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

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

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.

Publication types

  • Validation Study

MeSH terms

  • Blood Glucose / analysis
  • Chromatography, High Pressure Liquid
  • Cornea*
  • Corneal Diseases / blood
  • Corneal Diseases / diagnosis*
  • Corneal Diseases / mortality
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / mortality
  • Diagnosis*
  • Eye Banks / methods
  • Female
  • Glycated Hemoglobin A / analysis*
  • Humans
  • Male
  • Reproducibility of Results
  • Tissue Donors*

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human