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I found this info out while looking things up about Hypoglycemia this morning. I was trying to find answers as to what exactly causes low blood sugar and came across this article and read it. I thought that this should be put out there cause I didn't even hear of this until this morning. I didn't know if anyone else had heard anything about it or if the rest of the world was left as clueless as I was. I hope this helps and I hopes this brings new light into the Diabetic Community.


Dead In Bed Syndrome
Publication Date: 1/26/2010

What is the "dead in bed syndrome"?
In 1991, a report was published concerning sudden death occurring in teens and young adults with type 1 diabetes (T1DM) (1). After excluding deaths due to circumstances such as diabetic ketoacidosis and suicide. Twenty-two cases were reported where the patient "had gone to bed in apparently good health and been found dead in the morning." Most of them had no known complications of diabetes, and they died while asleep and were found in an undisturbed bed. Autopsy findings were absent. The authors suggested that "the timing of death and other circumstantial evidence suggests that hypoglycaemia or a hypoglycaemia-associated event was responsible."

Since then, other authors have estimated that as many as 6% of deaths in people with T1DM who die before the age of 40 are due to the dead in bed syndrome (2).

The syndrome is always mentioned in patients with T1DM; whether it may occur in T2DM is not discussed.
What causes the "dead in bed syndrome"?
The original description of the syndrome reviewed alternative causes of death, and came to the conclusion that these deaths were in some way associated with hypoglycemia. However, proving that hypoglycemia was the triggering event for the death is difficult and this explanation of the syndrome remains tentative.

Since the original article, there has been a modification of the theory that hypoglycemia is the cause, in which it's suggested that night-time low sugar (nocturnal hypoglycemia) may provoke changes in heart electrical activity, leading to heart rhythm disturbances (cardiac arrhythmias) that in turn lead to death. It's been found that hypoglycemia can change the electrical activity of the heart (technically, hypoglycemia can cause prolongation of the QT interval) and it's thought that in susceptible individuals, the change in electrical activity might cause lethal arrhythmias. A recent study of 25 patients with T1DM, using continuous glucose monitoring, found nocturnal hypoglycemia and using electrocardiographic monitoring, found that cardiac rhythm disturbances were occurring while the blood sugar was low (3).

It's possible that patients who die unexpectedly with the "dead in bed" syndrome" have early neuropathy affecting the nerves to the heart (cardiac autonomic neuropathy). One author suggests that the most susceptible individuals for the dead in bed syndrome are those with another cardiac finding: mitral valve prolapse. The mitral valve of the heart occasionally is found to be abnormal in shape and floppy; this prolapse is fairly common in young women, and in rare cases, has been associated with sudden death (4).

Several authors have looked at the possibility that the kind of insulin (semisynthetic human vs. animal source) may play a role, but have concluded that this was not a factor. Diabetes UK (the British Diabetes Association) states that "there has been no increase in the number of deaths attributed to this cause since the introduction of human insulin" (5).

Sadly, the risk of "dead in bed syndrome" cannot be excluded for anyone with type 1 diabetes on tight-control insulin programs.
Is it possible to prevent the "dead in bed syndrome"?
As the usual explanation for the sudden death is related to hypoglycemia, most authors suggest that avoidance of nocturnal hypoglycemia is important. Checking blood glucose levels at night occasionally, or using continuous glucose monitoring, will give a sense of the risk of nocturnal hypoglycemia. Making sure that the bedtime dose of insulin isn't accidentally too large, or that the bedtime dose of a long-acting insulin isn't accidentally replaced by a dose of a short-acting insulin, is appropriate (6). Switching the patient from older insulin programs (such as using NPH at suppertime), and avoidance of injections of short-acting insulin at bedtime, are particularly important to consider. Changes in meal planning, encouraging eating appropriate bedtime snacks, may help to prevent nocturnal hypoglycemia (7). Cutting overnight insulin doses after unexpected strenuous exercise should be considered, as there may be delayed hypoglycemia after exercise.

http://www.diabetesmonitor.com/learning-center/other-complications/dead-in-bed-syndrome.htm
 

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c_cat1979? If you can still find the link for this article, would you please edit to add it to your post? It's better copyright-wise if we have the link or at least the name of the website where it originated.

Thanks loads, and again - welcome to DF!

Forum rule #7: Don’t post articles, news items, or copyrighted material without permission from the copyright holder. You can however post a link to the article to illustrate your point.
 

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c_cat1979? If you can still find the link for this article, would you please edit to add it to your post? It's better copyright-wise if we have the link or at least the name of the website where it originated.
Looks like it's from here.
 

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I found this info out while looking things up about Hypoglycemia this morning. I was trying to find answers as to what exactly causes low blood sugar and came across this article and read it. I thought that this should be put out there cause I didn't even hear of this until this morning. I didn't know if anyone else had heard anything about it or if the rest of the world was left as clueless as I was. I hope this helps and I hopes this brings new light into the Diabetic Community.


Dead In Bed Syndrome
Publication Date: 1/26/2010

What is the "dead in bed syndrome"?
In 1991, a report was published concerning sudden death occurring in teens and young adults with type 1 diabetes (T1DM) (1). After excluding deaths due to circumstances such as diabetic ketoacidosis and suicide. Twenty-two cases were reported where the patient "had gone to bed in apparently good health and been found dead in the morning." Most of them had no known complications of diabetes, and they died while asleep and were found in an undisturbed bed. Autopsy findings were absent. The authors suggested that "the timing of death and other circumstantial evidence suggests that hypoglycaemia or a hypoglycaemia-associated event was responsible."

Since then, other authors have estimated that as many as 6% of deaths in people with T1DM who die before the age of 40 are due to the dead in bed syndrome (2).

The syndrome is always mentioned in patients with T1DM; whether it may occur in T2DM is not discussed.
What causes the "dead in bed syndrome"?
The original description of the syndrome reviewed alternative causes of death, and came to the conclusion that these deaths were in some way associated with hypoglycemia. However, proving that hypoglycemia was the triggering event for the death is difficult and this explanation of the syndrome remains tentative.

Since the original article, there has been a modification of the theory that hypoglycemia is the cause, in which it's suggested that night-time low sugar (nocturnal hypoglycemia) may provoke changes in heart electrical activity, leading to heart rhythm disturbances (cardiac arrhythmias) that in turn lead to death. It's been found that hypoglycemia can change the electrical activity of the heart (technically, hypoglycemia can cause prolongation of the QT interval) and it's thought that in susceptible individuals, the change in electrical activity might cause lethal arrhythmias. A recent study of 25 patients with T1DM, using continuous glucose monitoring, found nocturnal hypoglycemia and using electrocardiographic monitoring, found that cardiac rhythm disturbances were occurring while the blood sugar was low (3).

It's possible that patients who die unexpectedly with the "dead in bed" syndrome" have early neuropathy affecting the nerves to the heart (cardiac autonomic neuropathy). One author suggests that the most susceptible individuals for the dead in bed syndrome are those with another cardiac finding: mitral valve prolapse. The mitral valve of the heart occasionally is found to be abnormal in shape and floppy; this prolapse is fairly common in young women, and in rare cases, has been associated with sudden death (4).

Several authors have looked at the possibility that the kind of insulin (semisynthetic human vs. animal source) may play a role, but have concluded that this was not a factor. Diabetes UK (the British Diabetes Association) states that "there has been no increase in the number of deaths attributed to this cause since the introduction of human insulin" (5).

Sadly, the risk of "dead in bed syndrome" cannot be excluded for anyone with type 1 diabetes on tight-control insulin programs.
Is it possible to prevent the "dead in bed syndrome"?
As the usual explanation for the sudden death is related to hypoglycemia, most authors suggest that avoidance of nocturnal hypoglycemia is important. Checking blood glucose levels at night occasionally, or using continuous glucose monitoring, will give a sense of the risk of nocturnal hypoglycemia. Making sure that the bedtime dose of insulin isn't accidentally too large, or that the bedtime dose of a long-acting insulin isn't accidentally replaced by a dose of a short-acting insulin, is appropriate (6). Switching the patient from older insulin programs (such as using NPH at suppertime), and avoidance of injections of short-acting insulin at bedtime, are particularly important to consider. Changes in meal planning, encouraging eating appropriate bedtime snacks, may help to prevent nocturnal hypoglycemia (7). Cutting overnight insulin doses after unexpected strenuous exercise should be considered, as there may be delayed hypoglycemia after exercise.
I find this article very informative. I am T2 on long acting insulin and had several mornings where I was sleeping up to 4 in the afternoon. The last day that this happened my Mom had called the EMT because it was late in the day and I had not gotten out of bed and when she opened the door I was laying on the floor, my blood sugar was 27. This syndrome is probably not picky and I just talked to my doctor about these hypos, I have hypounawareness. I don't won't to die this way, so we are working through the problem.
 

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Discussion Starter #7
I feel you! my sugars have been low for quite a long time now, so long that I can not even feel when they are low. The only way I know they are low is when I test. It scares me but I can never get any answers from my doctor. I call the office and get the machine and leave at least 4 different numbers for them to get a hold of me, and I never get a call back. Last night when I went to bed, my sugar was 58, then dropped down to the low 30's. I couldn't sleep-I was afraid to. I have a very hard time even getting to my doctor bc I don't have a car and I don't trust myself driving not only bc of my lows but because I have a bad back as well. My dr is about 45 mins to an hour away and with gas prices going up and up and up-its hard to find someone willing to take me all the way out there and back for little to no gas money. I'm at my witts end here and half the time I just feel like throwing in the towel and calling it quits. I can never get a head! my sugars are always too low or too high, I can never get to a norm no matter what I do and how hard I do it...I'm beginning to question if insulin would be my best bet, but I know if I go in to my dr and ask about insulin, he'd look at me like I was some sort of disease... *sigh* I just don't know anymore...
 

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Is that the link? For some reason my computer wont let me click it..My roommate cleared the history last night so I can't find it-but if I find it, if what Beefy found isn't it I'll post it..
 

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Yes, Beefy posted a link to the article you pasted. Diabetes Monitor - Dead In Bed Syndrome
Dead in Bed syndrome is very real. In fact a young girl was found dead iin bed by her mother just two hours after she had checked her daughter's bg. It shook us to the core who are members of the CWD community. Her parents are members of CWD. They had done everything they could do to keeep their daughter safe and this happened. This is not the first time I have heard of this happening.
It is very scary and for those who are insulin dependent, I think it pays to check one's blood sugars during the night as well especially if one wakes up low or one wakes up high. The reason I would check in the middle of the night if the morning sugars are high is because the high could be a rebound from a low blood sugar so it is good to find out and know what to do.
 

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A 36 year old type 1 for 16 years was found dead in bed locally. Post mortem concluded dead in bed syndrome - well controlled according to local paper he was a very poular musiscian too :(
 

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As a 58 year old insulin dependent diabetic, this is a worry for me. My daughter currently lives with me due to a later than usual return to college, but she will graduate in a year or so, and I will be living alone.

We are researching options for my son and his family to move onto my property. (Having some building code problems re: two dwellings on one parcel.)
 

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Well it would seem that nothing can be done about ditb syndrome.When you sleep alone its the hypo that eventually wakes you ...and you cant always predict them. It appears that the nocturnal hypo may exacerbate an existing arythmia but that is not conclusive.
The message is live your life to the full, cherish every moment with loved ones and be the best you can be :)

Sent from my Nexus One using Diabetes
 

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The message is live your life to the full, cherish every moment with loved ones and be the best you can be :)

Sent from my Nexus One using Diabetes[/QUOTE]


Excellent advice! Thank you!:rolleyes:
 

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Hypoglycemia is nothing to fool around with. I recently came down with a viral infection, which rendered me incredibly weak and fatigued. One night I was feeling so ill and feverish and could barely stand up. I thought it was just the virus running its course and decided to sleep through it. In the morning, my mom found me in bed soaked with sweat and barely able to move. Immediately she tested my sugar and it came out to 33! Normally I can recognize the symptoms of a hypo -- shaking, weakness, rapid heartbeat, shortness of breath. Because of the illness, I had absolutely no idea. Thankfully, she did what she did, otherwise things could have turned out much differently.

Now, my mom is so worried about me dying in my sleep due to a hypo that she calls me every night to find out my evening glucose reading and makes me store snacks next to my bed.
 
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