Hypoglycemia as the responsible factor in a truck driver accident fatality

A case of hypoglycemia causing a truck driver to lose control of his vehicle and his resulting traumatic asphyxia death is presented. The incident was considered suspicious in spite of poor visibility, because an experienced, healthy operator lost control in the early morning hours after a relatively short (4-h) drive. The autopsy revealed no evidence of natural disease and the driver had no alcohol or drugs in his system. Although this is apparently a rare occurrence, the diagnosis of underlying hypoglycemia as the causative factor in a traffic fatality can be reasonably suspected and accurately made if appropriate specimens are properly obtained and tested. Legislation mandating the retention of antemortem blood specimens on all trauma patients will permit more accurate assessment of most chemical etiologies of traffic accidents.