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> | * 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> | ||
* 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="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== | ||
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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] or the 'hypoglycemia-unawareness syndrome'[4]
- Hypoglycemia-induced ventricular dysrhythmia due to QT prolongation during hypoglycemia[5]
- Hypoglycemia-induced autonomic dysfunction which may lead to ventricular dysrhythmia due to QT prolongation[6]
Diagnosis
Diabetic ketoacidosis may be sought during autopsy by vitreous fluid biochemical analyses [7].
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.
- ↑ 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.
- ↑ 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.