Point-of-care hemoglobin A1c testing in postmortem examination

Area of Science:

• Forensic Medicine
• Clinical Chemistry

Background:

• Glycated hemoglobin (HbA1c) is a key indicator of long-term glycemic control.
• Elevated postmortem HbA1c may suggest poor antemortem glycemic management.
• Point-of-care (POC) testing offers rapid and efficient analysis in forensic settings.

Purpose of the Study:

• To evaluate postmortem HbA1c levels in capillary and cardiac venous blood.
• To assess the utility of HbA1c POC testing in postmortem examinations.
• To determine the correlation between POC and laboratory HbA1c measurements.

Main Methods:

• Analyzed HbA1c levels in 103 autopsy cases.
• Utilized a portable SD A1cCare device for POC testing.
• Compared POC results with a Cobas Integra 800 automated analyzer.

Main Results:

• Demonstrated a strong correlation between HbA1c levels in postmortem capillary and cardiac venous blood.
• Showed high agreement between POC HbA1c measurements and laboratory results.
• Observed a tendency for HbA1c levels to decline when measured with the SD A1cCare up to 4 weeks post-autopsy.

Conclusions:

• HbA1c POC testing is a viable tool for postmortem inspections and autopsies.
• This method can accurately identify individuals with uncontrolled diabetes mellitus.
• POC testing enhances the efficiency of forensic evaluations related to glycemic control.