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May 1, 2001

Hyperglycemia and DKA

Question from Grain Valley, Missouri, USA:

My 64 year old mother had type 1 diabetes for years and died suddenly about three months ago. The autopsy report stated that her her glucose level was 1150 mg/dl [63.9 mmol/L] and she had acetone, ethanol, and isopropanol present in her system. It also said that she had kidney failure and pneumonia, neither of which we knew of. I know that acetone can be produced by people with diabetes, but specifically what about the ethanol and isopropanol (rubbing alcohol?). My mother never drank! Does an extremely high glucose level cause acetone, ethanol, and isopropanol to be produced in the body?

Answer:

Unfortunately, I cannot explain the presence of ethanol or isopropanol. Acetone can be produced from ketones in patients with diabetes.

JTL