Journal Mobile

I de Leeuw
Journal Issue: 
Volume 39: Issue 2: 2009




Queen  Maria  de’  Medici  (1573–1642)  died  in  a  miserable,  marasmic state. Infections, gangrene, weight loss, fatigue and respiratory problems suggest a progressive decompensation of a previously existing Type 2 diabetes. The lack of  biochemical  data,  however,  permits  only  circumstantial  evidence  of  this hypothesis. The  author  proposes  that  the  queen  developed  subclinical  diabetes after the age of 45, when she became obese due to excessive eating and lack of exercise.  With  a  clear  familial  predisposition,  she  could  have  become  insulin resistant and chronically hyperglycaemic. The presence of an internal deviation of the left eye, visible on several late portraits, suggests a mononeuropathy of cranial nerve VI. Repeated skin infections and gangrene of the lower limbs during the last month  of  her  life  complete  the  clinical  diagnosis.  Hyperglycaemic  ketosis  with Kussmaul respiration without adequate treatment may have caused her death.