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Detection of diabetic metabolism disorders post‐mortem – forensic case reports on cause of death hyperglycaemia
Author(s) -
Hess C.,
Wöllner K.,
Musshoff F.,
Madea B.
Publication year - 2013
Publication title -
drug testing and analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.065
H-Index - 54
eISSN - 1942-7611
pISSN - 1942-7603
DOI - 10.1002/dta.1479
Subject(s) - fructosamine , ketone bodies , coma (optics) , diabetes mellitus , diabetic coma , carbohydrate metabolism , medicine , endocrinology , glycosuria , metabolism , physics , optics
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. Copyright © 2013 John Wiley & Sons, Ltd.