Citation

Arbouche N, Raul JS, Kintz P. Toxicol. Anal. Clin. 2022; 34(3): 181-190.

Copyright

(Copyright © 2022, Société Française de Toxicologie Analytique, Publisher Elsevier Publishing)

DOI

10.1016/j.toxac.2022.03.006

PMID

unavailable

Abstract

The detection of oral antidiabetics or hypoglycaemic agents used for the treatment of type II diabetes, represents a challenge in forensic practice. In the case of hypoglycaemia with unclear origin, the detection of oral antidiabetic drugs allows discrimination between hypoglycaemia of factitious origin (suicide attempt, Munchausen's syndrome by proxy) induced by antidiabetic drugs and true hypoglycaemia (e.g. insulinoma). In addition, during treatment with oral antidiabetic drugs, it is important to monitor their plasma concentration in diabetic patients in order to adjust their dosage. In this study, a method using liquid chromatography-tandem mass spectrometry was developed and validated for the analysis of 13 oral antidiabetics in human whole blood after a double liquid-liquid extraction at two different pH values. The validation procedure showed acceptable linearity for all compounds between 1 and 5000 ng/mL for gliclazide, glibornuride and nateglinide and between 1 and 1000 ng/mL for all other antidiabetics. The limits of detection and quantification were 0,1 and 1 ng/mL respectively. Repeatability and intermediate precision were below 20% for all 13 molecules. The method was successfully applied to postmortem blood of 8 diabetic subjects. Blood samples tested positive for gliclazide (240-3000 ng/mL), sitagliptin (40-21,400 ng/mL) and repaglinide (15 ng/mL). © 2022 Société Française de Toxicologie Analytique

Language: en

Keywords

autopsy; LC-MS/MS; blood sampling; antidiabetic agent; hypoglycemia; non insulin dependent diabetes mellitus; Article; insulinoma; Munchausen syndrome by proxy; Hypoglycaemia; Diabetes; nateglinide; gliclazide; liquid chromatography-mass spectrometry; Antiabetic drugs; glibornuride