I just read a sad article about a T1 diabetic who passed away during her sleep at a baording school 
http://www.heraldsun.com.au/news/breaking-news/diabetic-girl-dies-at-boarding-school/story-e6frf7jx-1226037732475
Very sad and highlights the importance of educating carers as well as trying to ensure your blood sugars are within norms during sleep.
Perhaps the use of a CGM device wouldâve prevented this?
That is awfulâŚmy thoughts and prayers go out to this family and all of her peers at the boarding school.
The part that gets me is they say she was having seizure, did they not resond to that knowing her Bs was so low, and fix that.
Oh my, that is just so sad, I feel for her parents, but if my child had that, I couldnât let them go to a boarding school. Boy the trust these parents put into this boarding school⌠and the poor girls she was living with and going to school with. So sad for all. She is a little Angel know:)
Hismouse - they way they wrote it in that article suggests that it was an âafter the factâ observation. I think it is more than likely that she slipped into a hypo coma without showing any obvious symptoms. This event had tragic consequences but Iâm not sure that not letting her go to a boarding school is the answer - slipping into a hypo coma could happen at home just the same. The boading school was obviously happy to have a diabetic girl in their care and Iâm sure that the school nurse (or whatever) had appropriate training about what to do with a hypo/hyer in a diabetic but this doesnât help if it is happening at night. Perhaps the better precaution was as I suggested above - use a CGM with alarm during sleep hours which wouldâve alerted those around her.
How did they know she had a seizure? If someone saw her have a seizure, did someone just leave her alone afterwards? If anyone has a seizure you always stay with them until they are lucid again.
That is weird.
This is tragic, and happens too often. Itâs called âdead in bed syndromeâ. A CGM would only have helped if someone were awake to hear it and respond. I doubt that the other girls (if she was in a dorm) would have known what to do, even if they had had the necessary glucagon. Which they probably didnât. No one expects something like this to happen. 
I donât think there is any conclusive evidence as to why this happens. Hypoglycemia is most likely part of it (hard to prove in an autopsy, because the cells continue to process glucose after brain death â it takes a while for all the cells to die), but there may be a heart defect involved (sudden death from unrecognized heart defects sometimes occurs in high-school athletes, and not only when theyâre actively playing), or some other as-yet-unknown contributing factor. One thing that has been observed is that the covers are usually undisturbed â so itâs NOT likely to be a seizure. The child seems to just quietly pass away. That would be consistent with sudden heart death. But, like I said, no one really knows.
All I know is that I feel great sorrow for her family and friends. I wish this kind of thing didnât happen.
If the blankets were all tossed and the sheets and her pjâs soaked from sweat and if she bite her tongue there would be blood.
This would show she had a seizure. Perhaps her roommate was gone home for the week-end. Thereâs barely any details.
Poor Girl. Prayers for her and her Family.
That is so sad. Boarding schools have a lot to answer for! Perhaps she should not have been in a boarding school if she was prone to hypos. We had a problem here in Rugby, at the Rugby School (which is now co-ed) a girl was accused of faking it when she fell ill and died of meningitis! My thoughts and prayers go for the family of the girl
I have information from IDDT that one boy was found dead in bed and it turned out that it was because of a severe hypo - and that was because of the human insulins! I was put straight on human insulin when I failed to respond to tablets and was hypoing up to 6 or 7 times a day - until someone found me in a church sitting on the font stuffing sweets in my mouth and he put me in touch with IDDT which campaigns for patient choice - it took me another 3 years to get put on pork insulin as there was resistance from the clinic - apparently I might be allergic to pork insulin! Since then I have lost my hypo awareness but am doing a lot better on pork.
Prayers for her family, this is the absolute worst thing that can happen. Article mentioned she was in the cast of Annie and had more than one performance per day. So she was at more than usual risk because of the extra activity. I donât suppose the staff at a boarding school would care enough to do night checks⌠not positive about that, but I somehow doubt if they would do a check every night. Article also mentions the fact that boarding school was a necessity as parents had to work in Russia for a while. But, rationalizations aside, this can happen to anyone with Type 1. Insulin has been on the market many decades and still⌠still, they have not developed an insulin that does not cause hypoglycemia; we fight this daily. If only the researchers could come up with safer insulins. Even though it is rare, this still happens far too often. The loss of a child so young is unimaginable.
I know hypoglycemia is still a problem with pork insulin. I have read somewhere on the internet where a lot of the older people who used the pork insulins mentioned human insulin caused more hypos. It has been so many years since the discovery of insulin; why is the problem of insulin shock not considered serious enough that a remedy is not found? Maybe I am wrong, thinking it is too easy. But an insulin that does not cause hypos, and such careful monitoring hour by hour should have been a top priority. I do have my hope pinned on Smart Insulin. I donât care if it restores euglycemia using only one shot a day; the improvement in hypoglycemia is the improvement needed. Without the risk of lows, one could be as aggressive as necessary to bring down highs.
On the human insulins I was hypoing and going high 6 or 7 times a day. Someone found me sitting on the font in a local church stuffing sweets into my mouth during another one, and told me that I was on human insulin and that I had a problem with it. He told me that pork insulin was still available despite what doctors in the UK were saying. It took me another 4 years to get on to pork insulin because I was constantly being told that âyou might be allergic to pork insulinâ and I had to go far and wide trying to find a hospital that would support me in my quest.
I now hypo about 4 times a week - compared to the ones before! This has been proven several times since, when I have been in hospital for operations and they immediately put me on human insulins again via a drip - and I lost count of the times I was hypo on each stay. Now I insist that even if I am bedridden I will take my own insulins and that the hospital is not permitted to give me insulin via IV again. Pork insulin is far smoother.
I do believe you, but pork insulin would be hard to get, and we use Apidra, so too slow. They do not remove C-Peptide from pork insulin, do they? I donât know why I think this may be a factor, but removing C Peptide from human insulin,⌠may cause other problems. Hypos would be very common around here if we were not so proactive and check every three to four hours day and night.
I confess I know nothing about C-Peptide. Pork insulin is not as difficult to get hold of. Many people used it happily for years until modern pharmaceuticals brought out the âhuman insulinsâ which they say is superior but in fact, there is nothing human about it except that it is manufactured by man.
Pork insulin comes in slow acting and fast acting (and I believe medium acting, though I do not use that!) and a good balance should cause no problems.
I doubt there could be any such thing as a safer insulin simply because the nature of the beast is to bring down BGs. HOWEVER, this is a situation where, if hypoglycemia is the only thing going on (see my previous post about possible unrecognized heart defects), a CGM, along with an adult to hear the alarm, would be invaluable. Even though CGMs are currently in their technological infancy, they still are a lot better than nothing. Horrendously expensive, yes, but whatâs worth more than a childâs life?
Pork insulin is simply not available in the US. Iâve heard of some people importing it from the UK, but donât have the particulars.
As far as C-peptide, when the pancreas manufactures insulin, it starts out as a sort of a loop, with a connector bridge of molecules in approximately the middle of it. Then an enzyme snips off the end of the loop, creating a kind of H-like structure. The end that was snipped off is the C-peptide. For a long time, scientists thought that the C-peptide was simply useless waste matter, but now they are looking at whether it has useful function, although all the answers arenât in yet. Pork and beef insulins DID/DO have the C-peptide, but it did not prevent complications in those who used them, BUT they were on what we now know were inferior insulin regimens, and since they couldnât check BGs because it was before meters, we really donât know whether the C-peptide would have helped if they had had better control. (No one ever said diabetes was simple)
Jan, Smart Insulin sounds like a good idea, but Iâll believe it when I see it. Meanwhile, keep up the good work! 
Human insulin has the same protein sequence as ânormal people
insulin (well Actrapid and humalin did) which is why it is called âhumanâ as opposed to pork or beef insulins which have slightly different protein sequences. With Novorapid and Humalog there have been amino acid changes at single points The change to âsyntheticâ insulin was driven by a nmber of issues, the "Madcowâ crisis in the UK which has meant that no animal byproduct from the UK could be used in medical processing, the declining # of animals being slaughtered, the increasing cost of purifing from animal products and the sheer number of people requiring insulin.
I read that the heart arthymias found in people reported dead in bed with Type 1 are caused by a low of long duration. In other words, the prolonged low causes the arthymia. However, since there is great cardiac risk associated with Type 1 in general, no way of absolutely proving this.
I had a seizure due to high blood sugars a few weeks ago when I had a nasty bout of flu. I suffered a head trauma as well as a badly bitten tongueâŚI still donât know what happenedâŚthis article just makes me realise how lucky I wasâŚ
My prayers go out to her and her family
Iâm so glad you woke up! Seizures are scary!