Post-mortem biochemistry of vitreous humor and glucose metabolism: an update

2011 ◽  
Vol 49 (8) ◽  
Author(s):  
Camille Boulagnon ◽  
Roselyne Garnotel ◽  
Paul Fornes ◽  
Philippe Gillery
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Practice ◽  
Glucose Metabolism ◽  
Cause Of Death ◽  
Diabetic Complications ◽  
Metabolic Pathways ◽  
Vitreous Humor ◽  
Time Since Death ◽  
Post Mortem ◽  
Biochemical Analyses

AbstractPost-mortem biochemistry, also called thanatochemistry, has proved useful in forensics for estimating the time since death and assessing the cause of death. Ketoacidosis is a frequent complication of diabetes mellitus which can be lethal, with possible medicolegal implications. However, interpretation of biochemical analyses is difficult because of post-mortem blood alterations involving glucose metabolic pathways. Vitreous humor is better preserved than blood after death, and therefore is preferentially used in thanatochemistry. However, both the lack of experience of most biochemists with this matrix in clinical practice, and the paucity of post-mortem studies make interpretation of post-mortem analyses difficult. This review examines the recent advances in the knowledge of glucose metabolism in vitreous humor, and the methods used for the post-mortem diagnosis of diabetic complications.

Postmortem Diagnosis of Hypertonic Dehydration by Chemical Analysis of Vitreous Humor

2017 ◽  
Vol 68 (11) ◽  
pp. 2650-2653
Author(s):  
Simona Irina Damian ◽  
Paul Nedelea ◽  
Sofia David ◽  
Anton Knieling ◽  
Sorin Moldoveanu ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cause Of Death ◽  
Vitreous Humor ◽  
The Other ◽  
Post Mortem ◽  
Postmortem Diagnosis ◽  
Post Mortem Interval ◽  
Biochemical Analyses ◽  
Diagnosis Criteria ◽  
Survival Interval

The aim of forensic autopsy is to accurately reconstitute, as much as possible, the circumstances of death (the cause of death and the mechanism of death, the post-mortem interval, the related pathology and its role, the survival interval). Post-mortem biochemical analyses can help to various extents in establishing these issues. In order to elucidate the issue of post-mortem biochemical investigations, we conducted an analysis of forensic casuistry within a delimited territory, for a period of 3 years in order to identify the elements necessary for the diagnosis of hypertonic dehydration. By grouping the cases depending on the immediate cause of death, the diagnosis criteria for hypertonic dehydration showed the possibility of performing the differential diagnosis by biochemical analyses performed in vitreous humor (sodium, chlorine, urea, creatinine), the criteria being not met in any of the other groups.

scholarly journals HbA1c: a review of non-glycaemic variables

2018 ◽  
Vol 72 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Leon Campbell ◽  
Tessa Pepper ◽  
Kate Shipman
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Practice ◽  
Clinical Significance ◽  
Diabetic Complications ◽  
Clinical Relevance ◽  
Literature Search ◽  
Clinical Implications ◽  
Search Terms ◽  
Clinical Scenarios ◽  
Clinically Significant

Identification of the correlation between HbA1c and diabetic complications has yielded one of the most clinically useful biomarkers. HbA1c has revolutionised the diagnosis and monitoring of diabetes mellitus. However, with widespread adoption of HbA1c has come increasing recognition that non-glycaemic variables can also affect HbA1c, with varying clinical significance. Furthermore, the identification of a discrepancy between predicted and measured HbA1c in some individuals, the so-called ‘glycation gap’, may be clinically significant. We aimed to review the current body of evidence relating to non-glycaemic variables to quantify any significance and provide subsequent suggestions. A PubMed-based literature search was performed, using a variety of search terms, to retrieve articles detailing the non-glycaemic variables suggested to affect HbA1c. Articles were reviewed to assess the relevance of any findings in clinical practice and where possible guidance is given. A range of non-glycaemic variables have statistically significant effects on HbA1c. While the clinical implications are generally irrelevant, a small number of non-glycaemic variables do have clinically significant effects and alternative biomarkers should be considered instead of, or in addition to, HbA1c. There are a small number of non-glycaemic variables which have a clinically significant effect on HbA1c, However, the vast majority of non-glycaemic variables have no clinical relevance. While clinicians should have an awareness of those non-glycaemic variables with clinical significance, in the vast majority of clinical scenarios HbA1c should continue to be used with confidence.

scholarly journals Pathophysiology of diabetes mellitus complications: Metabolic events and control

2021 ◽  
Vol 8 (3) ◽  
pp. 4243-4257
Author(s):  
Franklyn O. Ohiagu ◽  
Paul C. Chikezie ◽  
Chinwendu M. Chikezie
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Complications ◽  
Metabolic Pathways ◽  
Enzyme Inhibitors ◽  
Vascular Complications ◽  
Polyol Pathway ◽  
Diabetic Control ◽  
Hexosamine Biosynthetic Pathway ◽  
Abnormal Metabolism ◽  
And Control

Background: Diabetes mellitus (DM) is a metabolic disorder that is characterized by hyperglycemia and glucose intolerance, which is associated with impaired insulin secretion and peripheral sensitivity and eventual b-cell dysfunction. This review summarized the major metabolic pathways leading to both microvascular and macrovascular complications in DM, with a view of highlighting the enzymes involved and the possible inhibition of the enzymes facilitating these processes as a measure of diabetic control. Methods: Data used in writing this review were sourced online from scientific search engines such as Google Scholar, Scopus, EMBASE, PubMed, ResearchGate, Mendeley, Medline, and SpringerLink, using keywords such as 'diabetic complications', 'hyperglycemia-induced diabetic mechanisms', 'diabetic enzymes' and 'diabetic enzyme inhibitors'. A total number of 109 references published online between 1990 and 2020 were generated and cited in this review. Results: The most scourging and dilapidating effects of DM as well as associated vascular complications are classified into four categories viz.: nephropathy, retinopathy, neuropathy and cardiovascular disease. Hyperglycemia, which is associated with uncontrolled DM, elicits abnormal metabolism such that the enzymes involved in metabolic events leading to diabetic complications are expressed and amplified. The disorders associated with DM are linked to various metabolic pathways facilitated by enzyme activities of the polyol pathway, hexosamine biosynthetic pathway, glucose autoxidation as well as increased synthesis of advanced glycation end-products (AGEs), hexokinase-2 driven glycolytic overload, increased activities of the cyclooxygenase (COX), lipoxygenase (LOX) and pyruvate kinase (PKC) enzymes. The inhibition of the enzymes involved in these pathways could serve to mitigate and arrest diabetic complications. Conclusion: Thus, suitable inhibitors for enzymes involved in DM metabolic events could serve as panaceas against DM complications, which will add to the growing list of new and more efficacious antidiabetic drugs.

Circulating Exosomal miRNA Signature in Gestational Diabetes Mellitus Influences Glucose Metabolism in Placental Cells

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 164-LB
Author(s):  
SOUMYALEKSHMI NAIR ◽  
VALESKA ORMAZABAL ◽  
NANTHINI JAYABALAN ◽  
DOMINIC GUANZON ◽  
ANDREW LAI ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Mirna Signature ◽  
Placental Cells ◽  
Exosomal Mirna

scholarly journals The Relationship between the Gut Microbiome and Metformin as a Key for Treating Type 2 Diabetes Mellitus

2021 ◽  
Vol 22 (7) ◽  
pp. 3566
Author(s):  
Chae Bin Lee ◽  
Soon Uk Chae ◽  
Seong Jun Jo ◽  
Ui Min Jerng ◽  
Soo Kyung Bae
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Metabolism ◽  
Gut Microbiome ◽  
Metabolic Disorders ◽  
Current Knowledge ◽  
Potential Target ◽  
The Relationship

Metformin is the first-line pharmacotherapy for treating type 2 diabetes mellitus (T2DM); however, its mechanism of modulating glucose metabolism is elusive. Recent advances have identified the gut as a potential target of metformin. As patients with metabolic disorders exhibit dysbiosis, the gut microbiome has garnered interest as a potential target for metabolic disease. Henceforth, studies have focused on unraveling the relationship of metabolic disorders with the human gut microbiome. According to various metagenome studies, gut dysbiosis is evident in T2DM patients. Besides this, alterations in the gut microbiome were also observed in the metformin-treated T2DM patients compared to the non-treated T2DM patients. Thus, several studies on rodents have suggested potential mechanisms interacting with the gut microbiome, including regulation of glucose metabolism, an increase in short-chain fatty acids, strengthening intestinal permeability against lipopolysaccharides, modulating the immune response, and interaction with bile acids. Furthermore, human studies have demonstrated evidence substantiating the hypotheses based on rodent studies. This review discusses the current knowledge of how metformin modulates T2DM with respect to the gut microbiome and discusses the prospect of harnessing this mechanism in treating T2DM.

Post-mortem ocular changes and time since death: Scoping review and future perspective

2021 ◽  
Vol 50 ◽  
pp. 101862
Author(s):  
Fabio De-Giorgio ◽  
Simone Grassi ◽  
Ernesto d'Aloja ◽  
Vincenzo L. Pascali
Keyword(s):  
Scoping Review ◽  
Future Perspective ◽  
Time Since Death ◽  
Post Mortem ◽  
Ocular Changes
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