Diabetes mellitus and hypopituitarism

A 38-year-old diabetic woman developed hyponatraemia and fatal non-ketotic coma after elective cholecystectomy. At the autopsy, it was revealed that the immediate cause of death was cerebral oedema with secondary pontine haemorrhage. The cerebral oedema was associated with severe hyponatraemia and atrophy of the endocrine organs, including the adrenal glands. Biochemical analysis of serum taken immediately before death indicated that the primary defect was pituitary insufficiency, a recognised but rare complication of diabetes.