| Investigation of markers to indicate and distinguish death due to Alcoholic Ketoacidosis, Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State using post-mortem samples. | |
| | |
MedLine Citation:
|
PMID: 21840144 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Data from 191 post-mortem cases where post-mortem blood beta-hydroxybutyrate (βHB) and acetone concentrations and vitreous humor glucose concentrations (where available) had been measured were retrospectively investigated to determine the markers required to identify and distinguish between Alcoholic Ketoacidosis (AKA), Diabetic Ketoacidosis (DKA) and Hyperosmolar Hyperglycemic State (HHS). Blood βHB concentrations above 250μg/mL were considered significant and it was shown to be the preferred marker of ketoacidosis. All cases with significant βHB detected also had acetone present (greater than 2mg/dL) demonstrating that acetone can be used as a marker to identify ketoacidosis and can be used to indicate when βHB measurement is necessary. Vitreous humor glucose concentrations above 6.9mmol/L were considered high and indicative of hyperglycemia prior to death. Vitreous humor glucose concentrations can be used to distinguish between DKA and ketoacidosis from other causes and to identify deaths due to HHS. The data showed that ketoacidosis can occur without a history of alcoholism or diabetes. Many diabetics are undiagnosed for many years. Therefore, DKA or HHS should be considered in sudden or unexplained deaths and glucose should be routinely measured especially in cases with risk factors for diabetes including obesity, old age, a history of mental health problems or treatment with atypical antipsychotic drugs including clozapine, olanzapine, quetiapine and risperidone. |
| | |
Authors:
|
Joanna Hockenhull; Waljit Dhillo; Rebecca Andrews; Sue Paterson |
Related Documents
:
|
10330294 - A conformationally-constrained mhc class ii i-ag7-derived peptide protects nod mice fro... 19965614 - Diabetes reduces the cholesterol exporter abca1 in mouse macrophages and kidneys. 15368274 - Prevention of diabetes in nod mice at a late stage by targeting ox40/ox40 ligand intera... 18608174 - Interferon-tau inhibits the development of diabetes in nod mice. 2691604 - Diabetic retinopathy. 1582604 - Mesalazine associated nephrogenic diabetes insipidus presenting as weight loss. |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2011-8-11 |
Journal Detail:
|
Title: Forensic science international Volume: - ISSN: 1872-6283 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
|
Created Date: 2011-8-15 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7902034 Medline TA: Forensic Sci Int Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
|
Toxicology Unit, Imperial College London, Charing Cross Hospital, St Dunstan's Road, London W6 8RP, United Kingdom. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants...
Next Document: Influence of CYP2D6 genotype on the disposition of the enantiomers of venlafaxine and its major meta...