Medical examiner cases associated with previously undiagnosed diabetes mellitus, North Carolina, 1994

Background. Approximately half of the 16 million Americans with diabetes mellitus (DM) are unaware they have the disease; the epidemiology of death from previously undiagnosed DM is unclear. We report medical examiner (ME) cases of death from DM in North Carolina in 1994 to determine the number and characteristics of these cases. Methods. Deaths from DM ICD-9 were identified and reviewed. Results. Of the 42 cases ascertained from ME records, 6 had previously undiagnosed DM, 5 had diabetes ketoacidosis, and 1 had nonketotic hyperosmolar hyperglycemia. Mean patient age at death for all cases was 42 years (range, 35 years to 57 years). Four patients felt bad at least 24 hours before death, indicating that they are not technically 'sudden deaths.' Conclusions. We provide a limited epidemiologic perspective of the phenomenon of death from undiagnosed DM. We suggest further investigation of mortality from previously undiagnosed diabetes.