Postmortem diagnosis of unsuspected diabetes mellitus.

Details

Serval ID
serval:BIB_55DD2C1824D9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Postmortem diagnosis of unsuspected diabetes mellitus.
Journal
Forensic Science International
Author(s)
Palmiere C., Bardy D., Mangin P., Werner D.
ISSN
1872-6283 (Electronic)
ISSN-L
0379-0738
Publication state
Published
Issued date
2013
Volume
226
Number
1-3
Pages
160-167
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
Vitreous glucose, blood beta-hydroxybutyrate and glycated hemoglobin were systematically measured in a series of 500 medico-legal autopsies in order to characterize the glycemic control during the weeks preceding death and identify ketoacidosis as the cause of death in diagnosed and unsuspected diabetics. Unenhanced CT-scans, histology and toxicology were performed in all cases. 16 cases of diabetic ketoacidosis were identified based on the results of all investigations. Among those, 13 cases concerned individuals with pre-existing diagnoses of diabetes mellitus whereas 3 cases concerned individuals with undiagnosed diabetes. A recent cocaine use was observed in 2 cases. C-reactive protein, interleukin-6 and interleukin-10 were measured and proved to be increased in all cases of diabetic ketoacidosis, whereas markers of generalized, bacterial infection and sepsis were normal in most of these cases. The results of this study highlight the usefulness of systematically performing biochemistry to identify ketoacidosis in unsuspected diabetics. It also emphasizes the role of toxicology and biochemistry to support the diagnosis of diabetic ketoacidosis and delineate the pathophysiological mechanisms that may disrupt the metabolic balance and finally lead to death in diabetic individuals.
Keywords
Postmortem biochemistry, Diabetes, Ketoacidosis, Vitreous humor, Beta-hydroxybutyrate, Glycated hemoglobin
Pubmed
Web of science
Create date
03/05/2013 19:47
Last modification date
20/08/2019 14:10
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