I was watching an episode recently and was surprised by the daignosis made by Dr. G. Does anyone know the link to a page where I can ask her about it - or can anyone with medical knowledge help me???
The person was an elderly (65-70) male (lived alone) who had central obesity, fatty liver and chronic pancreatitis, and coronary artery atherosclerosis. Lungs showed patterns continuous with cigarrette smoking. Dr G. propesed the idea of a chronic smoker and drinker with a possible MI resulting in death.
She sent off blood for toxicology and it came back with only low ethanol levels but extremely high (600mmol/L) glucose. So she said the patient died of complications of DKA (diabetic keto-acidosis), which is a complication of uncontrolled, or poorly controlled Diabetes Mellitus Type 1. However, given this persons age and risk factors, he is more likely to have Type 2 diabetes. In addition, someone with Type 1 diabetes would not have been able to continue for as long as he did without insulin injections and there is an incredibly rare chance of him developing Type 1 suddenly at that age. Plus, patients with DKA have a MUCH lower glucose level (she predicted that as he had a glucose of 600 at time of test, at time of death it was prob 1000mmol/L) as they'd go into a coma long before it could reach a level of 600. So if it was Type 2, then the person died from a HONK (hyper-osmolar non-ketotic coma)...and not a DKA - as Type 2 diabetics rarely produce ketones as they have a small level of insulin which is sufficient to inhibit ketone formation.
Can someone help me understand why she diagnosed a DKA then, or can I ask her directly???
