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Evaluation of death from hypoglycemia.

E C Klatt1, C Beatie, T T Noguchi

  • 1Department of Pathology, Los Angeles County-University of Southern California Medical Center 90033.

The American Journal of Forensic Medicine and Pathology
|June 1, 1988
PubMed
Summary

Severe hypoglycemia (serum glucose ≤ 40 mg/dl) can cause fatal coma. This study identified common underlying conditions and mechanisms of hypoglycemia in autopsy cases, highlighting alcoholism, drugs, and neoplasia as frequent contributors.

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Area of Science:

  • Forensic Pathology
  • Endocrinology
  • Toxicology

Background:

  • Hypoglycemia, defined as serum glucose of 40 mg/dl or less, can lead to fatal hypoglycemic coma.
  • Hypoglycemia is a potential factor in sudden or unexpected deaths investigated by medical examiners.

Purpose of the Study:

  • To investigate the range of underlying conditions leading to hypoglycemic coma.
  • To identify common mechanisms of hypoglycemia in autopsy cases.

Main Methods:

  • Retrospective review of data from 54,850 autopsies performed at a large acute-care medical center.
  • Identification and analysis of 123 cases with hypoglycemic coma.

Main Results:

  • Complications of alcoholism (33%), drugs (21%), and neoplasia (21%) were the most frequent underlying conditions.

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  • Other causes included liver disease (7%), neurological disorders (7%), endocrine disorders (3%), and miscellaneous conditions (8%).
  • Common mechanisms involved liver disease impairing carbohydrate metabolism, drug or hormonal effects, and inanition.

    • Conclusions:

    • Hypoglycemic coma has diverse underlying causes, with substance abuse and malignancy being prominent.
    • Understanding these mechanisms is crucial for medical examiners investigating unexplained deaths.