title: Diabetes and decomposition: a case of diabetic ketoacidosis with advanced postmortem change.
abstract: The case is presented of a 34-year-old man, an insulin-dependent diabetic, who was found decomposed in his apartment. The victim had been recently discharged from a mental hospital and was to be monitored by the community's mental health personnel. While the autopsy revealed little in the way of disease, toxicological studies yielded a blood acetone level of 0.070 g/dl and a urine acetone level of 0.086 g/dl. The medical examiner ruled the cause of death diabetic ketoacidosis. To support this conclusion in the absence of a vitreous humor glucose concentration, 18 well-documented cases of diabetic ketoacidosis were reviewed, and acetone concentrations were compared with the acetone concentrations found in the presented case.
authors.affiliation: Office of the Chief Medical Examiner, State of Maryland, Baltimore 21201, USA.
authors.forename: J E
authors.initials: JE
authors.lastname: Smialek
authors.forename: B
authors.initials: B
authors.lastname: Levine
mesh_terms: D000096:Acetone / Q000097:blood; D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002423:Cause of Death; D002648:Child; D002849:Chromatography, Gas; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000473:pathology*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000473:pathology*; D000431:Ethanol / Q000097:blood; D005947:Glucose / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D014822:Vitreous Body / Q000737:chemistry
chemical_list: D001786:Blood Glucose; D000096:Acetone; D000431:Ethanol; D005947:Glucose