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Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment

Background and objectives. In forensic medicine, the postmortem determination of glycated hemoglobin (HbA1c) helps identify undiagnosed cases of diabetes or cases with uncontrolled glycemic status. In order to contribute to the solidification of thanatochemistry, both globally and especially nationa...

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Autores principales: Girlescu, Nona, Stoica, Bogdan, Timofte, Andrei Daniel, Hunea, Iuliana, Diac, Madalina, Knieling, Anton, Damian, Simona Irina, Iov, Tatiana, Iliescu, Diana Bulgaru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066580/
https://www.ncbi.nlm.nih.gov/pubmed/33918183
http://dx.doi.org/10.3390/medicina57040342
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author Girlescu, Nona
Stoica, Bogdan
Timofte, Andrei Daniel
Hunea, Iuliana
Diac, Madalina
Knieling, Anton
Damian, Simona Irina
Iov, Tatiana
Iliescu, Diana Bulgaru
author_facet Girlescu, Nona
Stoica, Bogdan
Timofte, Andrei Daniel
Hunea, Iuliana
Diac, Madalina
Knieling, Anton
Damian, Simona Irina
Iov, Tatiana
Iliescu, Diana Bulgaru
author_sort Girlescu, Nona
collection PubMed
description Background and objectives. In forensic medicine, the postmortem determination of glycated hemoglobin (HbA1c) helps identify undiagnosed cases of diabetes or cases with uncontrolled glycemic status. In order to contribute to the solidification of thanatochemistry, both globally and especially nationally, we aimed to determine this biomarker postmortem, for the first time in our institution, in order to identify undiagnosed pre-mortem diabetics, as well as those with inadequate glycemic control. Materials and Methods. Our research consisted of analyzing a total number of 180 HbA1c values, 90 determinations from the peripheral blood and 90 from the central blood. The determination of HbA1c was performed by means of a fully automatic analyzer (HemoCue HbA1c 501), certified by the National Glycohemoglobin Standardization Program (NGSP)/Diabetes Control and Complications Trial (DCCT) and calibrated according to the standards developed by the International Federation of Clinical Chemistry (IFCC). According to ADA criteria, HbA1c values can provide us with the following information about the diagnosis of diabetes: normal 4.8–5.6%; prediabetes 5.7–6.4%; diabetes ≥ 6.5%. Results. A considerable number of cases with an altered glycemic status (cases that had HbA1c values equal to or greater than 5.7%) were identified—51% demonstrable by peripheral blood determinations and 41% by central blood determinations. Notably, 23 people with diabetes (25%) were identified by analyzing the peripheral blood; 18 other people with diabetes (20%) were identified by analyzing the central blood. Conclusions. Our study managed to confirm the antemortem diagnosis of DM using a simple point-of-care analyzer and applying standardized and certified criteria on HbA1c levels measured postmortem. We also identified a considerable number of cases with DM in patients with no antemortem history of glucose imbalance—at least 20% more cases. Although the two different sites used for blood collection showed a strong statistical correlation, it seems that the peripheral site could have a higher sensibility in detecting postmortem altered glycemic status.
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spelling pubmed-80665802021-04-25 Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment Girlescu, Nona Stoica, Bogdan Timofte, Andrei Daniel Hunea, Iuliana Diac, Madalina Knieling, Anton Damian, Simona Irina Iov, Tatiana Iliescu, Diana Bulgaru Medicina (Kaunas) Article Background and objectives. In forensic medicine, the postmortem determination of glycated hemoglobin (HbA1c) helps identify undiagnosed cases of diabetes or cases with uncontrolled glycemic status. In order to contribute to the solidification of thanatochemistry, both globally and especially nationally, we aimed to determine this biomarker postmortem, for the first time in our institution, in order to identify undiagnosed pre-mortem diabetics, as well as those with inadequate glycemic control. Materials and Methods. Our research consisted of analyzing a total number of 180 HbA1c values, 90 determinations from the peripheral blood and 90 from the central blood. The determination of HbA1c was performed by means of a fully automatic analyzer (HemoCue HbA1c 501), certified by the National Glycohemoglobin Standardization Program (NGSP)/Diabetes Control and Complications Trial (DCCT) and calibrated according to the standards developed by the International Federation of Clinical Chemistry (IFCC). According to ADA criteria, HbA1c values can provide us with the following information about the diagnosis of diabetes: normal 4.8–5.6%; prediabetes 5.7–6.4%; diabetes ≥ 6.5%. Results. A considerable number of cases with an altered glycemic status (cases that had HbA1c values equal to or greater than 5.7%) were identified—51% demonstrable by peripheral blood determinations and 41% by central blood determinations. Notably, 23 people with diabetes (25%) were identified by analyzing the peripheral blood; 18 other people with diabetes (20%) were identified by analyzing the central blood. Conclusions. Our study managed to confirm the antemortem diagnosis of DM using a simple point-of-care analyzer and applying standardized and certified criteria on HbA1c levels measured postmortem. We also identified a considerable number of cases with DM in patients with no antemortem history of glucose imbalance—at least 20% more cases. Although the two different sites used for blood collection showed a strong statistical correlation, it seems that the peripheral site could have a higher sensibility in detecting postmortem altered glycemic status. MDPI 2021-04-02 /pmc/articles/PMC8066580/ /pubmed/33918183 http://dx.doi.org/10.3390/medicina57040342 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Girlescu, Nona
Stoica, Bogdan
Timofte, Andrei Daniel
Hunea, Iuliana
Diac, Madalina
Knieling, Anton
Damian, Simona Irina
Iov, Tatiana
Iliescu, Diana Bulgaru
Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title_full Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title_fullStr Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title_full_unstemmed Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title_short Thanatochemical Study of Glycated Hemoglobin in Diabetic Status Assessment
title_sort thanatochemical study of glycated hemoglobin in diabetic status assessment
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066580/
https://www.ncbi.nlm.nih.gov/pubmed/33918183
http://dx.doi.org/10.3390/medicina57040342
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