Endocrine Pathology

, Volume 13, Issue 1, pp 39–45 | Cite as

Autopsy findings in diabetic patients: A 27-Yr clinicopathologic study with emphasis on opportunistic infections and cancers

  • King-Yin Lam
Clinical Research


Diabetes mellitus has become a growing epidemic in the Asia-Pacific region. The aims of this study were to determine at autopsy the prevalence and characteristics of pathologic lesions in patients with diabetes mellitus. The 13,215 autopsy reports in our institution were examined for the diagnosis of diabetes mellitus. In patients with diabetes mellitus, the demographic data and the different pathologic lesions noted were analyzed. Diabetes mellitus was found in 820 patients (426 men and 394 women), comprising 6.2% of all autopsies. The two most common types of disease were cardiovascular diseases and infections, found in 69 and 53% of diabetic patients, respectively. Bacterial infection, in particular tuberculosis, was the most common type of infection noted. Localized and disseminated fungal infections were also common. In addition, urinary tract diseases were noted in 48%, hepatobiliary tract lesions in 42%, central nervous system disorders in 25%, and tumors in 29% of the diabetic patients. Malignant tumors were more often seen than benign tumors (18 vs 11% of patients, respectively). Many of the tumors were adenocarcinomas, and the most common neoplastic lesions were carcinomas of the lung, pancreas, liver, large intestine, stomach, and esophagus. Diabetic complications and associated diseases are common problems in this population. Adequate health care resources are needed for their prevention and treatment.

Key Words

Diabetes mellitus autopsy complications tumor 


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  1. 1.
    King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care 21:1414–1431, 1998.PubMedCrossRefGoogle Scholar
  2. 2.
    Cockram CS. The epidemiology of diabetes mellitus in the Asia-Pacific region. Hong Kong Med J 6:43–52, 2000.PubMedGoogle Scholar
  3. 3.
    Andersson D, Svardsudd K. The value of death certification statistics in measuring mortality in persons with diabetes. Scand J Prim Health Care 12:114–120, 1994.PubMedGoogle Scholar
  4. 4.
    Eriksson L, Sundstrom C. Decreasing autopsy rate in Sweden reflects changing attitudes among clinicians. Qual Assur Health Care 5:319–323, 1993.PubMedCrossRefGoogle Scholar
  5. 5.
    Goto Y, Suzuki K. Causes of death in Japanese diabetic patients examined by autopsy. Diabetes Res Clin Pract 24:S291-S294, 1994.PubMedCrossRefGoogle Scholar
  6. 6.
    McLarty DG, Unwin N, Kitange HM, Alberti KG. Diabetes mellitus as a cause of death in sub-Saharan Africa: results of a community-based study in Tanzania. Diabet Med 13:990–994, 1996.PubMedCrossRefGoogle Scholar
  7. 7.
    Phillips CB, Patel MS, Weeramanthri TS. High mortality from renal disease and infection in Aboriginal central Australians with diabetes. Aust J Public Health 19:482–486, 1995.PubMedCrossRefGoogle Scholar
  8. 8.
    Mak KH. Number of notifications of infectious diseases. Public Health Epidemiol Bull Depart Health, Hong Kong 8:8, 1999.Google Scholar
  9. 9.
    Lam KY, Lo CY. A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol 54:633–639, 2001.CrossRefGoogle Scholar
  10. 10.
    Rees JR, Pinner RW, Hajjeh RA, Brandt ME, Reingold AL. The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992–1993: results of population-based laboratory active surveillance. Clin Infect Dis 27:1138–1147, 1998.PubMedGoogle Scholar
  11. 11.
    Wu TT, Wang HC, Yang PC, Kuo SH, Luh KT. Pulmonary cryptococcosis: manifestations in the era of acquired immunodeficiency syndrome. J Formos Med Assoc 98:621–626, 1999.PubMedGoogle Scholar
  12. 12.
    De Biscop J, Mondie JM, Venries de la Guillaumie B, Peri G. Mucormycosis in an apparently normal host: case study and literature review. J Craniomaxillofac Surg 19:275–278, 1991.PubMedGoogle Scholar
  13. 13.
    Chetchotisakd P, Boonma P, Sookpranee M, Pairojkul C. Rhinocerebral mucormycosis: a report of eleven cases. Southeast Asian J Trop Med Public Health 22:268–273, 1991.PubMedGoogle Scholar
  14. 14.
    Wilkin A, Feinberg J. Pneumocystis carinii pneumonia: a clinical review. Am Fam Physician 60:1699–1714, 1999.PubMedGoogle Scholar
  15. 15.
    Assan R, Perronne C, Assan D, Chotard L, Mayaud C, Matheron S, Zucman D. Pentamidine-induced derangements of glucose homeostasis: determinant roles of renal failure and drug accumulation—a study of 128 patients. Diabetes Care 18:47–55, 1995.PubMedCrossRefGoogle Scholar
  16. 16.
    Wideroff L, Gridley G, Mellemkjaer L, et al. Cancer incidence in a population-based cohort of patients hospitalized with diabetes mellitus in Denmark. J Natl Cancer Inst 89:1360–1365, 1997.PubMedCrossRefGoogle Scholar
  17. 17.
    Kim YI. Diet, lifestyle, and colorectal cancer: is hyperinsulinemia the missing link? Nutr Rev 56:275–279, 1998.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc 2002

Authors and Affiliations

  1. 1.School of MedicineJames Cook UniversityTownsvilleAustralia

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