Brittany Murphy, Type 2 Diabetes, and Cardiac Arrest: Speculation and Science

What made Brittany Murphy's heart stop beating? We're not likely to know why the actress went into cardiac arrest until toxicology reports come out sometime in the next six weeks. One clue, however, is that according to her mother, she had type 2 diabetes. If that's the case, her tragic death may have some simple medical answers.

Gossip Web sites have been quick to point out that Murphy was plagued by rumors of drug abuse and anorexia, both of which can put a strain on the cardiovascular system. But type 2 diabetes can be even harder on the heart. The high glucose levels associated with the disease affect the arteries, making the vessel walls rough and more likely to collect fatty deposits that block the flow of blood. If blood flow to the heart is interrupted, the cardiac muscle becomes starved for oxygen and dies.

Even when they're being treated effectively, people with type 2 diabetes are at a much higher risk for a heart attack or stroke than most of us. Having the disease is as big a risk factor as having already had one heart attack. When diabetes patients do have heart attacks, they're about twice as likely to die of them. Sixty-five percent of diabetes patients ultimately die of cardiovascular disease or related complications.

At 32, Murphy was young to go into cardiac arrest, but even children with diabetes can have heart trouble. It's impossible for us to know, without examining her, what lead to the cause of death. But someone in Murphy's situation may have had other risk factors for a heart attack─regardless of any rumors about anorexia and drug use. At the time of her death, she was reportedly "taking prescription meds for flu-like symptoms she had been experiencing for several days." Catching the flu can make a person more susceptible to heart attacks, and it's especially dangerous for diabetics, since it raises blood glucose levels. If blood sugar rises too high, the patient may start vomiting uncontrollably (as Murphy reportedly did before her death) before slipping into a coma and dying. Some of the medications used to treat flu symptoms can also cause abnormally high blood pressure, which is itself a risk factor for heart attacks.

It's medically plausible, given what we know about these conditions (though not about Murphy's personal health) that someone with Murphy's alleged health may have had a heart attack or that type 2 diabetes might have contributed to it. But it's somewhat surprising that Murphy had diabetes in the first place. The actress, who was often criticized for being too thin, wasn't exactly the face, or for that matter the body, of type 2 diabetes. According to the American Heart Association, half of men and 70 percent of women who have diabetes are obese. Perhaps that explains why many celebrities with diabetes─at least the ones on this list─have the other form, type 1, which isn't linked to obesity. (Type 1 diabetes occurs when the pancreas doesn't make enough insulin, type 2 diabetes occurs when the body ignores the insulin the body does make.)

Murphy also didn't have two of the other main risk factors for type 2 diabetes: being over 45 and belonging to certain ethnic groups (African-American, Latino/Hispanic American, Native American, Asian-American or Pacific Islander). But it's possible she had a family history─a common risk factor that often explains the phenomenon of the "thin type 2." As this writer makes clear, "If you think being thin gives you a free pass from this deadly disease, well, it may have a surprise in store for you ... No one should assume he's immune to this disease."

Maybe that's a lesson we should be learning from Brittany Murphy, too. But at this point, of course, all we can definitely say about her death is that it happened too soon.