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Erschienen in: International Journal of Legal Medicine 1/2021

18.06.2020 | Short Communication

Usefulness of a blood glucose and ketone monitoring device as a screening tool for lethal diabetic ketoacidosis

verfasst von: Pierre-Antoine Peyron, Maëlle Plawecki, Maisy Lossois, Manuela Lotierzo, Eric Baccino, Jean-Paul Cristol

Erschienen in: International Journal of Legal Medicine | Ausgabe 1/2021

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Abstract

Diabetic ketoacidosis (DKA) is a frequent and life-threatening complication, whose diagnosis remains challenging in forensic practice. We aimed at assessing the performance of a commercially available blood glucose and ketone monitoring device (BGMD) in measuring glucose and ketone levels in post-mortem vitreous (VH) and blood samples, in order to determine if such a device can be used for screening lethal cases of DKA at autopsy. VH and blood samples were collected in cases of unexplained causes of death at autopsy. Glucose and β-hydroxybutyrate (BHB) were measured in VH and BHB in blood using the BGMD. The values were compared to those obtained with validated enzymatic methods. Values ≥ 10 mmol/L were considered to be elevated for glucose, and BHB values ≥ 2.5 mmol/L were considered to indicate ketoacidosis. There was a strong and significant correlation between VH glucose and blood BHB concentrations measured with the BGMD and the validated method (r = 0.78 and r = 0.80, p < 0.0001, respectively), whereas no correlation was found for VH BHB values (r = 0.19, p = 0.19). The sensitivity and specificity of the BGMD were both excellent (1.0) to detect elevated VH glucose levels with a threshold of 14.4 mmol/L, and to detect elevated blood BHB levels with a threshold of 2.85 mmol/L. In contrast, the specificity of the BGMD to detect high BHB levels in VH was poor (0.50) with an optimal threshold of 2.5 mmol/L. We showed that a commercially available BGMD is suitable for identifying cases of lethal DKA and other metabolic disorders at autopsy, through the investigation of vitreous glucose and blood BHB. We therefore recommend the systematic use of a BGMD for screening these conditions in cases of unexplained deaths.
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Metadaten
Titel
Usefulness of a blood glucose and ketone monitoring device as a screening tool for lethal diabetic ketoacidosis
verfasst von
Pierre-Antoine Peyron
Maëlle Plawecki
Maisy Lossois
Manuela Lotierzo
Eric Baccino
Jean-Paul Cristol
Publikationsdatum
18.06.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Legal Medicine / Ausgabe 1/2021
Print ISSN: 0937-9827
Elektronische ISSN: 1437-1596
DOI
https://doi.org/10.1007/s00414-020-02343-8

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