Dead in bed - A systematic review of overnight deaths in type 1 diabetes

Jessica Jones; Steven James; Fran Brown; David O'Neal; Elif I Ekinci

doi:10.1016/j.diabres.2022.110042

Dead in bed - A systematic review of overnight deaths in type 1 diabetes

Diabetes Res Clin Pract. 2022 Sep:191:110042. doi: 10.1016/j.diabres.2022.110042. Epub 2022 Aug 23.

Authors

Jessica Jones¹, Steven James², Fran Brown³, David O'Neal⁴, Elif I Ekinci⁵

Affiliations

¹ Department of Medicine, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Endocrinology, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia; Australian Centre of Accelerating Diabetes Innovations (ACADI), University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia.
² Department of Medicine, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Australian Centre of Accelerating Diabetes Innovations (ACADI), University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, 1 Moreton Parade, Petrie, Queensland 4502, Australia.
³ Melbourne Diabetes Education & Support, 76 Edwin St, Heidelberg Heights, Victoria 3081, Australia.
⁴ Department of Medicine, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Australian Centre of Accelerating Diabetes Innovations (ACADI), University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Endocrinology, St Vincent's Hospital, 41 Victoria Parade, Fitzroy, Victoria 3065, Australia.
⁵ Department of Medicine, University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia; Department of Endocrinology, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia; Australian Centre of Accelerating Diabetes Innovations (ACADI), University of Melbourne, Grattan Street, Parkville, Victoria 3010, Australia. Electronic address: Elif.Ekinci@unimelb.edu.au.

PMID: 36007797
DOI: 10.1016/j.diabres.2022.110042

Abstract

Background: Type 1 diabetes is a significant, life-long condition which affects many people worldwide. One of the most feared causes of type 1 diabetes mortality, overnight mortality, often caused by the dead in bed syndrome, is largely underreported. A systematic literature search was undertaken to understand the frequency, risk factors, causes and impact that diabetes-related technologies have on overnight mortality, in this population.

Methods: MEDLINE (Ovid), Embase (Ovid) and Cochrane were searched to June 2021, using defined inclusion and exclusion criteria. Quality appraisal was undertaken.

Results: Overall, 26 records met the inclusion criteria. Large-scale cohort studies examined data up to 2013, and there were no studies published after 2018. The proportion of deaths attributable to the dead in bed syndrome was between 2 and 5% of deaths in children, adolescents, and young adults, with a slight decrease in proportion of dead in bed syndrome since 1991.

Conclusion: Overnight mortality is occurring for people with type 1 diabetes, reported as recently as in 2018. Living alone, alcohol and illicit substances consistently appear as risk factors, and the impact of technology on overnight mortality is not fully understood, with more recent data, from larger cohort studies being required.

Keywords: Continuous glucose monitoring; Dead in bed syndrome; Mortality; Overnight; Type 1 diabetes.

Publication types

Review
Systematic Review

MeSH terms

Adolescent
Child
Cohort Studies
Diabetes Mellitus, Type 1*
Humans
Risk Factors
Young Adult