Michelle Trachtenberg died from diabetes complications, medical examiner rules. What problems can the disease cause?

Michelle Trachtenberg died as a result of complications of diabetes, New York City’s medical examiner said Wednesday, ruling the manner of death as natural. The 39-year-old actress was found dead in her apartment in the city on Feb. 26.

Since then, the cause and manner of her death had remained unclear. The Gossip Girl star’s family had objected to an autopsy, the New York City Medical Examiner’s Office told People the day after authorities found her.

However, a spokesperson for the office explained “the amended determination was made following review of toxicology testing results.” They indicated toxicology testing can be done without an autopsy.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

Trachtenberg had a liver transplant months before she died, a source confirmed with Yahoo Entertainment. According to People, a source said the Buffy the Vampire Slayer star had been “really, really down emotionally” and “told friends she was struggling” in the last year. They added she was “really, really sick,” and looked “pale, gaunt, very thin and dealing with health issues.”

In January 2024, the New York-born actress hit back at critics who made comments about her appearance after she shared a selfie on Instagram. “Fun fact. This is my face,” she wrote at the time. “Not malnutrition no problems. Why do you have to hate? Get a calendar.”

Read on to learn more about diabetes, and what potential complications can arise from the condition.

The Gossip Girl and Buffy the Vampire Slayer actress reportedly had a liver transplant months before she died at 39. (Photo by Gilbert Flores/WWD via Getty Images)

Diabetes, or diabetes mellitus, is a chronic disease that occurs when the body has problems with insulin, either with the pancreas not producing enough of the hormone or when the body can’t effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar, or glucose, which is the brain’s main source of fuel; glucose is also an important source of energy for the cells that make up the muscles and tissues.

When the body has problems with insulin, glucose can build up in the bloodstream, causing high blood sugar or hyperglycemia. Over time, having consistently high blood glucose can lead to serious health problems.

There are several types of diabetes, including type 1 and type 2 diabetes. Type 1 diabetes is an autoimmune disease where the immune system attacks insulin-producing cells in your pancreas. Type 2 diabetes is when the body doesn’t make enough insulin and/or when the body’s cells are resistant to insulin.

It’s important for people with diabetes to monitor their blood glucose levels and try to keep it as close to target range as possible. (Photo via Getty Images)

Some people who have diabetes won’t have symptoms, according to Mayo Clinic, especially those with prediabetes, gestational diabetes or type 2 diabetes. For people with type 1 diabetes, symptoms are typically more severe and arise more quickly. Symptoms of type 1 and type 2 diabetes include:

  • Feeling thirstier than usual
  • Frequent urination
  • Unexplained weight loss
  • Fatigue
  • Blurred vision
  • Numbness or tingling in the hands or feet
  • Slow-healing cuts and sores
  • Frequent infections, such as skin, gum and vaginal infections

Developing diabetes is a common complication after having an organ transplant. Posttransplant diabetes mellitus, or PTDM, affects between 10 per cent and 40 per cent of patients undergoing solid organ transplantation, according to the National Institutes of Health. It’s also associated with a higher mortality rate compared to patients who don’t develop the condition.

A 2022 study published in the National Library of Medicine noted developing diabetes is as common for kidney transplant recipients (up to 25 per cent) as those who receive liver transplants. It’s also more common for lung (up to 35 per cent) and heart transplant patients (up to 40 per cent).

Posttransplant diabetes mellitus, or PTDM, is a condition commonly developed after people undergo an organ transplant. (Photo via Getty Images)

According to Cleveland Clinic, diabetes can lead to acute and long-term health complications. Acute — meaning sudden and severe — problems might include:

  • Hyperosmolar hyperglycemic state (HHS): Mainly affecting people with type 2 diabetes, this occurs when a person’s blood sugar levels are very high for a long period, requiring immediate medical treatment.
  • Diabetes-related ketoacidosis (DKA): Mainly affecting people with type 1 diabetes, this occurs when your body doesn’t have enough insulin. Without insulin and glucose, the body will burn fat for energy, releasing a substance called ketones that will turn your blood acidic.
  • Severe low blood sugar (hypoglycemia): This occurs when your blood sugar level drops below the healthy range, mainly affecting people with diabetes who use insulin.

If blood glucose levels remain too high for too long, it can damage the body’s tissues and organs. This is mainly due to damage to the blood vessels and nerves. Cardiovascular are the most common type of long-term diabetes complication, including coronary artery disease, heart attack, stroke and atherosclerosis. Other long-term issues might be:

  • Nerve damage
  • Nephropathy, which can lead to kidney failure
  • Retinopathy, which can lead to blindness
  • Foot conditions
  • Skin infections
  • Amputations
  • Sexual dysfunction, such as erectile dysfunction or vaginal dryness
  • Gastroparesis
  • Hearing loss
  • Oral health issues, such as gum disease
  • Mental health problems

People who have diabetes are two to three times more likely to have depression than people without diabetes, according to Cleveland Clinic. (Photo via Getty Images)

According to Diabetes Canada, the condition contributes to 40 per cent of heart attacks, 30 per cent of strokes, 50 per cent of kidney failure requiring dialysis and 70 per cent of all non-traumatic leg and foot amputations. Diabetes is also the leading cause of blindess.

Diabetes is one of the most common conditions affecting people living in Canada. The Public Health Agency of Canada noted around 3.8 million people over the age of one live with diagnosed diabetes. That’s 10 per cent of the population, but also excludes gestational diabetes.

The number of people living with diabetes in Canada is expected to grow as the population ages and grows. Diabetes is also one of the most common chronic diseases among children and youth; while type 1 diabetes is more common, type 2 diabetes is rising amid growing rates of childhood obesity.

The World Health Organization (WHO) noted that as of 2022, roughly 830 million people around the world are living with diabetes. That’s a rise from around 200 million people reportedly living with the disease in 1990.

There are three tests health-care professionals will use to determine if a patient has diabetes. They’ll also typically use more than one test. (Photo via Getty Images)

Health-care providers will diagnose diabetes by checking glucose levels in a blood test. Three tests can measure your blood glucose level, including a fasting test, a random test and a A1c test. Typically, medical professionals rely on more than one test to diagnose diabetes.

  • The fasting test requires patients to not eat or drink for eight hours, allowing health-care providers to see the body’s baseline blood sugar level.
  • The random test means a patient can get the test at any time, regardless of whether they’ve fasted.
  • The third A1c or glycated hemoglobin test shows the average blood glucose level over the past two to three months.

It’s important to note people living with diabetes can live a healthy life — if they make proper lifestyle changes. That might include regular exercise, dietary changes and regular blood sugar monitoring.

Diabetes Canada noted the condition can reduce people’s lifespans by five to 13 years. “It is estimated that the all-cause mortality rate among people living with diabetes is twice as high as the all-cause mortality rate for those without diabetes,” the organization indicated.

Diabetes was the direct cause of 1.6 million deaths around the world in 2021, according to the WHO. Moreover, an additional 530,000 kidney disease deaths were caused by diabetes.

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