Diabetes mellitus as a cause of sudden natural death--case report

Forensic medicine may face a serious problem when solving the death cause associated with disorders in glucose metabolism, especially in cases when dying due to diabetes mellitus is characterized as unclear natural death. In this article the authors present a case of sudden death of a 31-year-old male, allegedly an active healthy sportsman. On the basis of microscopical findings (hyalinisation of arterioles, vacuolisation of nuclei of hepatocytes, nodular intercapillar glomerulosclerosis as characteristic diabetic change of kidney, and diffuse myocardial fibrosis) it was concluded that this person had suffered from unrevealed diabetes mellitus that caused an early onset of atherosclerotic microangiopathy and chronic ischaemic heart disease leading to sudden death probably due to fatal arrhythmia (electrical cardiac death). In this particular case diabetes mellitus was unexpectedly suspected only because of the changes detected by the microscopic examination. Therefore, a possible fatal influence of diabetic hyperglycemia or hypoglycemia could not be excluded on the basis of the applied diagnostic procedures.