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Postmortem diagnosis of diabetes mellitus and diabetic coma : a comparison of HBA1, glucose, lactate, and combined glucose and lactate values in vitreous humour and in cerebrospinal fluid
Zorec-Karlovšek, Majda
HbA1 in blood, glucose, lactate and the combined glucose and lactate levels invitreous humour and in cerebrospinal fluid were examined in 41 autopsy caseswith diabetes and 71 cases in a control ...group. The mean levels of hbAI, glucose and the combined glucose and lactate levels in vitreous humour and in cerebrospinal tluid showed statistically significant differences between the diabetic and control groups. Postmortem glucose levels in vitreous humour werestatistically significantly higher than in cerebrospinal fluid; the average lactate levels were significantly higher in cerebrospinal fluid than in corpus vitreum in both groups. As a result there were no statistically significant differences between the combined glucose and lactate levels in vitreous humour and in cerebrospinal fluid in the control group. The calculated 99% threshold values for the right-hand tail of the glucose-lactateconcentration curve in the control group were 427 mg/dl and 422mg/dl for vitreous humour and cerebrospinal fluid respectively. To avoid the use of conventional units (mg/dl, mg%) for the threshold values, a new graphical representation in the form of a lactate - glucose diagram is introduced. The calculated regression coefficients in the correlation study led to the conclusion that postmortem-determined hbA 1 and the parameters (glucose and combined glucose and lactate levels) in vitreous humour provide the best information on the pre-mortal glycemie of the diabetic group in all parameters studied.
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