Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany.
Int J Legal Med. 2011 Mar;125(2):163-70. doi: 10.1007/s00414-010-0509-6. Epub 2010 Sep 29.
In developed countries, diabetes is one of the ten most common causes of death. Post mortem diagnosis of glucose metabolism disorders can be difficult and vague because of the lack of characteristic morphological findings. Reviews of the literature are presented concerning biochemical problems in cases of unclear hyper- or hypoglycemia. After repetition of causes, frequency, and mortality of diabetic metabolism disorders, we give hints for the detection of diabetic ketoacidosis, hyperosmolar coma, insulinoma, and insulin- or oral diabetic-induced hypoglycemia. The first part discusses the analytes glucose and lactate, glycated proteins and oral antidiabetics, with special regard to their matrices post mortem, to reference concentrations, stability data and to analytic procedures that should be used in clinical or toxicological laboratories to detect diabetic metabolism disorders after death.
在发达国家，糖尿病是十大常见死因之一。由于缺乏特征性的形态学发现，死后诊断葡萄糖代谢紊乱可能很困难且模糊。本文就低血糖或高血糖原因、频率和死亡率方面的生化问题进行了文献复习。在重复了糖尿病代谢紊乱的检测之后，我们为糖尿病酮症酸中毒、高渗性昏迷、胰岛素瘤、胰岛素或口服糖尿病引起的低血糖的检测提供了提示。第一部分讨论了分析物葡萄糖和乳酸、糖化蛋白和口服抗糖尿病药物，特别关注了它们死后的基质、参考浓度、稳定性数据以及应在临床或毒理学实验室中使用的分析程序，以检测死后的糖尿病代谢紊乱。
