1Senior Resident, Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, Karnataka
2Professor, Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, Karnataka
3Associate Professor, Department of Forensic Medicine & Toxicology, Kasturba Medical College, Manipal, Karnataka
*Corresponding Author: Dr. Vinod C Nayak, Professor, Department of Forensic Medicine, Kasturba Medical College, Manipal, E-mail: vinod.nayak@manipal.edu, Contact : +919845240393
Online Published on 10 September, 2024.
Estimating the time since death is one of the prime objectives of conducting medico-legal autopsies. Biochemical changes commence with the early postmortem changes which starts as early as around 3 hours post-mortem and last upto 72 hours. Blood glucose has been extensively studied in the past, and it has been shown that the value decreases with increase in postmortem time interval (PMI), but the values were too erratic and with not much of forensic value. Insulin, on the other hand, has shown significant correlation. Therefore, an attempt has been made by carrying out a study of blood glucose and insulin level and to see their correlation with cause of death and time since death.
The aim of this study was to analyse the quantitative changes of postmortem blood glucose and insulin levels independently and together and correlate it with time since death and the causes of death in brought dead cases.
The study constituted of 76 brought dead cases from 2018 to 2021, brought to the mortuary of Kasturba Medical College, MAHE, Manipal, where the time of death was known and was not hospitalised earlier. Blood sample was collected at the time of autopsy and sent to Biochemistry lab for estimating blood glucose and insulin level, using Hexokinase Enzymatic reference method [Roche Cobas 6000 (c 501), Cobas 8000 (c702/c502)] and electrochemiluminescence immunoassay method [Roche Cobas 6000 (e601), Cobas 8000 (e602)] respectively.
Correlation between postmortem blood glucose and insulin level, with time since death and cause of death were analysed. We found that there is moderate negative correlation between blood glucose level and time since death and a weak negative correlation between PMI with insulin, but the correlation is not significant (p>0.05). In our study, where the majority of cases consisted of traumatic head injury, myocardial infarction and asphyxia, we found that there is significant difference in distribution of insulin among different causes of death with p value less than 0.05.
Postmortem Blood, Time Since Death, Blood Glucose, Blood Insulin, Autopsy
