Dead in Bed Syndrome - Part II - How to prevent?

What can be done to avoid this from happening?
1. Checking a nighttime glucose value will give you an impression of the risk of hypoglycemia.
2. If you use pen injectors, make sure the pen for your bedtime insulin looks and feels quite different from the one you use for daytime meal doses (not just another color that may be difficult to observe in the dark).
3. If you use syringes and vials, store daytime and bedtime insulin in different places. When mixing insulin, be extra careful not to take the often higher bedtime dose of the wrong type.
4.  For physically active persons, it is important to check for late hypoglycemia after the exercise, particularly in the night. Remember to decrease the bedtime dose after more strenous exercise, especially if you do not exercise regularly. If you have problems with nighttime hypoglycemia, ask your diabetes team for a continuous glucose monitoring device that may help you to detect nighttime glycemia patterns and adjust your insulin doses to avoid this.
5. HbA1c targets may need to be relaxed in persons with hypoglycemia unawareness to allow this awareness to recover. Aim for a slightly higher average blood glucose. Above all, you should avoid a blood glucose level that is lower than 65-70 mg/dl (3.5-4.0 mmol/l). Within a fortnight (two weeks), you are likely to find you can recognize symptoms of hypoglycemia more easily.
There is one pump (Medtronic Veo), so far available only on the European market, which shuts off the basal rate for two hours when the blood glucose goes below a certain threshold, thereby hopefully avoiding a further decline in blood glucose. This feature is called Low Glucose Suspend (LGS).

Courtesy: http://www.childrenwithdiabetes.com/d_0n_g00.htm

References

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Ragnar Hanas, MD
January 16, 2011