Michelle Trachtenberg. Photo:
John Salangsang/Variety/Penske Media via Getty
When Michelle Trachtenberg unexpectedly died at age 39, fans were left wondering what had happened to the star.
On Feb. 26, 2025, the Gossip Girl actress was found dead in a New York City apartment by police officers who had responded to a 911 call. When they arrived at the residence, they found a woman unconscious and unresponsive.
Trachtenberg was pronounced dead at the scene and was later identified as the actress. The New York City Office of the Chief Medical Examiner ruled her cause of death “undetermined,” and her family refused an autopsy on religious grounds. On April 16, though, the coroner confirmed her cause of death via a toxicology test, renewing questions about the star’s health.
After Trachtenberg’s death, many of her former costars paid tribute to her career in Hollywood, including Sarah Michelle Gellar, who starred with her on Buffy the Vampire Slayer in the early 2000s.
“Michelle, listen to me. Listen. I love you. I will always love you,” Gellar wrote in an Instagram post, quoting Trachtenberg’s character from the season 5 finale. “The hardest thing in this world, is to live in it. I will be brave. I will live… for you.”
So, what was Michelle Trachtenberg’s cause of death — and what did it reveal about her final days?
Michelle Trachtenberg takes a selfie in January 2024. Michelle Trachtenberg/Instagram
On April 16, 2025, the New York City Office of the Chief Medical Examiner confirmed that Trachtenberg’s cause of death was ruled natural and was the result of complications of diabetes mellitus.
It is not known what type of diabetes the actress had, as diabetes mellitus refers to “a group of diseases that affect how the body uses blood sugar,” according to the Mayo Clinic.
Michelle Trachtenberg attends the 28th Annual Elton John AIDS Foundation Academy Awards Viewing Party on February 09, 2020 in West Hollywood, California. Jemal Countess/Getty
The day after Trachtenberg died, the New York City Medical Examiner’s Office told PEOPLE that her family had objected to an autopsy. Trachtenberg’s parents are Jewish immigrants from Germany and Russia, and oftentimes, autopsies are not performed in their faith because bodies are believed to be sacred, as the Los Angeles Times reported.
“If it’s a suicide, if it’s a natural death [or] those types of cases where no one’s going to be prosecuted, the autopsy is not required by law,” legal expert Neama Rahmani explained to PEOPLE.
He continued, “The problem is sometimes we’ve seen autopsies become public, and the family members will actually file lawsuits to keep autopsies private because sometimes there’s information in the autopsy that can cast a bad light on the deceased.”
Because an autopsy wasn’t performed, the medical examiner was only allowed to conduct an external exam of the actress’ body.
Michelle Trachtenberg in January 2025. Michelle Trachtenberg/Instagram
Trachtenberg had undergone a liver transplant before she died and may have been experiencing complications, ABC reported. Sources told PEOPLE that the actress had been “struggling” over the last year and was “really really down emotionally.”
“She was really, really sick and open with those in her circle about how much she was struggling,” the insider said. They added that Trachtenberg was “pale, gaunt” and “very thin,” and had been dealing with “health issues.”
Though she never publicly shared that she had been diagnosed with any health conditions, Trachtenberg had defended her appearance on Instagram. Alongside a selfie she shared in January 2024, she wrote, “Fun fact. This is my face. Not malnutrition no problems. Why do you have to hate? Get a calendar.”
In a different post, Trachtenberg wrote that she had received “several comments” about her looks and that she was “happy and healthy.”
Michelle Trachtenberg at the 15 Years of Siriano Party on November 2, 2023 in Los Angeles, California. Gilbert Flores/WWD via Getty
A spokesperson for the New York City Office of Chief Medical Examiner told PEOPLE that they were able to determine Trachtenberg’s cause of death through toxicology testing, which can be done without an autopsy.
Michelle Trachtenberg attends Cadillac Celebrates the 92nd Annual Academy Awards on February 06, 2020 in Los Angeles, California. JC Olivera/WireImage
Though less than 50% of all diabetes-related deaths occur in patients under the age of 70, according to the World Health Organization, the condition can be more dire for those who develop it after a liver transplant.
A 2018 study in the journal Diabetes Therapy found that up to one-third of patients who have undergone a liver transplant develop diabetes, which can increase the risk of transplant failure and death.
“There’s a name for that. It’s called NODAT, or New Onset Diabetes After Transplant,” Dr. Zinoviy Abelev told PEOPLE after Trachtenberg’s cause of death was revealed. “[Patients] are placed on chronic immunosuppressive medications and steroids called prednisone, and we do encounter patients on chronic steroid replacement having elevated blood sugar.”
The doctor called diabetes “a silent killer,” saying, “A lot of times people don’t even recognize the signs of diabetes. It’s slow damage to the organs, slow damage to the heart, slow damage to the kidneys, liver, eyes, blood vessels.”
Dr. Abelev concluded, “The only way to prevent this is proper recognition of the symptoms and controlling the blood sugar.”
