Dead in Bed: A Rare Complication of Type 1 Diabetes Mellitus

Abstract

Introduction: Type 1 diabetes or juvenile diabetes or insulin-dependent diabetes, is a chronic condition of autoimmune destruction of the beta cells in the pancreas due to which the pancreas makes little or no insulin. Treatment requires insulin supplementation, which has its own side effects. Dead in bed syndrome is the name given for fatal outcome seen in young diabetic patients who are found dead in morning in a clearly undisturbed surrounding. In most of the cases there is no history of diabetes related complication, and the post-mortem examination is ordinarily negative. Case description: We described a case of sudden death of a Type 1 Diabetic young female brought for post-mortem examination along with a short commentary on “Death in Bed Syndrome” seen in such diabetic individuals. At post-mortem examination the cause of death was not apparent. The biochemical and histopathological examination as well as the chemical analysis of viscera were inconclusive. No definite opinion was given regarding cause of death. However, the police insisted that death be declared natural or unnatural. Conclusion: To reduce premature mortality in people with childhood-onset diabetes focus should be on prevention of acute complications. Medicolegal experts should be careful in giving opinion in such cases and such opinion should be based on exclusion. Keywords: [Diabetes Mellitus, Sudden death, Hypoglycaemia, nocturnal]