Alcohol measurement between cerebrospinal fluid and other bodily fluids in absorptive and post absorptive phases: two illustrative cases

Abstract

During hypothermia, alteration of glucose metabolism can result in a hyperglycaemic and ketoacidotic state. 1 Conversely, diabetic ketoacidosis (DKA) can precipitate hypothermia by impaired thermoregulation and autonomic dysfunction. 2 Both DKA and hypothermia can demonstrate overlapping pathological and biochemical findings. 3 Aim: Due to the related pathophysiology between hypothermia and DKA, we hypothesised that were would be a higher number of deaths from DKA in winter than in any other season. Method: We performed a 12-year retrospective study on all deaths related to DKA at the Department of Forensic Pathology, Auckland City Hospital, New Zealand. The decedents' age and sex, and the season they died, were recorded. Statistical analysis was performed using R statistics. Results: A total of 35 cases were included. Age and sex were not statistically significant between the seasons. Winter had the highest number of deaths from DKA (n=12), followed by summer (n=9), autumn (n=8) and spring (n=6). Discussion: This study demonstrated that winter months had the highest number of deaths from DKA compared to other seasons. Given the similar pathophysiology and pathologic findings between hypothermia and DKA, this implies that winter may be a factor that can precipitate or exacerbate DKA that may be under recognised.Obesity is an increasingly prevalent co-morbidity that is associated with sudden unexpected death and is commonly encountered in post mortem practice. Due to the effects of increased body-habitus it is, however, uncommon to encounter a death in an obese individual from hypothermia, especially during S102 PATHOLOGY 2020 ABSTRACT SUPPLEMENT Pathology (2020), 52(S1)