Duration of nocturnal hypoglycemia before seizures.
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.


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.
Buckingham
Bruce
B
Lucile Packard Children's Hospital at Stanford, Pediatric Endocrinology, Stanford, California, USA. buckingham@stanford.edu.
Wilson
Darrell M
DM
Lecher
Todd
T
Hanas
Ragnar
R
Kaiserman
Kevin
K
Cameron
Fergus
F
D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring; D002648:Child; D002940:Circadian Rhythm; D004827:Epilepsy / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000097:blood / Q000175:diagnosis*; D008297:Male
D001786:Blood Glucose