Korean J Leg Med.  2016 Feb;40(1):19-22. 10.7580/kjlm.2016.40.1.19.

Postmortem Diagnosis of Diabetic Ketoacidosis: An Autopsy Case

  • 1Medical Examiner's Office, National Forensic Service, Wonju, Korea. forensic@korea.kr
  • 2Forensic Medicine Division, National Forensic Service Daejeon Institute, Daejeon, Korea.


Diabetic ketoacidosis is an acute complication of type 1 diabetes mellitus, which is observed frequently in routine autopsies. However, there are limitations of postmortem diagnosis of diabetic ketoacidosis. Clinical diagnostic criteria of the disease are not applicable to postmortem diagnosis because of the postmortem changes of the body; hence, diagnostic morphological changes cannot be observed. We report the case of a 47-year-old man that was diagnosed with diabetic ketoacidosis via routine autopsy and laboratory tests without information regarding his medical history. Additionally, we present a brief literature review.


Diagnosis; Diabetic ketoacidosis; Autopsy

MeSH Terms

Diabetes Mellitus, Type 1
Diabetic Ketoacidosis*
Middle Aged
Postmortem Changes


  • Fig. 1. Histological image of diabetic glomerulosclerosis shows capillary basement membrane thickening (arrowheads) and diffuse mesangial sclerosis (arrow) (A, H&E, ×100; B, H&E, ×400).

  • Fig. 2. Histological image of the pancreas in type 1 diabetes mellitus shows reduction in the number and size of the islets and leukocytic infiltration of the islets (A, H&E, ×100; B, H&E, ×400).

Cited by  1 articles

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Korean J Leg Med. 2016;40(4):99-103.    doi: 10.7580/kjlm.2016.40.4.99.


1.Braunwald E., Fauci AS., Kasper DL, et al. Harrison's principles of internal medicine. 15th ed.New York: McGraw-Hill;2001. p. 2116–8.
2.Maitra A. The endocrine system. Kumar V, Abbans AK, Fausto N, editors. . ., eds.Robbins and Cotran pathologic basis of disease. 8th ed.Philadelphia, PA: Elsevier;2009. p. 1097–64.
3.Palmiere C., Mangin P. Postmortem chemistry update: part I. Int J Legal Med. 2012. 126:187–98.
4.Kanetake J., Kanawaku Y., Mimasaka S, et al. The relationship of a high level of serum beta-hydroxybutyrate to cause of death. Leg Med (Tokyo). 2005. 7:169–74.
5.Kodikara S., Paranitharan P., Pollanen MS. The role of the Armanni-Ebstein lesion, hepatic steatosis, biochemical analysis and second generation anti-psychotic drugs in fatal diabetic ketoacidosis. J Forensic Leg Med. 2013. 20:108–11.
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