The Somogyi hypothesis: a parallelism with Michael Somogyi's life

Abstract

Michael Somogyi (Somogyi Mihály, 1883-1971) was a Hungarian biochemist who developed his scientific career in Europe and, primarily, the United States. He gave the name to the eponymous Somogyi effect or Somogyi hypothesis (in short, rebound hyperglycemia after insulin-induced hypoglycemia, particularly nocturnal), which was an axiom in the treatment of diabetes for decades. Although it is currently debated whether the Somogyi hypothesis is a real or relevant phenomenon in patients with diabetes, Somogyi's other significant career achievements are often overlooked. The aim of this historical note is to compile and highlight Michael Somogyi's scientific achievements. Michael Somogyi was a pioneer in the administration of insulin to patients with diabetes in the United States and in devising a method for insulin production. In addition, he highlighted the relevance of diet in patients with diabetes and was one of the first chemists to be integrated into clinical laboratories. There, Somogyi standardized long-lasting biological determinations, such as that of amylase, and he was one of the first scientists to combine basic research (from his training as a biochemist) with clinical research in close collaboration with physicians caring for patients, which is what we know today as translational research. Notably, the trajectory of his scientific career resembles the rebound effect of Somogyi's hypothesis: after reaching a low point of work activity well below his professional qualifications, his effort and tenacity led to the aforementioned achievements, and he became part of the history of hypoglycemia and diabetes.

Keywords: Diabetes; Hypoglycemia; Insulin; Somogyi.

Fig. 1

Schematic representation of Dr. Somogyi’s biography with the main events of his professional career. The units of the ordinate axis are arbitrary and attempt to represent the professional category of the work carried out at each moment in relation to his academic training. The lows and highs of this indicator resemble the ups and downs that characterize the so-called Somogyi effect that he described (lower panel)

Fig. 2

Portraits of Dr. Somogyi during his time in Hungary (left photo, the back of which reads "Taken in Europe", c. 1900–1925) and during his later time at the Jewish Hospital in St. Louis (MO, USA; right photo, c. 1940–1949). Courtesy of the Science History Institute, Philadelphia, USA. Available at: https://digital.sciencehistory.org. No known copyright (left photo); In Copyright-Rights-holder(s) unlocatable or unidentifiable (right photo)

Fig. 3

Various devices for estimating urinary glucose designed by Dr. Somogyi (c. 1930–1950) and developed by the local A.S. Aloe Co. in St. Louis (MO, USA). The estimation of urinary glucose concentration was carried out by colorimetric comparison, on paper (upper panel), plastic wells (middle panel), or wooden comparator for urine in a test tube (lower panel). Courtesy of the Science History Institute, Philadelphia, USA. Available at https://digital.sciencehistory.org. Public Domain Mark 1.0 (upper panel); Creative Commons Attribution 4.0 International License (middle and lower panel)