Now more than two years after the sudden death of independent journalist Sanjiv Handa, many Oakland residents are still wondering what took the life of the 55-year-old journalist, who was found dead at a friend’s residence on Dec. 27, 2011.

A well-known fixture at public meetings, Handa irritated some officials but endeared himself to many residents as a tireless crusader for transparent government. He covered virtually every council meeting, including committee hearings, since 1991. He was the sole proprietor of the East Bay News Service, an email newsletter.

According to the coroner’s report, Handa died of “acute diabetic ketoacidosis,” a potentially life threatening complication that affects patients with diabetes.

DKAoccurs predominantly in those with type 1 diabetes, but it can occur in those with type 2. DKA results from a shortage of insulin. In response, the body switches to burning fatty acids and producing acidic ketone bodies that cause most of the symptoms and complications.

DKA may be the first symptom of previously undiagnosed diabetes, but it may also occur in people known to have diabetes. Vomiting, dehydration, deep gasping breathing, confusion and occasionally coma are typical symptoms. It can also be smelled on a person’s breath, due to acetone. It is often described as smelling like nail polish remover.

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Without treatment, DKA can lead to death.

Shortly before his death, Handa had been “feeling weak…and had been coughing a lot,” according to the Coroner Investigator’s Report. Handa had gone to see his doctor, who sent him for blood work, but he never got the results. “There were no signs of trauma or foul play to the body,” and there was no drugs or alcohol in his blood, the report said.

The report concluded that the evidence was “consistent with a natural death.” The case was reviewed and officially closed on April 21, 2013.

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