Why is femoral vein blood glucose considered UNRELIABLE for diagnosing ante-mortem hypoglycaemia at autopsy?

• A Continuing anaerobic glycolysis by surviving red blood cells consumes glucose ✓
• B Blood glucose equilibrates with cerebrospinal fluid after death
• C Hepatic glycogen releases glucose into the circulation after death
• D Anticoagulants in collection tubes degrade glucose enzymatically

Explanation

After death, red blood cells and leucocytes continue anaerobic glycolysis, consuming glucose until the level reaches zero, usually within a few hours. Postmortem blood glucose therefore trends toward nil regardless of the ante-mortem state, and a low reading cannot diagnose hypoglycaemia. Hepatic glycogenolysis is minimal once enzymatic regulation ceases, and there is no clinically meaningful glucose equilibration with cerebrospinal fluid. Vitreous glucose falls more slowly, making it the preferred specimen.

Reference: The Essentials of Forensic Medicine and Toxicology, K. S. Narayan Reddy, 34th ed.

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