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Postmortem diagnosis of unsuspected diabetes mellitus

Palmiere, Cristian ; Bardy, Daniel ; Mangin, Patrice ; Werner, Dominique

Forensic science international, 2013-03, Vol.226 (1), p.160-167 [Periódico revisado por pares]

Ireland: Elsevier Ireland Ltd

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Título:
Postmortem diagnosis of unsuspected diabetes mellitus
Autor: Palmiere, Cristian ; Bardy, Daniel ; Mangin, Patrice ; Werner, Dominique
Assuntos: 2-Propanol - analysis ; 3-Hydroxybutyric Acid - analysis ; Acetone - analysis ; Acute-Phase Proteins ; Adolescent ; Adult ; Bacteria ; Benzodiazepines - analysis ; Beta-hydroxybutyrate ; Biochemistry ; C-Reactive Protein - analysis ; Calcitonin - blood ; Carrier Proteins - blood ; Cocaine - urine ; Death ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus - blood ; Diabetes Mellitus - diagnosis ; Diabetic Ketoacidosis - diagnosis ; Diagnosis ; Fatalities ; Female ; Forensic Pathology ; Forensic science ; Forensic sciences ; Glucose ; Glucose - analysis ; Glycated hemoglobin ; Glycated Hemoglobin A - analysis ; Health care ; Humans ; Interleukin-10 - blood ; Interleukin-6 - blood ; Ketoacidosis ; Male ; Markers ; Membrane Glycoproteins - blood ; Middle Aged ; Narcotics - urine ; Pancreas ; Pathology ; Postmortem biochemistry ; Protein Precursors - blood ; Toxicology ; Vitreous Body - chemistry ; Vitreous humor
É parte de: Forensic science international, 2013-03, Vol.226 (1), p.160-167
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Descrição: 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.
Editor: Ireland: Elsevier Ireland Ltd
Idioma: Inglês

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Postmortem diagnosis of unsuspected diabetes mellitus

Palmiere, Cristian ; Bardy, Daniel ; Mangin, Patrice ; Werner, Dominique

Ireland: Elsevier Ireland Ltd

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