Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Utility of a Handheld Blood Ketone Meter as a Postmortem Indicator of Diabetic Ketoacidosis

Utility of a Handheld Blood Ketone Meter as a Postmortem Indicator of Diabetic Ketoacidosis Abstract When investigating a death potentially due to diabetic ketoacidosis (DKA), it is challenging to assess the glucose level in the blood, but β-hydroxybutyrate, the most prevalent ketone body in the blood, is relatively stable after death. The aim of this project is to prove that a commercially available ketone meter can be used on postmortem blood samples to aid the diagnosis of DKA in a novel setting (during coroner/medical examiner examination). Samples with acetone detected via gas chromatography were chosen retrospectively to determine whether the meter could detect ketones in postmortem blood (proof-of-concept). In all of the thawed samples, the meter detected an elevated ketone level. Samples were then obtained in a prospective manner to include those with a possible cause of death from DKA along with controls. We correctly identified 16 cases in which death was due to DKA with use of the ketone manner. The ketone levels ranged from 2.6 to 5.4 mmol/L in those cases. The diagnosis was confirmed with a greatly elevated vitreous glucose concentration or glycated hemoglobin concentration. Detecting the presence of ketones while in the autopsy suite allowed for more accurate preliminary diagnoses and utilization of resources. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Forensic Medicine & Pathology Wolters Kluwer Health

Utility of a Handheld Blood Ketone Meter as a Postmortem Indicator of Diabetic Ketoacidosis

Download PDF
4 pages

Loading next page...
 
/lp/wolters-kluwer-health/utility-of-a-handheld-blood-ketone-meter-as-a-postmortem-indicator-of-JpJBF3SgP0
Publisher
Wolters Kluwer Health
Copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
ISSN
0195-7910
eISSN
1533-404X
DOI
10.1097/paf.0000000000000794
Publisher site
See Article on Publisher Site

Abstract

Abstract When investigating a death potentially due to diabetic ketoacidosis (DKA), it is challenging to assess the glucose level in the blood, but β-hydroxybutyrate, the most prevalent ketone body in the blood, is relatively stable after death. The aim of this project is to prove that a commercially available ketone meter can be used on postmortem blood samples to aid the diagnosis of DKA in a novel setting (during coroner/medical examiner examination). Samples with acetone detected via gas chromatography were chosen retrospectively to determine whether the meter could detect ketones in postmortem blood (proof-of-concept). In all of the thawed samples, the meter detected an elevated ketone level. Samples were then obtained in a prospective manner to include those with a possible cause of death from DKA along with controls. We correctly identified 16 cases in which death was due to DKA with use of the ketone manner. The ketone levels ranged from 2.6 to 5.4 mmol/L in those cases. The diagnosis was confirmed with a greatly elevated vitreous glucose concentration or glycated hemoglobin concentration. Detecting the presence of ketones while in the autopsy suite allowed for more accurate preliminary diagnoses and utilization of resources.

Journal

American Journal of Forensic Medicine & Pathology – Wolters Kluwer Health

Published: Mar 6, 2023

References

  • National Diabetes Statistics Report
  • Postmortem diagnosis of diabetes mellitus and its complications
    Palmiere, C
  • Hyperglycemic crisis: diabetic ketoacidosis and hyperglycemic hyperosmolar state
    Gosmanov, AR; Gosmanova, EO; Kitabchi, AE; Feingold, KR; Anawalt, B; Boyce, A
  • Management of hyperglycemic crises: diabetic ketoacidosis and hyperglycemic hyperosmolar state
    Fayfman, M; Pasquel, FJ; Umpierrez, GE
  • Seventy-two hour mortality prediction model in patients with diabetic ketoacidosis: a retrospective cohort study
    Siregar, NN; Soewondo, P; Subekti, I
  • Diabetic ketoacidosis and hyperosmotic and hyperglycemic state in adults: treatment
    Hirsch, IB; Emmett, M
  • Postmortem vitreous analysis
    Collins, K
  • Utility of postmortem vitreous beta-hydroxybutyrate testing for distinguishing sudden from prolonged deaths and for diagnosing ketoacidosis
    Klaric, KA; Milroy, CM; Parai, JL
  • Postmortem vitreous beta-hydroxybutyrate: interpretation in a forensic setting
    Heninger, M
  • The usefulness of point-of-care (POC) tests in screening elevated glucose and ketone body levels postmortem
    Walta, AM; Keltanen, T; Lindroos, K