The New York City medical examiner has determined that Buffy and Gossip Girl actor Michelle Trachtenberg died of complications from diabetes, clearing up some questions about her cause of death that have lingered since she passed away in February at age 39.
It’s unusual for somebody so young to die from diabetes, says Clare Kelly, MD, an endocrinologist at the University Hospitals Diabetes and Metabolic Care Center in Cleveland.
“In the United States, this does not happen frequently,” Dr. Kelly says. “It is devastating when it does.”
It’s not clear what type of diabetes Trachtenberg had or what kind of complications contributed to her death. However, uncontrolled blood sugar over a long period of time is the most common cause of both chronic and acute complications in different types of diabetes, Kelly says.
What Is Diabetes Mellitus?
- Type 1 diabetes: an autoimmune disorder that causes the body to stop making insulin, a hormone used to control blood sugar.
- Type 2 diabetes: a condition that develops when the body can’t use insulin well to manage blood sugar.
- Gestational diabetes: an issue for some pregnant people who previously had normal blood sugar.
What Are Common Diabetes Symptoms?
- Feeling more thirsty than usual
- Urinating often
- Losing weight without trying
- Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there’s not enough available insulin)
- Feeling tired and weak
- Feeling irritable or having other mood changes
- Having blurry vision
- Having slow-healing sores
- Getting a lot of infections, such as gum, skin, and vaginal infections
What Are Common Diabetes Complications?
The most common long-term complications of both type 1 and type 2 diabetes are similar, Kelly says.
“The cause of the chronic complications of both diseases is uncontrolled blood sugars over a long period of time” Kelly says. These can include cardiovascular disease, heart attacks, strokes, kidney failure, eye disease, and neurological disease, Kelly says.
- Hyperosmolar Hyperglycemic State (HHS) This mostly impacts people with type 2 diabetes and happens when blood sugar levels are very high for a long period, leading to severe dehydration and confusion. It requires immediate medical treatment.
- Diabetes-Related Ketoacidosis (DKA) DKA usually impacts people with type 1 diabetes and happens when the body doesn’t have enough insulin. Without adequate insulin the body can’t use glucose for energy, so it breaks down fat instead. This process eventually releases substances called ketones, which turn blood acidic. The result can be labored breathing, vomiting, and loss of consciousness. DKA requires immediate medical treatment.
- Severe Low Blood Sugar (Hypoglycemia) Hypoglycemia happens when blood sugar drops to dangerously low levels, and it mainly impacts people with diabetes who use insulin. Signs include blurred or double vision, clumsiness, disorientation. and seizures. It requires treatment with emergency glucagon or medical intervention.
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Can Diabetes Complications Be Prevented?
“Both chronic and acute complications can be prevented by careful attention to blood sugar control,” Kelly says.
Depending on the actual complication, there are more specific ways to treat it or prevent progression once it develops, Kelly adds.
This is why it is important for people with diabetes to have routine follow-up with either their primary care provider or their endocrinologist to ensure that their blood sugar is well managed and any other chronic health issues are addressed, Kelly advises.
Patients can also discuss what complications may happen in their specific situation and learn what signs to watch for.
How Many People Die of Diabetes Complications?
“There is likely an impact of diabetes on life expectancy,” Kelly says. “That impact is heightened by uncontrolled diabetes leading to the chronic complications, and that impact is minimized by good glycemic control and ongoing surveillance and preventative care regarding potential complications of diabetes.”
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