Point-of-care hemoglobin A1c testing in postmortem examination

Glycated hemoglobin (HbA1c) is a good marker for monitoring glycemic control, and an elevated postmortem blood HbA1c level might indicate poor glycemic control during the antemortem period. The HbA1c level can be measured as a point-of-care (POC) test. In forensic medicine, POC testing is useful for performing autopsies and postmortem inspections since POC testing is both rapid and efficient. This study evaluated HbA1c levels in the capillary and cardiac venous blood of postmortem specimens as well as the usefulness of evaluating HbA1c levels as POC testing in postmortem examinations. For HbA1c testing performed on 103 autopsy cases, a portable SD A1cCare (test) was used for the POC testing, along with a Cobas Integra 800 (comparative). There was a strong correlation between HbA1c levels from postmortem capillary and cardiac venous blood (regression equation, 0.000 + 1.000×), and between HbA1c levels of cardiac venous blood measured using the portable SD A1cCare as a POC test and the Cobas Integra 800 (regression equation, -0.532 + 1.080×). HbA1c levels measured up to 4 weeks following the autopsy with the SD A1cCare had a tendency to decline. The author concluded that HbA1c POC testing can be used during postmortem inspection and during autopsy to accurately identify patients who had uncontrolled diabetes mellitus.