The father of an 11-year-old child with type 1 diabetes mellitus says that the child has frequent nightmares and wakes up in the middle of the night. What could be the cause of the nightmares?
1. The child is experiencing anxiety related to the diabetes.
2. The child might be experiencing Somogyi phenomenon, which often occurs at night.
3. The child might be experiencing dawn phenomenon with blood sugar elevations.
4. The child's nightmares have nothing to do with the diabetes.
Answer: 2
1. Anxiety is most likely not the cause for the nightmares.
2. The Somogyi phenomenon involves nighttime episodes of hypoglycemia, which cause tremors, restlessness, and night sweats, followed by a morning rise in blood sugar. They are a likely cause of the nightmares.
3. Dawn phenomenon is a rise in blood sugar between 5 and 8 a.m.
4. The Somogyi phenomenon involves nighttime episodes of hypoglycemia, which cause tremors, restlessness, and night sweats, followed by a morning rise in blood sugar. They are a likely cause of the nightmares.
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