Canfield D V, Chaturvedi A K, Boren H K, Veronneau S J, White V L
Civil Aerospace Medical Institute, Federal Aviation Administration, Oklahoma City, OK, USA.
Aviat Space Environ Med. 2001 Sep;72(9):813-5.
The Federal Aviation Administration's Office of Aerospace Medicine is responsible for the certification of pilots with diabetic conditions. The present study evaluated the use of postmortem vitreous humor and urine glucose levels in transportation accident fatalities as indicators of potentially incapacitating medical conditions or performance impairment.
Vitreous humor and/or urine from 192 accident fatalities were analyzed for glucose using a hexokinase method. Cases with values below the lower limit of detection (10 mg x dl(-1)) and above 3 standard deviations (SD) from the mean were not included in the final statistics. All cases more than 5 SD above the mean were deemed abnormal and a full case history was evaluated based on the available medical history.
The mean vitreous humor glucose concentration was 30+/-21 mg x dl(-1) (N=98), while it was 27+/-16 mg x dl(-1) in urine (N=127). Of the 192 cases, 9 were identified as having abnormal glucose levels. Abnormal glucose levels were found in 5 of the 8 cases with a known diabetic condition. Glycosuria or low renal threshold was reported in 2 fatal pilots; 1 of these pilots had an abnormal glucose level.
Hyperglycemia can be established from the vitreous humor and urine glucose levels. All of the abnormal glucose cases detected were previously identified during the medical certification process or had a medical reason for the abnormal level. Elevated vitreous humor and urine glucose levels have proven useful in identifying individuals with a pre-existing diabetic condition that might have been a factor in the accident.
美国联邦航空管理局航空航天医学办公室负责对患有糖尿病的飞行员进行认证。本研究评估了在交通事故死亡人员中，死后玻璃体液和尿液葡萄糖水平作为潜在致残性疾病或性能损害指标的用途。
采用己糖激酶法分析了192例事故死亡人员的玻璃体液和/或尿液中的葡萄糖。最终统计未纳入检测值低于检测下限（10mg·dl⁻¹）以及高于均值3个标准差（SD）的病例。所有高于均值5个标准差以上的病例均被视为异常，并根据现有的病史对完整病例进行评估。
玻璃体液葡萄糖平均浓度为30±21mg·dl⁻¹（N = 98），而尿液中为27±16mg·dl⁻¹（N = 127）。在192例病例中，有9例被确定为葡萄糖水平异常。在8例已知患有糖尿病的病例中，有5例发现葡萄糖水平异常。2名致命飞行员报告有糖尿或低肾阈值；其中1名飞行员葡萄糖水平异常。
可根据玻璃体液和尿液葡萄糖水平确定高血糖。所有检测出的葡萄糖异常病例在医学认证过程中均已被先前识别，或有医学原因导致水平异常。玻璃体液和尿液葡萄糖水平升高已被证明有助于识别可能是事故因素的既往糖尿病患者。
