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Cornea. 2017 Aug;36(8):942-947. doi: 10.1097/ICO.0000000000001211.

Validity of Postmortem Glycated Hemoglobin to Determine Status of Diabetes Mellitus in Corneal Donors.

Author information

1
*Indiana Lions Eye Bank, Indianapolis, IN; †Department of Medicine, University of Washington and the Northwest Lipid Metabolism and Diabetes Research Laboratories, Seattle, WA; ‡SightLife, Seattle, WA; §Jaeb Center for Health Research, Tampa, FL; ¶Eversight Illinois, Chicago, IL; ‖Lions VisionGift, Portland, OR; **Iowa Lions Eye Bank, Iowa City, IA; ††Department of Medicine, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, OH; ‡‡Cornea Research Foundation of America, Indianapolis, IN; §§University Hospitals Eye Institute, Cleveland, OH; ¶¶Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH; and ‖‖Eversight Ohio, Cleveland, OH.

Abstract

PURPOSE:

To examine the stability of postmortem glycated hemoglobin (HbA1c) measurement and its relationship to premortem glycemia.

METHODS:

Postmortem blood samples were obtained from 32 donors (8 known diabetic) and shipped on ice to a central laboratory to examine the stability of HbA1c measurements during the first 9 postmortem days. Thirty-nine other suspected diabetic donors underwent comparison of premortem and postmortem HbA1c measurements.

RESULTS:

Postmortem HbA1c measurements remained stable after 9 postmortem days (all measurements within ±0.2% from baseline with a mean difference of 0.02% ± 0.10%). Of the premortem measurements obtained within 90 days before death, 79% were within ±1.0% of the postmortem measurements compared with 40% for measurements more than 90 days apart. Three of the postmortem HbA1c measurements exceeded 6.5% (considered a threshold for diabetes diagnosis), although the medical histories did not indicate any previous diabetes diagnosis.

CONCLUSIONS:

Postmortem HbA1c testing is feasible with current eye bank procedures and is reflective of glycemic control of donors during 90 days before death. HbA1c testing could potentially be a useful adjunct to review of the medical history and records for donor assessment for endothelial keratoplasty suitability and long-term graft success.

PMID:
28542087
DOI:
10.1097/ICO.0000000000001211
[Indexed for MEDLINE]

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