemic control. The dawn phenomenon occurs when endogenous insulin secretion decreases or when the effect of exogenous insulin given to the patient the day before disappears, along with a physiological increase in insulin antagonist hormone. When people with diabetes eat too late at night, consume alcohol, or use insulin too late, it will cause a spike in blood sugar levels in the morning. This condition is known as the Somogyi effect and is caused by the human activity itself. The Somogyi effect is present in the case of excessive amounts of exogenous insulin. The dawn phenomenon is more common than the Somogyi effect. This research method uses a case study to explore the problem of nursing care in patients with diabetes mellitus at St Paul University Hospital, Philippines. Data were collected using interviews, observation, physical examination, and documentation. The data obtained were analysed by descriptive method, compiled from diagnosis to evaluation using three diabetic patients as sampling. To diagnose this dawn phenomenon, it is important for nurses to measure plasma glucose levels over several nights between 3 am and 5 am or use a continuous glucose monitoring system. Although the treatments are different, the best way to prevent the dawn phenomenon and the Somogyi effect is to control diabetes optimally with insulin therapy. It is hoped that nurses, clients, and families can monitor the patient's glucose levels periodically to prevent complications in diabetes.
 Keywords : Diabetic, Somogyi, Down Phenomenon Effect, case study