What is the main difference between the Somogyi effect and the dawn phenomenon in patients with diabetes?

A. Low-residue diet predisposes to colon diverticula: A low-fiber (low-residue) diet leads to harder stools and increased intraluminal pressure during bowel movements, which promotes the formation of diverticula, especially in the sigmoid colon.

B. Diverticulum may become infected, causing diverticulitis: When fecal material becomes trapped in a diverticulum, it can lead to localized infection and inflammation known as diverticulitis, which may cause pain, fever, or even abscess formation.

C. Ulceration of lining of diverticula caused by fecal material in the diverticula may cause bleeding from the ulcerated diverticulum: Trapped fecal matter can irritate and ulcerate the mucosal lining of diverticula, leading to localized bleeding, which may be seen as rectal bleeding or blood in the stool.

D. Diverticula predispose to colon carcinoma: Diverticulosis is not considered a premalignant condition. Although both conditions may coexist in older adults, the presence of diverticula does not increase the risk of colon cancer.

A. Increase their intake of cranberry juice and other fluids: While cranberry juice and increased fluids may help prevent or relieve mild urinary tract infections, the presence of blood in the urine (hematuria) and lower abdominal pain may indicate a more serious condition that requires professional evaluation rather than home remedies alone.

B. Wait and see if it goes away without treatment: Ignoring hematuria and pain can delay diagnosis and treatment of potentially serious conditions such as infections, stones, or other urinary tract problems. Prompt assessment is important to prevent complications.

C. Go to the emergency room right away: Unless symptoms are severe, such as uncontrollable pain, fever, or signs of systemic infection, immediate emergency care may not be necessary. However, timely medical evaluation is still essential.

D. Get an appointment with their family provider: This is the most appropriate advice because a healthcare provider can perform necessary assessments, such as history, physical exam, and diagnostic tests, to determine the cause of hematuria and pain and initiate appropriate treatment.