Diabetic monitors can prevent nighttime seizures

NEW YORK (Reuters Health) - Monitors that continuously measure sugar levels under the skin can alert diabetics when levels fall too low during sleep and awaken them before a seizure occurs, according to a report in the journal Diabetes Care.

“Concerns over nocturnal hypoglycemia (low sugar levels during sleep) are a major reason for people with type 1 diabetes welcoming the possibility of using real-time continuous glucose monitoring with real-time hypoglycemic alarms,” Dr. Bruce Buckingham of Stanford University, California, and colleagues write.

However, they note, continuous glucose monitoring has a 5- to 18-minute delay when compared with glucose levels measured directly from the blood. Greater delays occur when blood sugar levels are rapidly changing. This might mean that a seizure could occur before an alarm sounds, although there are no published reports of hypoglycemic seizures while a patient is wearing a continuous glucose monitoring device.

In the current study, the researchers examined the duration of sensor-detected nocturnal hypoglycemia preceding a seizure by asking investigators from around the world to submit cases. Four were included in the study.

Nocturnal hypoglycemia was documented on the continuous glucose monitoring record for 2.25 to 4 hours before the seizure occurred.

In two cases, the monitors were early models without alarms, but in one instance the alarm was inaudible under the subject’s bedding.

“Glucose sensors should have sufficiently robust alarm systems, particularly at night, to insure either the patient or a surrogate is awoken to intervene,” Buckingham and colleagues emphasize. “We suggest augmenting the alarm with a bedside device that would turn on a light and transmit the alarm to another location in the house, such as a parent’s bedroom.”

SOURCE: Diabetes Care, November 2008.

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