The diagnostic value of postmortem blood glucose determinations in cases of diabetes mellitus

Gormsen, H; Lund, Asger

doi:10.1016/0379-0738(85)90066-0

Cited by 33 publications

(22 citation statements)

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“…In case of diabetic ketoacidosis, acetone concentrations > 21 mg/l were found. [15] In the presently described cases, concentrations were much higher while hydroxybutyrate-concentrations always exceeded 6761 mmol/l. Palmiere et al measured hydroxybutyrate-concentrtions in 12 cases of DKA and described concentrations between 7900 mmol/l and 15100 mmol/l.…”

Section: Discussionmentioning

confidence: 92%

“…H 2 O 2 which is also formed in this reaction oxidizes a colourant (4-Chinoimine colourant) and the colour change can be detected photometrically. LoQ is 1 mg/dl, linearity is given up to 200 mg/dl, cross reactivity only with ascorbic acid > 20 mg/dl; intra-day precision 1,44 % (at 15 HbA1c was determined by an immunturbidimetric test from Labor und Technik (Berlin, Germany) on an Olympus 400 AU Immunoanalyzer. The determination works without measurement of the total haemoglobin level.…”

Section: Methodsmentioning

confidence: 99%

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Detection of diabetic metabolism disorders post‐mortem – forensic case reports on cause of death hyperglycaemia

Heß

Wöllner

Mußhoff

et al. 2013

Drug Testing and Analysis

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Diabetic coma is the most severe form of hyperglycaemic metabolic disorders. The post-mortem diagnosis of this disorder of glucose metabolism can be difficult and vague due to a lack of characteristic morphological findings. Six death cases caused by diabetic coma are described with special focus on biochemical (and histological) findings. The possible glycaemia markers glucose, lactate, HbA1c, fructosamine, anhydroglucitol, and ketone bodies were measured and the usefulness of these parameters is evaluated and discussed. Estimations of glucose concentrations in vitreous humour or cerebrospinal fluid and of ketone bodies in blood or other matrices are obligatory while measurements of HbA1c, fructosamine, or anhydroglucitol can only provide additional information on the long-term adjustment of diabetes in the deceased. Lactate concentrations (addition of glucose and lactate levels to form the sum formula of Traub) do not give more information than the glucose concentration itself and can be therefore omitted.

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Section: Discussionmentioning

confidence: 92%

Section: Methodsmentioning

confidence: 99%

Detection of diabetic metabolism disorders post‐mortem – forensic case reports on cause of death hyperglycaemia

Heß

Wöllner

Mußhoff

et al. 2013

Drug Testing and Analysis

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“…Such increases are not manifested in vitreous humor (DiMaio et al 1977). Gormsen and Lund (1985) found that the only condition which undoubtedly induces high glucose levels in peripheral postmortem blood are attempts at resuscitation, including heart massage, although these authors felt that uncontrolled diabetes could still be diagnosed from properly performed blood glucose determinations on samples removed at autopsy. In our study, no correlation was found between biochemical concentrations in vitreous humor and the use of cardiopulmonary resuscitation.…”

Section: Discussionmentioning

confidence: 94%

“…Glycolysis continues spontaneously and the blood glucose concentration falls extremely rapidly (Coe 1993;Forrest 1993). Furthermore, death may be preceded by agonal processes and cardiopulmonary resuscitation which are often associated with the secretion or the administration of catecholamines, which result in further mobilization of liver glycogen and the release of glucose into the circulation (Lund 1964;Gormsen and Lund 1985) as a counterbalancing phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Vitreous humor fructosamine concentrations in the autopsy diagnosis of diabetes mellitus

Osuna

García-víllora

Pérez-Cárceles

et al. 1999

International Journal of Legal Medicine

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In clinical practice, biochemical markers, particularly serum glucose levels are used to diagnose diabetes mellitus. However, at autopsy this marker is of no value due to the substantial and capricious fluctuations in glucose levels after death. The aim of this study was to evaluate the usefulness of the postmortem determination of fructosamine in vitreous humor for confirming the presence of antemortem hyperglycemia. This was a study of 92 cadavers with a mean age of 60.05 years (SD 17.73) and a mean postmortem interval of 17.02 h (SD 9.76, range 2-58 h). Cases were assigned to two diagnostic groups according to the antemortem diagnosis of diabetes mellitus based on the patients' medical records. In vitreous humor statistically significant differences were found in glucose and fructosamine concentrations between the two diagnostic groups, the highest values being obtained in the group of subjects with a previous diagnosis of diabetes mellitus.

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“…Determination of ketone bodies in corpse fluid and its application to forensic practice has been analysed by several authors [7][8][9][10][11][12][13]. β-OHB serum concentrations provide more information about severity of ketoacidosis whether it is related to diabetes [14], alcohol [9] or starvation [15] than other ketone bodies.…”

Section: Ketone Bodiesmentioning

confidence: 99%

Disorders of glucose metabolism: post mortem analyses in forensic cases–part II

2010

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In continuation to part I, a literature review is presented concerning biochemical problems of forensic post mortem cases of unclear hyperglycaemia or hypoglycaemia. Clinical parameters for this purpose were recently reviewed. Particular attention was paid to the detection of diabetic ketoacidosis, of hyperosmolar coma, insulinoma, insulin-induced or oral diabetic-induced hypoglycaemia. The second part of the review discusses the analytes ketone bodies, synthetic insulins, human insulin, C-peptide, proinsulin and insulin antibodies. Special interest is given to post mortem matrices for those analytes to reference concentrations, stability data, analytic interferences and analytical procedures which should be used in toxicological laboratories willing to detect diabetic metabolism disorders after death.

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The diagnostic value of postmortem blood glucose determinations in cases of diabetes mellitus

Cited by 33 publications

References 1 publication

Detection of diabetic metabolism disorders post‐mortem – forensic case reports on cause of death hyperglycaemia

Detection of diabetic metabolism disorders post‐mortem – forensic case reports on cause of death hyperglycaemia

Vitreous humor fructosamine concentrations in the autopsy diagnosis of diabetes mellitus

Disorders of glucose metabolism: post mortem analyses in forensic cases–part II

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