From Labrador City, Newfoundland, Canada:
My sister died of diabetes a week ago. There was no family history and we didn't notice any signs. The doctors told us that it was "acute diabetes" but there is another name for it and I was wondering if you would be able to tell me so I can get more information on this. The doctor also told us that it was really sudden she just slipped into a coma. On that morning her blood sugars were 98. I was wondering how they could have risen so quickly.
Assuming that the diagnosis of diabetes was indeed correct, there are a number of possible explanations for your sister's story.
- That her diabetes was precipitated by a second life threatening condition, especially an acute infection of some kind or perhaps acute adrenal failure (Addison's Disease) if she had autoimmune diabetes and that the primary cause of death was not the diabetes; but the complicating disorder. You might want to ask if a blood sample was sent for antibodies and especially anti-21 hydoxylase.
- That the insulin she was given when the diagnosis was first made brought her blood sugars down much more rapidly than had been expected and that this led either to severe hypoglycemia or to cerebral edema.
- It occasionally happens at the onset of diabetes that the blood sugars are within normal limits; but that there is a very severe degree of ketoacidosis with massive ketone production. In these instances both cerebral edema and cerebral hemorrhages may occur.
The lack of a family history is not surprising and I don't quite know what the other name was that your doctor had in mind unless it was 'ketoacidosis'. I am sorry not to be more specific; but this would really require access to the medical record.
Last Updated: Tuesday April 06, 2010 15:09:00
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