Dead-in-bed syndrome: Difference between revisions
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== Etiology == | == Etiology == | ||
Proposed causes include: | Proposed causes include: | ||
* Hypoglycemic unawareness<ref name="pmid9274591">{{cite journal| author=Hanas R| title=Dead-in-bed syndrome in diabetes mellitus and hypoglycaemic unawareness. | journal=Lancet | year= 1997 | volume= 350 | issue= 9076 | pages= 492-3 | pmid=9274591 | doi=10.1016/S0140-6736(05)63081-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9274591 }} </ref> or the 'hypoglycemia-unawareness syndrome'<ref name="pmid17326710">{{cite journal| author=Schultes B, Jauch-Chara K, Gais S, Hallschmid M, Reiprich E, Kern W et al.| title=Defective awakening response to nocturnal hypoglycemia in patients with type 1 diabetes mellitus. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 2 | pages= e69 | pmid=17326710 | doi=10.1371/journal.pmed.0040069 | pmc=1808097 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17326710 }} </ref> | * Hypoglycemic unawareness<ref name="pmid9274591">{{cite journal| author=Hanas R| title=Dead-in-bed syndrome in diabetes mellitus and hypoglycaemic unawareness. | journal=Lancet | year= 1997 | volume= 350 | issue= 9076 | pages= 492-3 | pmid=9274591 | doi=10.1016/S0140-6736(05)63081-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9274591 }} </ref><ref name="pmid1760993">{{cite journal| author=Gerich JE, Mokan M, Veneman T, Korytkowski M, Mitrakou A| title=Hypoglycemia unawareness. | journal=Endocr Rev | year= 1991 | volume= 12 | issue= 4 | pages= 356-71 | pmid=1760993 | doi=10.1210/edrv-12-4-356 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1760993 }} </ref> or the 'hypoglycemia-unawareness syndrome'<ref name="pmid17326710">{{cite journal| author=Schultes B, Jauch-Chara K, Gais S, Hallschmid M, Reiprich E, Kern W et al.| title=Defective awakening response to nocturnal hypoglycemia in patients with type 1 diabetes mellitus. | journal=PLoS Med | year= 2007 | volume= 4 | issue= 2 | pages= e69 | pmid=17326710 | doi=10.1371/journal.pmed.0040069 | pmc=1808097 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17326710 }} </ref> | ||
* Hypoglycemia-induced ventricular dysrhythmia due to [[QT prolongation]] during hypoglycemia<ref name="pmid9272590">{{cite journal| author=Marques JL, George E, Peacey SR, Harris ND, Macdonald IA, Cochrane T et al.| title=Altered ventricular repolarization during hypoglycaemia in patients with diabetes. | journal=Diabet Med | year= 1997 | volume= 14 | issue= 8 | pages= 648-54 | pmid=9272590 | doi=10.1002/(SICI)1096-9136(199708)14:8<648::AID-DIA418>3.0.CO;2-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9272590 }} </ref> | * Hypoglycemia-induced ventricular dysrhythmia due to [[QT prolongation]] during hypoglycemia<ref name="pmid18972096">{{cite journal| author=Gill GV, Woodward A, Casson IF, Weston PJ| title=Cardiac arrhythmia and nocturnal hypoglycaemia in type 1 diabetes--the 'dead in bed' syndrome revisited. | journal=Diabetologia | year= 2009 | volume= 52 | issue= 1 | pages= 42-5 | pmid=18972096 | doi=10.1007/s00125-008-1177-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18972096 }} </ref><ref name="pmid9272590">{{cite journal| author=Marques JL, George E, Peacey SR, Harris ND, Macdonald IA, Cochrane T et al.| title=Altered ventricular repolarization during hypoglycaemia in patients with diabetes. | journal=Diabet Med | year= 1997 | volume= 14 | issue= 8 | pages= 648-54 | pmid=9272590 | doi=10.1002/(SICI)1096-9136(199708)14:8<648::AID-DIA418>3.0.CO;2-1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9272590 }} </ref> | ||
* Hypoglycemia-induced autonomic dysfunction which may lead to ventricular dysrhythmia due to [[QT prolongation]]<ref name="pmid10477206">{{cite journal| author=Weston PJ, Gill GV| title=Is undetected autonomic dysfunction responsible for sudden death in Type 1 diabetes mellitus? The 'dead in bed' syndrome revisited. | journal=Diabet Med | year= 1999 | volume= 16 | issue= 8 | pages= 626-31 | pmid=10477206 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10477206 }} </ref> | * Hypoglycemia-induced autonomic dysfunction which may lead to ventricular dysrhythmia due to [[QT prolongation]]<ref name="pmid10477206">{{cite journal| author=Weston PJ, Gill GV| title=Is undetected autonomic dysfunction responsible for sudden death in Type 1 diabetes mellitus? The 'dead in bed' syndrome revisited. | journal=Diabet Med | year= 1999 | volume= 16 | issue= 8 | pages= 626-31 | pmid=10477206 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10477206 }} </ref> | ||
==Diagnosis== | ==Diagnosis== | ||
[[Diabetic ketoacidosis]] may be sought during [[autopsy]] by vitreous fluid biochemical analyses <ref name="pmid24641923">{{cite journal| author=Luna J, Gilliland MG, Hewan-Lowe KO, Tanenberg RJ| title=Postmortem Diagnosis of Diabetic Ketoacidosis Presenting as the "Dead-in-Bed Syndrome". | journal=Endocr Pract | year= 2014 | volume= 20 | issue= 7 | pages= e123-5 | pmid=24641923 | doi=10.4158/EP13473.CR | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24641923 }} </ref>. | [[Diabetic ketoacidosis]] may be sought during [[autopsy]] by vitreous fluid biochemical analyses <ref name="pmid24641923">{{cite journal| author=Luna J, Gilliland MG, Hewan-Lowe KO, Tanenberg RJ| title=Postmortem Diagnosis of Diabetic Ketoacidosis Presenting as the "Dead-in-Bed Syndrome". | journal=Endocr Pract | year= 2014 | volume= 20 | issue= 7 | pages= e123-5 | pmid=24641923 | doi=10.4158/EP13473.CR | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24641923 }} </ref>. | ||
==Prevention== | |||
Nocturnal hypoglycemia may be prevented by glucose sensors | |||
[[Clinical practice guideline]]s by the [[American Diabetic Association]] recommend<ref name="pmid26696682">{{cite journal| author=American Diabetes Association| title=7. Approaches to Glycemic Treatment. | journal=Diabetes Care | year= 2016 | volume= 39 Suppl 1 | issue= | pages= S52-9 | pmid=26696682 | doi=10.2337/dc16-S010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26696682 }} </: | |||
:"For patients with frequent nocturnal hypoglycemia, recurrent severe hypoglycemia, and/or hypoglycemia unawareness, a sensor-augmented low glucose threshold suspend pump may be considered." | |||
[[Randomized controlled trial]]s support this recommendation<ref name="pmid24065010">{{cite journal| author=Ly TT, Nicholas JA, Retterath A, Lim EM, Davis EA, Jones TW| title=Effect of sensor-augmented insulin pump therapy and automated insulin suspension vs standard insulin pump therapy on hypoglycemia in patients with type 1 diabetes: a randomized clinical trial. | journal=JAMA | year= 2013 | volume= 310 | issue= 12 | pages= 1240-7 | pmid=24065010 | doi=10.1001/jama.2013.277818 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24065010 }} </<ref><ref name="pmid23789889">{{cite journal| author=Bergenstal RM, Klonoff DC, Garg SK, Bode BW, Meredith M, Slover RH et al.| title=Threshold-based insulin-pump interruption for reduction of hypoglycemia. | journal=N Engl J Med | year= 2013 | volume= 369 | issue= 3 | pages= 224-32 | pmid=23789889 | doi=10.1056/NEJMoa1303576 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23789889 }} [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24042390 Review in: Ann Intern Med. 2013 Sep 17;159(6):JC7] </ref>. | |||
The MiniMed(®) Paradigm™ Veo system may be the most effective system<ref name="pmid26933827">{{cite journal| author=Riemsma R, Corro Ramos I, Birnie R, Büyükkaramikli N, Armstrong N, Ryder S et al.| title=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. | journal=Health Technol Assess | year= 2016 | volume= 20 | issue= 17 | pages= v-xxxi, 1-251 | pmid=26933827 | doi=10.3310/hta20170 | pmc=4809467 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26933827 }} </ref>. However, the cost effectiveness is not certain<ref name="pmid29541282">{{cite journal| author=Health Quality Ontario | title=Continuous Monitoring of Glucose for Type 1 Diabetes: A Health Technology Assessment. | journal=Ont Health Technol Assess Ser | year= 2018 | volume= 18 | issue= 2 | pages= 1-160 | pmid=29541282 | doi= | pmc=5836597 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29541282 }} </ref>. | |||
Closed loop systems (artificial pancreases) may be effective according to a [[systematic review]]<ref name="pmid28533136">{{cite journal| author=Weisman A, Bai JW, Cardinez M, Kramer CK, Perkins BA| title=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. | journal=Lancet Diabetes Endocrinol | year= 2017 | volume= 5 | issue= 7 | pages= 501-512 | pmid=28533136 | doi=10.1016/S2213-8587(17)30167-5 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28533136 }} </ref>. | |||
Sensors may not completely prevent dead in bed syndrome<ref>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}}</ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
Latest revision as of 21:14, 29 July 2020
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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