Methamphetamine use and the risk of diabetic ketoacidosis
Methamphetamine use and the risk of diabetic ketoacidosis
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DOI：
10.1177/00258024211020936
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发表时间：
2021-06-09
影响因子：
1.5
通讯作者：
Byard, Roger W.
中科院分区：
文献类型：
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作者：
Lewis, Daniel;van den Heuvel, Corinna;Byard, Roger W.
糖尿病酮症酸中毒（DKA）是胰岛素依赖型糖尿病患者出现的一种危及生命的疾病，与高脂血症和高酮血症相关。虽然美沙酮、可卡因和某些处方药等药物可能会导致DKA，但甲基苯丙胺的潜在影响尚不清楚。因此，从2019年1月1日至12月31日，在南澳阿德莱德的法医科学SA对所有在死后血液样本中检测到甲基苯丙胺的案件进行了尸检和毒理学案件档案分析。糖尿病患者94例，其中1型6例，2型5例。6例1型糖尿病死亡患者中有4例发生致死性DKA（66.7%;年龄范围30-54岁;平均年龄44.6 ± 10.5岁; M：F比1：1）。DKA的发生率高于一般胰岛素依赖型糖尿病人群（6%），也显著高于法医病例（13%; p < 0.05）。因此，对出现DKA的胰岛素依赖型糖尿病患者的临床和尸检评估应包括甲基苯丙胺的特异性筛查。社区中胰岛素依赖型糖尿病和甲基苯丙胺滥用的增加可能导致医疗-法律和卫生方面的此类案件增加。
Diabetic ketoacidosis (DKA) is a life-threatening condition arising in individuals with insulin-dependent diabetes mellitus, associated with hyperglycaemia and hyperketonaemia. While drugs such as methadone, cocaine and certain prescription medications may precipitate DKA, the potential effect of methamphetamine is unclear. Analysis of autopsy and toxicology case files at Forensic Science SA, Adelaide, South Australia, was therefore undertaken from 1 January to 31 December 2019 of all cases where methamphetamine was detected in post-mortem blood samples. There were 94 cases with 11 diabetics (n = 6 type 1 and n = 5 type 2). Four of the six decedents with type 1 diabetes had lethal DKA (66.7%; age range 30-54 years; average age 44.6 +/- 10.5 years; M:F ratio 1:1). This incidence of DKA was higher than that of the general insulin-dependent diabetic population (6%) and also significantly higher than in medico-legal cases (13%; p < 0.05). The clinical and autopsy assessment of insulin-dependent diabetics presenting with DKA should therefore include specific screening for methamphetamine. The increase in both insulin-dependent diabetes and methamphetamine abuse in the community may lead to increases in such cases in medico-legal and health contexts.