Sudden Death Related to Diabetes Mellitus: Current and Emerging Relevance to the Forensic Pathologist

Ely, Susan F.

doi:10.23907/2016.017

Cited by 5 publications

(3 citation statements)

References 38 publications

(76 reference statements)

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“…Analyzing the impact on mortality from diabetes for women versus men or separated by age does not produce statistically significant result. An important caveat for the diabetes analysis is the fact that diabetes does not lead to a sudden unexpected death, but rather leads to a development of many symptoms which can result in individual's death (Ely, 2016). Deaths caused by underlying diabetes can manifest in deaths due to heart attack, heart failure, stroke, kidney failure and coma, resulting in death being recorded as a death due to cardiovascular disease and not diabetes.…”

Section: Effects Of Sanctions On Mortalitymentioning

confidence: 99%

Sanctions and their impacts on medical trade and health outcomes

Miromanova

2023

Rev International Economics

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Despite the intention that sanctions, by design, should not harm civilians' welfare, evidence shows that they can negatively affect health outcomes. In this study, I measure the impact of sanctions on international trade in medical supplies and cross‐country mortality rates. I find that sanctions, particularly those imposed by the United States, decrease the volume of medical exports to targeted countries, potentially leading to worse health outcomes. I also discover that sanctions increase mortality rates in the targeted countries, particularly for women with HIV/AIDS infections. Termination of foreign aid, blockades, and partial embargoes have the most damaging effect on mortality.

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Section: Effects Of Sanctions On Mortalitymentioning

confidence: 99%

Sanctions and their impacts on medical trade and health outcomes

Miromanova

2023

Rev International Economics

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“…A previous clinical study showed that type 1 DM patients less than 40 years of age have a 4to 10-fold rate of sudden and unexpected death compared with the general population; thus, this condition should be always considered as one of the possible causes of death in this population. [36][37][38] Both postmortem pathologic and serologic investigations targeting DM should be emphasized, even in younger victims.…”

Section: Clinicopathologic Features Of Ketoacidosis With Bvmentioning

confidence: 99%

Clinicopathologic Appearance of Advanced Ketoacidosis With Basal Vacuolation in Renal Tubules

Ichimata

Hata

Nishida

2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Basal vacuolization (BV) in renal tubules is a histopathologic hallmark of advanced ketoacidosis that enables us to retrospectively diagnose these cases. Objective.— To clarify the pathologic background and serologic findings of ketoacidosis with BV, and to reveal the pathologic findings by each pathologic background. Design.— We examined 664 serial autopsy cases. A systemic histopathologic examination and measurement of serum β-hydroxybutyrate concentration were performed for the cases with BV. The extent of steatosis and fibrosis in the organs and the degree of coronary artery stenosis were semiquantitatively investigated. Immunohistochemistry for adipophilin was also performed to analyze its usefulness for the pathologic diagnosis. Results.— Basal vacuolization was found in 16 cases, all of which showed a pathologic serum β-hydroxybutyrate concentration. The main background of ketoacidosis was considered as alcohol abuse in 6 cases, diabetes in 5, malnutrition in 3, and hypothermia and infection in 1 case each. Severe hepatic fibrosis was observed only in the alcohol-abuser group. Moreover, cardiac steatosis was more severe in patients with possible alcohol abuse than in those with other causes. Immunohistochemistry for adipophilin showed immunoreactivity consistent with BV in 13 of 16 cases. There was no correlation between β-hydroxybutyrate concentration and either the postmortem or storage interval. Conclusions.— Basal vacuolization may be a useful finding for detecting ketoacidosis cases in a postmortem investigation. Serum β-hydroxybutyrate was a stable and reliable compound for the definitive diagnosis of ketoacidosis in such cases. The present study showed that pathologic changes in some organs may vary by each pathologic background of ketoacidosis with BV.

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“…Hypoglycemia is thought to be the cause of death for 2–4 percent of people with diabetes mellitus. It could explain the "dead-in-bed syndrome," which refers to the mysterious deaths of type 1 diabetics that happen at night [ 4 , 7 ]. The signs of low blood sugar levels can change over time and vary from person to person [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemia prevention practice and associated factors among diabetes mellitus patients in Ethiopia: Systematic review and meta-analyssis

Ayalew

Wale²

2022

PLoS ONE

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Background Hypoglycemia is an urgent, life-threatening condition that requires prompt recognition and treatment for diabetes mellitus patients to prevent organ and brain damage. Hypoglycemia is one of the most important complications of diabetes mellitus patients around the globe. Hypoglycemia may increase vascular events and even death, in addition to other possible detrimental effects. In spite of the absence of other risk factors, patients receiving intensive insulin therapy are more likely to experience hypoglycemia. To reduce the risk of hypoglycemia and calculate the combined prevalence of hypoglycemia prevention practices among diabetes mellitus patients, recognition of hypoglycemia is critical. Objective The main aim of this review was to evaluate the available data on Ethiopian diabetes mellitus patients’ practices for preventing hypoglycemia and related factors. Methods and materials This review was searched using PubMed, the Cochrane Library, Google, Google Scholar, and the Web of Sciences. Microsoft Excel was used to extract the data. All statistical analyses were done using STATA Version 14 software with a random-effects model. The funnel plot and heterogeneity of the studies were checked. Subgroup analysis was done with the study area and authors’ names. Results In this systematic review, 12 studies totaling 3,639 participants were included. The estimated overall practice for preventing hypoglycemia among diabetic patients in Ethiopia were 48.33% (95% CI (28.21%, 68.46%, I2 = 99.7%, p ≤ 0.001). According to the subgroup analysis based on region, the highest estimated prevalence of the prevention practice of hypoglycemia among diabetes patients in Addis Ababa was 90%, followed by SNNRP at 76.18% and in the Amhara region at 68.31% respectively. The least prevalent was observed in the Oromia region 6.10%. In this meta-analysis, diagnoses with type II diabetes (AOR = 2.53, 95%CI: 1.05, 4.04), duration (AOR = 5.49, 95%CI:3.27,7.70), taking insulin for a long time(AOR = 4.31,95%CI:2.60,6.02), having good prevention knowledge (AOR = 2.89, 95%CI: 1.15,4.23), and occupation (AOR = 4.17, 95%CI: 2.20, 6.15) were significantly associated with hypoglycemia prevention practice. Conclusions This systematic review revealed that diabetic patients in Ethiopia had poor hypoglycemia prevention practices. Being an employee, taking insulin for a long time, having a good prevention practice, and having a type of diabetes mellitus were strongly correlated with practicing hypoglycemia prevention. This review implied the subsequent need for educational interventions for an individualized patient.

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Sudden Death Related to Diabetes Mellitus: Current and Emerging Relevance to the Forensic Pathologist

Cited by 5 publications

References 38 publications

Sanctions and their impacts on medical trade and health outcomes

Sanctions and their impacts on medical trade and health outcomes

Clinicopathologic Appearance of Advanced Ketoacidosis With Basal Vacuolation in Renal Tubules

Hypoglycemia prevention practice and associated factors among diabetes mellitus patients in Ethiopia: Systematic review and meta-analyssis

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