Type 1 Diabetes and Dead in Bed Syndrome
By now it is known that Eilish passed while she was sleeping, which is referred to as "dead in bed syndrome." Ann Bartlett wrote a very complete piece about this on HealthCentral:
"This week has been a difficult week for the diabetes community, when it was revealed that young girl of 13 never woke up. There have been 4 deaths of type 1 teens recently reported and many of us remember Cynthia Kahn who passed away earlier this year. We have lost some great people simply “while they were sleeping”, which is commonly referred to as “dead in bed syndrome”. It is always alarming, and probably more disappointing that we don’t have an answer for how someone, in otherwise good health, could go to bed and never wake up."
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Tags: complications, syndrome
Replies to This Discussion
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Permalink Reply by HockeyDad on -
Our nurses mentioned to us that the liver stores a "reserve" of sugar and provided you have not experience an actual low BG in the previous 24 hours, the stored reserve is rapidly released by the liver when you experience a severe low effectively saving you from potential disaster. Whether I believe that or not I am unsure but our son has been awakened on his own by a few low BG's over the years. His sensitivity to a low seems keen and after treating a few severe lows on a couple of occasions over the years his BG has been cranked a couple hours later so there may be some truth to this bit of info. Still, I do not think CGMS are covered in Canada at this time and I would love to have one...anyone know any different?
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Permalink Reply by Gerri on -
Unfortunately, T1s don't have the the same counter-regulatory response to raise lows by the liver releasing glucagon like normal people. If we did, we wouldn't have life threatening lows. Afraid you received misinformation from the nurses.
Canadians here have CGMS covered, but I don't know the policy by province.
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Permalink Reply by Brian (bsc) on -
Actually, T1s do have the same counter-regulatory response. The thing is that circulating insulin suppresses the response and the response may not occur until severe hypos occur, if at all. T2s on insulin have the same problem with hypos, but in many cases their suppression is not as complete as in a T1. It is also true that one aspect of hypo unawareness is a dysfunction in the counterregulatory response, but in a young boy with hypo awareness you can certainly have a counterregulatory response.
The counter-regulatory response is signalled by a raising glucagon and dropping insulin. Surprisingly, glucagon in T1s is fine, the autoimmune attack is focused on beta-cells, but spares the alpha cells which produce glucagon. So a T1 will produce the proper glucagon to counterregulate, but it won't get through to the liver.
T1s can experience a counter-regulatory response, but it usually happens at more extreme conditions. And once you have a forceful counterregulatory response, whether from a glucagon pen or from your own response, you may well deplete the liver of any glycogen, making a second counter-regulation impossible. This is why one needs to only use a glucagon pen as a last ditch measure. If you use the glucagon pen and then have another bad hypo, you can be in deep 'doo doo' (sorry for the technical term).
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Permalink Reply by HockeyDad on
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Thanks for the clarification, I hope our nurses no more than I. When you mention depleting the liver of glycogen, you mean temporarily depleting correct? I was told it took at least 24 hours to restore the levels in the liver so yes, another low without treatment would put one in "deep doo doo". My son has (only about 3 times in 7 years) been lower than 2mmol, very scary but still alert to take oral measures and on at least 2 of those occurrences our correction for the low resulted in a fairly high BG later on so I had always thought this was possibly due to the counter regulatory response from the liver? Thanks again for the response. Take care
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Permalink Reply by Brian (bsc) on
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Yes, if you have a harsh counterregulation, such as with the use of a glucagon pen, it can take 24 hours or more to restore the glycogen in the liver. I can't tell you if your son had a counterregulatory response, it may just have been an overtreatment of a low. If the rise was very disproportionate to how much glucose you have him then that my indicate a counterregulation.
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Permalink Reply by Annie on -
This is something that is always in the back of my mind! My son, now 5 years old was dx'd with type 1 when he was 2. There hasn't been one night since then that I haven't checked him at least once a night (usally more offten!) Sleep is something I can live without to ensure my son wakes up every morning!
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Permalink Reply by MissKitka on -
There have been many dozens of these reported to Health Canada over the years. The major cause has been synthetic insulin which, according to the inserts in this insulin, does not provide the usual symptoms of low BG, Most people using synthetics have to be sure BG is over a certain number before sleep. Most times these events are seen as heart failure and fake or synthetc insulin is never a factor due to bribes. Of course that is my opinion.
At the very bottom of this page is a link to a CBC Canada show called video19, a Marketplace show which tells the story. I was on the board of directors of the Canadian Society of Diabetic Rights for a time, and our leader, Colleen Fuller plays a large roll.:
It has always been beyond my belief to think that any human could have the gall to think they could actually copy anything that nature does. Of course synthetic insulin is worth 10.000% profit, 5 cents per vial total cost and this is the reason humans mean nothing to these people. Profits have trumped life every time in the last 40 years.
I have many links and much more info it you want.
Don
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Permalink Reply by MelissaBL on -
When you are writing in the text field, you should be able to write out text, highlight it, and then click the fifth icon with the little chain link on it. In that field, after the http://, you can finish out the url. Click ok and the highlighted text will then point to that link.
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Permalink Reply by Khürt Williams on -
I've gone to bed with blood glucose as low as 70 with no problems. Wake up the next day and BG is 95. I stopped worrying about dead in bed several years ago once I educated myself about how my body works.
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Permalink Reply by Annie on
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I'm Sure when my son is older he will have more stable #'s, him, being 5 yrs old can go from low to high, high to low, high to higher, low to lower without any rhyme or reason. Not to mention sick days and naps @ school, or long trips and exercise, endorphins the list of unknown is endless!!! Also me being his mother and not the person with D I think I will always worry about him in general... this is just one of the items on top of my worry list!
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Permalink Reply by Khürt Williams on
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I'm on Levemir. I also never take a bolus or basal, before going to bed. That would be irresponsible. I take my basal insulin twice daily at 7 AM and 7 PM. I test before my bolus of Novolog, and two hours after. I test before going to bed. If I am hypo ( below 70 mg/dL ) I take 5g of glucose. Nothing more. 5g of glucose will raise my blood glucose 15 mg/dL.
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