Duration of Nocturnal Hypoglycemia Before Seizures
- Bruce Buckingham, MD1,
- Darrell M. Wilson, MD1,
- Todd Lecher, MPH2,
- Ragnar Hanas, MD, PHD3,
- Kevin Kaiserman, MD4 and
- Fergus Cameron, MD5
- 1Lucile Packard Children's Hospital at Stanford, Pediatric Endocrinology, Stanford, California
- 2St. George University, Grenada, West Indies
- 3Pediatrics, Uddevalla Hospital, Uddevalla, Sweden
- 4West Covina, California
- 5Royal Children's Hospital, Parkville, Australia
- Corresponding author: Bruce Buckingham, buckingham{at}stanford.edu
Abstract
OBJECTIVE—Despite a high incidence of nocturnal hypoglycemia documented by the use of continuous glucose monitoring (CGM), there are no reports in the literature of nocturnal hypoglycemic seizures while a patient is wearing a CGM device.
RESEARCH DESIGN AND METHODS—In this article, we describe four such cases and assess the duration of nocturnal hypoglycemia before the seizure.
RESULTS—In the cases where patients had a nocturnal hypoglycemic seizure while wearing a CGM device, sensor hypoglycemia (<60 mg/dl) was documented on the CGM record for 2.25–4 h before seizure activity.
CONCLUSIONS—Even with a subcutaneous glucose lag of 18 min when compared with blood glucose measurements, glucose sensors have time to provide clinically meaningful alarms. Current nocturnal hypoglycemic alarms need to be improved, however, since patients can sleep through the current alarm systems.
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 11 August 2008.
B.B. serves on the Medical Advisory Board and has received research support from Medtronic Minimed. K.K. is a paid speaker/consultant of Medtronic. F.C. has received research funding support, travel support, and honoraria from Novo Nordisk, Eli Lilly, Aventis, Medtronic, and Animas.
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted July 31, 2008.
- Received May 7, 2008.
- DIABETES CARE
