My 16 year old step-daughter passed away last week with what the doctors say is a very rare complication of diabetes. Her brain swelled, she went into a coma and never woke up. I have never heard of this, we had no warning, no one told us this could happen. She was only diagnosed with diabetes a year and a half ago. Could you please send me any information on this that you have? It would help to know why this has happened.

First, please accept my sympathy for your loss. I, too, had a patient, and I consider all my patients my children, develop cerebral edema. She became ill and vomited a few times, like she had the flu. The parents gave fluids and insulin, very appropriately but she seemed to get sicker and they took her to the ER. On the way to the hospital, she developed cerebral edema, became comatose, and ultimately she expired.

This is a rare complication of diabetes. We do know that all children in diabetic ketoacidosis seem to develop some degree of brain swelling, but we don’t really know why a few seem to develop the fatal form. We have speculated in the literature, but truly don’t know why. We do know it only seems to happen to children. We also know that prevention of ketoacidosis is the best treatment..

I know this isn’t a satisfactory answer. I don’t have a satisfactory answer. I do worry about this rare complication whenever I have a patient in the hospital, but I don’t tend to worry the parents about it unless the child is severely ill.

LD