Disorders of glucose metabolism-post mortem analyses in forensic cases: Part I

International Journal of Legal Medicine

Volumn 125, Issue 2, 2011, Pages 163-170

  Hess, Cornelius ^a   Musshoff, Frank ^a   Madea, Burkhard ^a  

^a UNIVERSITY OF BONN   (Germany)

Author keywords

Diabetes mellitus; Glucose metabolism; Hyperglycemia; Hypoglycemia; Oral antidiabetics; Post mortem

Indexed keywords

ANTIDIABETIC AGENT; FRUCTOSAMINE; GLUCOSE; GLYCOSYLATED HEMOGLOBIN; LACTIC ACID; PLASMA PROTEIN;

BLOOD; CADAVER; CHEMICALLY INDUCED DISORDER; DIABETES MELLITUS; DIABETIC KETOACIDOSIS; DISORDERS OF CARBOHYDRATE METABOLISM; FORENSIC PATHOLOGY; HUMAN; HYPERGLYCEMIA; HYPOGLYCEMIA; NONKETOTIC DIABETIC COMA; REVIEW;

BLOOD PROTEINS; DIABETES MELLITUS; DIABETIC KETOACIDOSIS; FORENSIC PATHOLOGY; FRUCTOSAMINE; GLUCOSE; GLUCOSE METABOLISM DISORDERS; HEMOGLOBIN A, GLYCOSYLATED; HUMANS; HYPERGLYCEMIA; HYPERGLYCEMIC HYPEROSMOLAR NONKETOTIC COMA; HYPOGLYCEMIA; HYPOGLYCEMIC AGENTS; LACTIC ACID; POSTMORTEM CHANGES;

EID: 79955884503     PISSN: 09379827     EISSN: 14371596     Source Type: Journal    
DOI: 10.1007/s00414-010-0509-6     Document Type: Review

References (131)

1. Federal Statistic Office Germany press release 454 (2007) Zahl der Diabetiker leicht ruecklaeufig. http://www.destatis.de/jetspeed/portal/cms/ Sites/destatis/Internet/DE/Presse/pm/2007/11/PD07-454-232,templateId= renderPrint.psml. Accessed 13 april 2010
2. Hess C, Musshoff F, Madea B (2010) Disorders of glucose metabolism - post mortem analyses in forensic cases - Part II. Int J Leg Med. Submitted
3. Thomas L (2000) Labor und Diagnose. Indikationen und Bewertung von Laborbefunden für die medizinische Diagnostik. 5.erweiterte Auflage. TH Books, Frankfurt
4. Faber OK, Binder C (1986) C-peptide: an index of insulin secretion. Diabetes Metab Rev 2:331-345 (Pubitemid 16009513)
5. Karam JH (2007) Pancreatic hormones and diabetes mellitus In: Greenspan FS, Gardner DG (ed.) Basic and Clinical Endocrinology 8th edn, chapter 18
6. Galloway JA, Hooper SA, Spradlin CT, Howey DC, Frank BH, Bowsher RR, Anderson JH (1992) Biosynthetic human proinsulin. Review of chemistry, in vitro and in vivo receptor binding, animal and human pharmacology studies, and clinical trial experience. Diab Care 15:666-692
7. Lehnert H, Schuster HP (1999) In: Innere Medizin. Thieme Verlag. pp 136-137
8. Marks V, Teale JD (1993) Hypoglycaemia in the adult. Baillières Clin Endocrinol Metab 7:705-729 (Pubitemid 23243434)
9. Butler PC, Rizza RA (1989) Regulation of carbohydrate metabolism and response to hypoglycemia. Endocrinol Metab Clin North Am 18:1-25 (Pubitemid 19058099)
10. Nilsson A, Tideholm B, Kalen J, Katzman P (1988) Incidence of severe hypoglycemia and its causes in insulin-treated diabetics. Acta Med Scand 224:257-262
11. MacLeod KM, Hepburn DA, Frier BM (1993) Frequency and morbidity of severe hypoglycaemia in insulin-treated diabetic patients. Diabet Med 10:238-245 (Pubitemid 23096132)
12. Lai MW, Klein-Schwartz W, Rodgers GC, Abrams JY, Haber DA, Bronstein AC, Wruk KM (2006) 2005 Annual Report of the American Association of Poison Control Centers' national poisoning and exposure database. Clin Toxicol (Phila) 44:803-932 (Pubitemid 44498213)
13. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE (2008) 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila) 46:927-1057
14. Hirsch IB (2005) Insulin analogues. N Engl J Med 352:174-183 (Pubitemid 40096614)
15. Rodriguez Perez C, Lizondo Escuder A, Lopez Garcia MJ, Escriva Cholbi L, Alpera Lacruz R, Collado Perez C (2008) A study of variability in glycaemia in children and adolescents with diabetes mellitus type 1 on treatment with insulin glargine. An Pediatr (Barc) 69:426-431
16. Fletcher SM (1983) Insulin. A forensic primer. J Forensic Sci Soc 23:5-17 (Pubitemid 13116026)
17. Arem R, Zoghbi W (1985) Insulin overdose in eight patients: insulin pharmacokinetics and review of the literature. Medicine (Baltimore) 64:323-332 (Pubitemid 16224047)
18. Walfish PG, Feig DS, Bauman WA (1987) Factitious hyperinsulinemic hypoglycemia: confirmation of the diagnosis by a species-specific insulin radioimmunoassay. J Endocrinol Invest 10:601-604 (Pubitemid 18058118)
19. Grunberger G, Weiner JL, Silverman R, Taylor S, Gorden P (1988) Factitious hypoglycemia due to surreptitious administration of insulin. Diagnosis, treatment, and long-term follow-up. Ann Intern Med 108:252-257 (Pubitemid 18081200)
20. Kaminer Y, Robbins DR (1988) Attempted suicide by insulin overdose in insulin-dependent diabetic adolescents. Pediatrics 81:526-528
21. Lebowitz MR, Blumenthal SA (1993) The molar ratio of insulin to C-peptide. An aid to the diagnosis of hypoglycemia due to surreptitious (or inadvertent) insulin administration. Arch Intern Med 153:650-655 (Pubitemid 23072394)
22. Patel F (1995) Successful suicide by insulin injection in a nondiabetic. Med Sci Law 35:181-182
23. Waickus CM, de Bustros A, Shakil A (1999) Recognizing factitious hypoglycemia in the family practice setting. J Am Board Fam Pract 12:133-136
24. Giordano BP, Rainwater NG (1986) Factitious hypoglycemia: case report. Diabetes Educ 12:37-39
25. Colsky LC, Campo AE, Gonzalez-Blanco M (1985) Insulin and the suicidal patient. West J Med 143:679 (Pubitemid 16225352)
26. Critchley JA, Proudfoot AT, Boyd SG, Campbell IW, Brown NS, Gordon A (1984) Deaths and paradoxes after intentional insulin overdosage. Br Med J (Clin Res Ed) 289:225 (Pubitemid 15209185)
27. Cooper AJ (1994) Attempted suicide using insulin by a non diabetic: a case study demonstrating the acute and chronic consequences of profound hypoglycemia. Can J Psychiatry 39:103-107 (Pubitemid 24118501)
28. Megarbane B, Deye BV, Sonneville R, Collet C, Launay JM, Baud FJ (2007) Intentional overdose with insulin: prognostic factors and toxicokinetic/ toxicodynamic profiles. Crit Care 11: R115
29. von Mach MA, Meyer S, Omogbehin B, Kann PH, Weilemann LS (2004) Epidemiological assessment of 160 cases of insulin overdose recorded in a regional poisons unit. Int J Clin Pharmacol Ther 42:277-280 (Pubitemid 38679016)
30. Marks V (1999) Murder by insulin. Med Leg J 67:147-163
31. Marks V (2009) Insulin murders. Med Leg J 77:39-47
32. Lindquist O, Rammer L (1975) Insulin in post-mortem blood. Z Rechtsmed 75:275-277
33. Kernbach-Wighton G, Puschel K (1998) On the phenomenology of lethal applications of insulin. Forensic Sci Int 93:61-73 (Pubitemid 28220887)
34. Ferner RE, Neil HA (1988) Sulphonylureas and hypoglycaemia. Br Med J (Clin Res Ed) 296:949-950 (Pubitemid 18093424)
35. Amiel SA, Dixon T, Mann R, Jameson K (2008) Hypoglycaemia in Type 2 diabetes. Diabet Med 25:245-254 (Pubitemid 351322690)
36. Holstein A, Plaschke A, Egberts EH (2001) Lower incidence of severe hypoglycaemia in patients with type 2 diabetes treated with glimepiride versus glibenclamide. Diabetes Metab Res Rev 17:467-473 (Pubitemid 34030749)
37. Holstein A, Plaschke A, Hammer C, Egberts EH (2003) Characteristics and time course of severe glimepiride- versus glibenclamide-induced hypoglycaemia. Eur J Clin Pharmacol 59:91-97 (Pubitemid 36793719)
38. Asplund K, Wiholm BE, Lithner F (1983) Glibenclamideassociated hypoglycaemia: a report on 57 cases. Diabetologia 24:412-417
39. Wark G (2009) How to look for insulin etc. SAS Peptide Hormone Section, RSCH. Guildford Peptide Hormones Scheme
40. Nakayama S, Hirose T, Watada H, Tanaka Y, Kawamori R (2005) Hypoglycemia following a nateglinide overdose in a suicide attempt. Diab Care 28:227-228 (Pubitemid 40095809)
41. Winter WE (1999) Evaluation of hypoglycemia and hyperglycemia. In: Jialal I, Winter WE, Chan DW (eds) Handbook of diagnostic endocrinology. AACC, Washington, pp 157-158
42. Young DS (2000) Effects of Drugs on Clinical Laboratoty tests. Vol. 1.Washington. AACC Press 3:349-371
43. Lund E, Wamberg E (1964) Phenylketonuria. A review with special reference to diagnostic methods. Ugeskr Laeger 126:497-505
44. Coe JI (1977) Postmortem chemistry of blood, cerebrospinal fluid, and vitreous humor. Leg Med Annu 1976:55-92 (Pubitemid 8229237)
45. Forrest AR (1993) ACP Broadsheet no 137: April 1993. Obtaining samples at post mortem examination for toxicological and biochemical analyses. J Clin Pathol 46:292-296 (Pubitemid 23138738)
46. Gormsen H, Lund A (1985) The diagnostic value of postmortem blood glucose determinations in cases of diabetes mellitus. Forensic Sci Int 28:103-107 (Pubitemid 16217991)
47. Sturner WQ, Gantner GE Jr (1964) Postmortem vitreous glucose determinations. J Forensic Sci 9:485-491
48. Coe JI (1969) Postmortem chemistries on human vitreous humor. Am J Clin Pathol 51:741-750
49. Bray M, Luke JL, Blackbourne BD (1983) Vitreous humor chemistry in deaths associated with rapid chilling and prolonged freshwater immersion. J Forensic Sci 28:588-593 (Pubitemid 13076252)
50. Bray M (1984) The eye as a chemical indicator of environmental temperature at the time of death. J Forensic Sci 29:396-403 (Pubitemid 14134021)
51. Bray M (1984) The effect of chilling, freezing, and rewarming on the postmortem chemistry of vitreous humor. J Forensic Sci 29:404-411 (Pubitemid 14134022)
52. Kernbach G, Puschel K, Brinkmann B (1986) Biochemical measurements of glucose metabolism in relation to cause of death and postmortem effects. Z Rechtsmed 96:199-213 (Pubitemid 16071360)
53. Traub F (1969) Methode zur Erkennung von tödlichen Zuckerstoffwechselstörungen an der Leiche (Diabetes mellitus und Hypoglykämie). Zbl Allg Path Path Anat 112:390-399
54. Coe JI (1977) Postmortem chemistry of blood, cerebrospinal fluid, and vitreous humor. Leg Med Annu 1976:55-92 (Pubitemid 8229237)
55. Kernbach G, Puschel K, Brinkmann B (1986) Biochemical measurements of glucose metabolism in relation to cause of death and postmortem effects. Z Rechtsmed 96:199-213 (Pubitemid 16071360)
56. Osuna E, Garcia-Villora A, Perez-Carceles M, Conejero J, Maria Abenza J, Martinez P, Luna A (2001) Glucose and lactate in vitreous humor compared with the determination of fructosamine for the postmortem diagnosis of diabetes mellitus. Am J Forensic Med Pathol 22:244-249 (Pubitemid 32845455)
57. Osuna E, Garcia-Villora A, Perez-Carceles MD, Conejero J, Abenza JM, Martinez P, Luna A (1999) Vitreous humor fructosamine concentrations in the autopsy diagnosis of diabetes mellitus. Int J Legal Med 112:275-279 (Pubitemid 29409060)
58. Vivero G, Vivero-Salmeron G, Perez Carceles Bedate A, Luna A, Osuna E (2008) Combined determination of glucose and fructosamine in vitreous humor as a post-mortem tool to identify antemortem hyperglycemia. Rev Diabet Stud 5:220-224
59. Gressner A, Arndt T (2006) Lexikon der Medizinischen Laboratoriumsdiagnostik. Band 1: Klinische Chemie. Springer Verlag, Berlin
60. Sippel H, Mottonen M (1982) Combined glucose and lactate values in vitreous humour for postmortem diagnosis of diabetes mellitus. Forensic Sci Int 19:217-222 (Pubitemid 12131649)
61. De Letter EA, Piette MH (1998) Can routinely combined analysis of glucose and lactate in vitreous humour be useful in current forensic practice? Am J Forensic Med Pathol 19:335-342 (Pubitemid 29024541)
62. Peretz DI, McGregor M, Dossetor JB (1964) Lactatacidosis: a clinically significant aspect of shock. Can Med Assoc J 90:673-5
63. Kleine TO, Baerlocher K, Niederer V, Keller H, Reutter F, Tritschler W, Bablok W (1979) Diagnostic significance of lactate concentration in CSF in patients with meningitis (author's transl). Dtsch Med Wochenschr 104:553-557 (Pubitemid 9150498)
64. Hindle EJ, Rostron GM, Gatt JA (1985) The diagnostic value of glycated haemoglobin levels in post-mortem blood. Ann Clin Biochem 22:144-147 (Pubitemid 15115402)
65. Astles R, Williams CP, Sedor F (1994) Stability of plasma lactate in vitro in the presence of antiglycolytic agents. Clin Chem 40:1327-1330 (Pubitemid 24205953)
66. Liss E, Bechtel S (1990) Improvement of glucose preservation in blood samples. J Clin Chem Clin Biochem 28:689-690 (Pubitemid 20346938)
67. Rick W (1977) Klinische Chemie und Mikroskopie, 5th edn. Springer Verlag, Berlin
68. Müller B (2005) In: Madea B, Musshoff F (eds) Rechtsmedizin. Springer Verlag, Berlin
69. Bunn HF (1981) Nonenzymatic glycosylation of protein: relevance to diabetes. Am J Med 70:325-330 (Pubitemid 11146018)
70. Svendsen PA, Lauritzen T, Soegaard U, Nerup J (1982) Glycosylated haemoglobin and steady-state mean blood glucose concentration in Type 1 (insulin-dependent) diabetes. Diabetologia 23:403-405 (Pubitemid 12037379)
71. Nathan DM, Kuenen J, Borg R, Zheng H, Schoenfeld D, Heine RJ (2008) Translating the A1C assay into estimated average glucose values. Diab Care 31:1473-1478
72. The American Diabetes Association, European Association for the Study of Diabetes, International Federation of Clinical Chemistry and Laboratory Medicine, the International Diabetes Federation (2007) Consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diab Care 30:2399-2400
73. Nordin G, Dybkaer R (2007) Recommendation for term and measurement unit for "HbA1c". Clin Chem Lab Med 45:1081-1082 (Pubitemid 47424865)
74. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM, Sacks DB (2004) Tests of glycemia in diabetes. Diab Care 27:1761-1773 (Pubitemid 38857461)
75. Goldstein DE, Walker B, Rawlings SS, Hess RL, England JD, Peth SB, Hewett JE (1980) Hemoglobin A1c levels in children and adolescents with diabetes mellitus. Diab Care 3:503-507 (Pubitemid 10011608)
76. Chen C, Glagov S, Mako M, Rochman H, Rubenstein AH (1983) Post-mortem glycosylated hemoglobin (HbA1c): evidence for a history of diabetes mellitus. Ann Clin Lab Sci 13:407-410 (Pubitemid 13046889)
77. Kernbach G, Brinkmann B (1983) Postmortem pathochemistry for the determination of the cause of death in diabetic coma. Pathologe 4:235-240 (Pubitemid 14229425)
78. Uemura K, Shintani-Ishida K, Saka NM, Ikegaya H, Kikuchi Y, Yoshida K (2008) Biochemical blood markers and sampling sites in forensic autopsy. J Forensic Leg Med 15:312-317
79. Goulle JP, Lacroix C, Bouige D (2002) Glycated hemoglobin: a useful post-mortem reference marker in determining diabetes. Forensic Sci Int 128:44-49
80. Winecker RE, Hammett-Stabler CA, Chapman JF, Ropero-Miller JD (2002) HbA1c as a postmortem tool to identify glycemic control. J Forensic Sci 47:1373-1379 (Pubitemid 35314474)
81. Kobold U, Jeppsson JO, Dulffer T, Finke A, Hoelzel W, Miedema K (1997) Candidate reference methods for hemoglobin A1c based on peptide mapping. Clin Chem 43:1944-1951 (Pubitemid 27452286)
82. Jeppsson JO, Kobold U, Barr J, Finke A, Hoelzel W, Hoshino T, Miedema K, Mosca A, Mauri P, Paroni R, Thienpont L, Umemoto M, Weykamp C (2002) Approved IFCC reference method for the measurement of HbA1c in human blood. Clin Chem Lab Med 40:78-89 (Pubitemid 34196455)
83. Lapolla A, Fedele D, Traldi P (2001) Diabetes and mass spectrometry. Diabetes Metab Res Rev 17:99-112 (Pubitemid 32427958)
84. Tahara Y, Shima K (1995) Kinetics of HbA1c, glycated albumin, and fructosamine and analysis of their weight functions against preceding plasma glucose level. Diab Care 18:440-447
85. Johnson RN, Metcalf PA, Baker J (1983) Fructosamine: a new approach to the estimation of serum glycosylprotein. An index of diabetic control. Clin Chim Acta 127:87-95 (Pubitemid 13168108)
86. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM (1995) Tests of glycemia in diabetes. Diab Care 18:896-909
87. Hill RP, Hindle EJ, Howey JE, Lemon M, Lloyd DR (1990) Recommendations for adopting standard conditions and analytical procedures in the measurement of serum fructosamine concentration. Ann Clin Biochem 27:413-424 (Pubitemid 20340286)
88. Cohen MP (1992) Perspective: measurement of circulating glycated proteins to monitor intermediate-term changes in glycaemic control. Eur J Clin Chem Clin Biochem 30:851-859 (Pubitemid 23027896)
89. Lloyd DR, Nott M, Marples J (1985) Comparison of serum fructosamine with glycosylated serum protein (determined by affinity chromatography) for the assessment of diabetic control. Diabet Med 2:474-478 (Pubitemid 16210030)
90. Gordon A, Glaser B, Wald M, Del Rio G, Della Casa L, Gross J, Cerasi E (1992) Glycosylated serum protein levels assayed with highly sensitive immunoradiometric assay accurately reflect glycemic control of diabetic patients. Diab Care 15:645-650
91. Baker J, Reid I, Holdaway I (1985) Serum fructosamine in patients with diabetes mellitus. N Z Med J 98:532-535
92. Lemon M, Forrest AR (1986) Fructosamine activity of proteins in serum. Clin Chem 32:2101
93. Koskinen P, Irjala K (1988) Stability of serum fructosamine during storage. Clin Chem 34:2545-2546 (Pubitemid 19017272)
94. Ritz S, Mehlan G, Martz W (1996) Postmortem diagnosis of diabetic metabolic derangement: elevated alpha 1-antitrypsin and haptoglobin glycosylation levels as an index of antemortem hyperglycemia. J Forensic Sci 41:94-100
95. Boyle PJ, Justice K, Krentz AJ, Nagy RJ, Schade DS (1993) Octreotide reverses hyperinsulinemia and prevents hypoglycemia induced by sulfonylurea overdoses. J Clin Endocrinol Metab 76:752-756 (Pubitemid 23086500)
96. Gordon MR, Flockhart D, Zawadzki JK, Taylor T, Ramey JN, Eastman RC (1988) Hypoglycemia due to inadvertent dispensing of chlorpropamide. Am J Med 85:271-272
97. Schulz M, Schmoldt A (2003) Therapeutic and toxic blood concentrations of more than 800 drugs and other xenobiotics. Pharmazie 58:447-474 (Pubitemid 36869876)
98. TIAFT reference blood level list of therapeutic and toxic substances (2004) http://www.gtfch.org/cms/images/stories/Updated-TIAFT-list-202005.pdf, accessed 13 april 2010
99. Mutschler E, Geisslinger G, Kroemer HK, Schäfer-Korting M (2001) Arzneimittelwirkungen, Lehrbuch der Pharmakologie und Toxikologie, 8th edn. Wissenschaftliche Verlagsgesellschaft mbH Stuttgart
100. Ho EN, Yiu KC, Wan TS, Stewart BD, Watkins KL (2004) Detection of anti-diabetics in equine plasma and urine by liquid chromatography-tandem mass spectrometry. J Chromatogr B Analyt Technol Biomed Life Sci 811:65-73 (Pubitemid 39348851)
101. Thevis M, Geyer H, Schanzer W (2005) Identification of oral antidiabetics and their metabolites in human urine by liquid chromatography/tandem mass spectrometry - a matter for doping control analysis. Rapid Commun Mass Spectrom 19:928-936 (Pubitemid 40445569)
102. Hess C, Musshoff F, Madea B (2010) Identification and validated quantification of oral hypoglycaemic drugs in plasma byelectrospray ionisation liquid chromatography - mass spectrometry. Submitted July 2010
103. Sacks DB, Bruns DE, Goldstein DE, Maclaren NK, McDonald JM, Parrott M (2002) Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Clin Chem 48:436-472 (Pubitemid 34174577)
104. Chevenne D, Trivin F, Porquet D (1999) Insulin assays and reference values. Diabetes Metab 25:459-476 (Pubitemid 30003159)
105. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, Wall BM (2004) Hyperglycemic crises in diabetes. Diab Care 27(Suppl 1):S94-102
106. Eledrisi MS, Alshanti MS, Shah MF, Brolosy B, Jaha N (2006) Overview of the diagnosis and management of diabetic ketoacidosis. Am J Med Sci 331:243-251 (Pubitemid 43804601)
107. Kaufman FR, Halvorson M (1999) The treatment and prevention of diabetic ketoacidosis in children and adolescents with type I diabetes mellitus. Pediatr Ann 28:576-582 (Pubitemid 29446328)
108. Faich GA, Fishbein HA, Ellis SE (1983) The epidemiology of diabetic acidosis: a population-based study. Am J Epidemiol 117:551-558 (Pubitemid 13091425)
109. UK Prospective Diabetes Study Group (UKPDS) (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837-853
110. Standards of medical care in diabetes (2006) Diab Care 29(Suppl 1):S4-42
111. Gouni-Berthold I, Krone W (2006) Diabetic ketoacidosis and hyperosmolar hyperglycemic state. Med Klin (Munich) 101 (Suppl 1):100-105
112. Kitabchi AE, Umpierrez GE, Murphy MB, Barrett EJ, Kreisberg RA, Malone JI, Wall BM (2001) Management of hyperglycemic crises in patients with diabetes. Diab Care 24:131-153 (Pubitemid 32106687)
113. Foster (1995) Diabetes mellitus. In: Schmailzl KJG (ed) Harrisons Innere Medizin 2, 13th edn. Blackwell, Berlin Vienna Oxford, pp 2314-2338
114. Radermacher L, D'Orio V (2005) Metabolic emergencies related to diabetes mellitus: ketoacidosis and hyperosmolar state. Rev Méd Liège 60:466-471 (Pubitemid 40941526)
115. Fishbein H, Palumbo PJ (1995) Acute metabolic complications in diabetes. In: National Diabetes Data Group. Diabetes in America. Bethesda (MD): National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. pp 283-291
116. Kadis P, Balazic J, Ferlan-Marolt V (1999) Alcoholic ketoacidosis: a cause of sudden death of chronic alcoholics. Forensic Sci Int 103:S53-S59 (Pubitemid 29371840)
117. Nilsson A, Tideholm B, Kalen J, Katzman P (1988) Incidence of severe hypoglycemia and its causes in insulin-treated diabetics. Acta Med Scand 224:257-262
118. The DCCT Research Group (1991) Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med 90:450-459
119. Schwartz NS, Clutter WE, Shah SD, Cryer PE (1987) Glycemic thresholds for activation of glucose counterregulatory systems are higher than the threshold for symptoms. J Clin Invest 79:777-781 (Pubitemid 17050902)
120. Mitrakou A, Ryan C, Veneman T, Mokan M, Jenssen T, Kiss I, Durrant J, Cryer P, Gerich J (1991) Hierarchy of glycemic thresholds for counterregulatory hormone secretion, symptoms, and cerebral dysfunction. Am J Physiol 260:E67-E74
121. Fanelli C, Pampanelli S, Epifano L, Rambotti AM, Ciofetta M, Modarelli F, Di Vincenzo A, Annibale B, Lepore M, Lalli C (1994) Relative roles of insulin and hypoglycaemia on induction of neuroendocrine responses to, symptoms of, and deterioration of cognitive function in hypoglycaemia in male and female humans. Diabetologia 37:797-807 (Pubitemid 24247851)
122. Marks V (2006) Hypoglycaemia: insulin and conflicts with the law. Br J Diabetes Vasc Dis 6:281-285 (Pubitemid 46115650)
123. Coe JI (1974) Postmortem chemistry: practical considerations and a review of the literature. J Forensic Sci 19:13-32
124. Coe JI (1993) Postmortem chemistry update. Emphasis on forensic application. Am J Forensic Med Pathol 14:91-117 (Pubitemid 23180357)
125. Forrest AR (1993) ACP Broadsheet no 137: April 1993. Obtaining samples at post mortem examination for toxicological and biochemical analyses. J Clin Pathol 46:292-296 (Pubitemid 23138738)
126. Sturner WQ, Gantner GE Jr (1964) Postmortem vitreous glucose determinations. J Forensic Sci 9:485-491
127. Peclet C, Picotte P, Jobin F (1994) The use of vitreous humor levels of glucose, lactic acid and blood levels of acetone to establish antemortem hyperglycemia in diabetics. Forensic Sci Int 65:1-6 (Pubitemid 24112954)
128. Leahy MS, Farber ER (1967) Postmortem chemistry of human vitreous humor. J Forensic Sci 12:214-222
129. Karlovsek M (2004) Diagnostic values of combined glucose and lactate values in cerebrospinal fluid and vitreous humour - our experiences. Forensic Sci Int 146(Suppl):S19-23 (Pubitemid 40091541)
130. Ritz S, Kaatsch HJ (1990) Postmortem diagnosis of fatal diabetic metabolic dyscontrol: what is the significance of cerebrospinal fluid and vitreous body total values and HbA1? Pathologe 11:158-165
131. Kugler J, Oehmichen M (1986) Studies of glucose metabolism in the cadaver. Beitr Gerichtl Med 44:185-8