Diagnostic post-mortem d'acidocétose diabétique

The prevalence of diabetes (mellitus) is constantly on the rise in western countries. It is necessary to be able to diagnose post-mortem any complications that could have led to death, but the metabolism of glucose is particularly modified after death and hence makes the blood test unreliable. By using three case studies and a literature review, we proceeded with a reliable and reproductible diagnostic procedure thanks to the post-mortem (thanatos) biochemistry. The results of our study demonstrate that the vitreous humor is the best liquid medium to reflect the blood glucose concentration in a deceased person and the study of a strong organic acid such as the 3-hydroxybutiric enables a differential diagnostic between the different etiologies of the diabetic disease complications. The objective was to determine the pathological threshold values. A specific consensus was reached by using different case studies. A level of glucose in the vitreous humour superior to 10 mmol/L and a level of acid 3-hydroxybutirique superior to 500 μmol/L present in blood, are regarded as high/excessive. A 3-hydroxybutyric value greater than 2500 μmol/L is considered by several authors to be pathological. These results enabled us to reach a reliable diagnostic of the diabetic ketoacidosis disease decompensation, speeding up the death of the victim.