Hypoglycaemia documented with real‐time continuous glucose sensing in a case of ‘dead in bed’ syndrome

The objective of this observational case report was to present the first case consistent with the ‘dead in bed’ syndrome in which hypoglycaemia has been documented by real‐time glucose monitoring at the time of death. We report the case of a 41‐year‐old male with type 1 diabetes. Diagnosed at age 14, he had poor glycaemic control during his teen years and suffered from severe hypoglycaemia unawareness. His diabetes was complicated by nephropathy, neuropathy and retinopathy. He was last seen alive and well by the family seven days before he was found dead in bed with his insulin pump and sensor in situ. The last recorded interaction between the patient and the pump system was seven days previously with evidence of prolonged hypoglycaemia around the time. Post‐mortem examination showed no specific cause of death. The findings in this case report are consistent with the hypothesis that hypoglycaemia is a precipitant of the ‘dead in bed’ syndrome in diabetes and indicate that the presence of low glucose alarms does not provide complete protection against such an event.