Dead-in-bed syndrome
|
Diabetes mellitus type 1 Microchapters |
|
Differentiating Diabetes mellitus type 1 from other Diseases |
|
Diagnosis |
|
Treatment |
|
Cardiovascular Disease and Risk Management |
|
Case Studies |
|
Diabetes mellitus Main page |
|
Patient Information |
|---|
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Robert G. Badgett, M.D.[2]
Dead-in-bed syndrome unexpected death in young type 1 diabetic patients "with no history of diabetic complications, and in particular no autonomic dysfunction. They are found in an undisturbed bed, which seems to exclude death during a convulsive attack"[1].
This was first described in a series of 20 patients in 1991[2].
Etiology
Proposed causes include:
- Hypoglycemic unawareness[3][4] or the 'hypoglycemia-unawareness syndrome'[5]
- Hypoglycemia-induced ventricular dysrhythmia due to QT prolongation during hypoglycemia[6][7]
- Hypoglycemia-induced autonomic dysfunction which may lead to ventricular dysrhythmia due to QT prolongation[8]
Diagnosis
Diabetic ketoacidosis may be sought during autopsy by vitreous fluid biochemical analyses [9].
Prevention
Nocturnal hypoglycemia may be prevented by glucose sensors
Clinical practice guidelines by the American Diabetic Association recommend.
The MiniMed(®) Paradigm™ Veo system may be the most effective system[10]. However, the cost effectiveness is not certain[11].
Closed loop systems (artificial pancreases) may be effective according to a systematic review[12].
Sensors may not completely prevent dead in bed syndrome[13]
References
- ↑ Sovik O, Thordarson H (1999). "Dead-in-bed syndrome in young diabetic patients". Diabetes Care. 22 Suppl 2: B40–2. PMID 10097898.
- ↑ Tattersall RB, Gill GV (1991). "Unexplained deaths of type 1 diabetic patients". Diabet Med. 8 (1): 49–58. PMID 1826245.
- ↑ Hanas R (1997). "Dead-in-bed syndrome in diabetes mellitus and hypoglycaemic unawareness". Lancet. 350 (9076): 492–3. doi:10.1016/S0140-6736(05)63081-4. PMID 9274591.
- ↑ Gerich JE, Mokan M, Veneman T, Korytkowski M, Mitrakou A (1991). "Hypoglycemia unawareness". Endocr Rev. 12 (4): 356–71. doi:10.1210/edrv-12-4-356. PMID 1760993.
- ↑ Schultes B, Jauch-Chara K, Gais S, Hallschmid M, Reiprich E, Kern W; et al. (2007). "Defective awakening response to nocturnal hypoglycemia in patients with type 1 diabetes mellitus". PLoS Med. 4 (2): e69. doi:10.1371/journal.pmed.0040069. PMC 1808097. PMID 17326710.
- ↑ Gill GV, Woodward A, Casson IF, Weston PJ (2009). "Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes--the 'dead in bed' syndrome revisited". Diabetologia. 52 (1): 42–5. doi:10.1007/s00125-008-1177-7. PMID 18972096.
- ↑ Marques JL, George E, Peacey SR, Harris ND, Macdonald IA, Cochrane T; et al. (1997). "Altered ventricular repolarization during hypoglycaemia in patients with diabetes". Diabet Med. 14 (8): 648–54. doi:10.1002/(SICI)1096-9136(199708)14:8<648::AID-DIA418>3.0.CO;2-1. PMID 9272590.
- ↑ Weston PJ, Gill GV (1999). "Is undetected autonomic dysfunction responsible for sudden death in Type 1 diabetes mellitus? The 'dead in bed' syndrome revisited". Diabet Med. 16 (8): 626–31. PMID 10477206.
- ↑ Luna J, Gilliland MG, Hewan-Lowe KO, Tanenberg RJ (2014). "Postmortem Diagnosis of Diabetic Ketoacidosis Presenting as the "Dead-in-Bed Syndrome"". Endocr Pract. 20 (7): e123–5. doi:10.4158/EP13473.CR. PMID 24641923.
- ↑ Riemsma R, Corro Ramos I, Birnie R, Büyükkaramikli N, Armstrong N, Ryder S; et al. (2016). "Integrated sensor-augmented pump therapy systems [the MiniMed® Paradigm™ Veo system and the Vibe™ and G4® PLATINUM CGM (continuous glucose monitoring) system] for managing blood glucose levels in type 1 diabetes: a systematic review and economic evaluation". Health Technol Assess. 20 (17): v–xxxi, 1–251. doi:10.3310/hta20170. PMC 4809467. PMID 26933827.
- ↑ Health Quality Ontario (2018). "Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment". Ont Health Technol Assess Ser. 18 (2): 1–160. PMC 5836597. PMID 29541282.
- ↑ Weisman A, Bai JW, Cardinez M, Kramer CK, Perkins BA (2017). "Effect of artificial pancreas systems on glycaemic control in patients with type 1 diabetes: a systematic review and meta-analysis of outpatient randomised controlled trials". Lancet Diabetes Endocrinol. 5 (7): 501–512. doi:10.1016/S2213-8587(17)30167-5. PMID 28533136.
- ↑ Waheed N, Butt M, Dayan C. Hypoglycaemia documented with real-time continuous glucose sensing in a case of ‘dead in bed’ syndrome. Practical Diabetes. 30(1):33–5. doi:10.1002/pdi.1737