Dead-in-bed syndrome: Difference between revisions

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Nocturnal hypoglycemia may be prevented by glucose sensors
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  }} </:
[[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  }} </ref>:
:"For patients with frequent nocturnal hypoglycemia, recurrent severe hypoglycemia, and/or hypoglycemia unawareness, a sensor-augmented low glucose threshold suspend pump may be considered."
:"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>.
[[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 (Medtronic Inc., Northridge, CA, USA) 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>.
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>.
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>.
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==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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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

  1. Sovik O, Thordarson H (1999). "Dead-in-bed syndrome in young diabetic patients". Diabetes Care. 22 Suppl 2: B40–2. PMID 10097898.
  2. Tattersall RB, Gill GV (1991). "Unexplained deaths of type 1 diabetic patients". Diabet Med. 8 (1): 49–58. PMID 1826245.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. 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

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