title: Fatal self-induced hyperinsulinaemia: a delayed post-mortem analytical detection.
abstract: The inconspicuous number of cases of self-induced hyperinsulinaemia reported in the literature may suggest that many are obscure enough to escape their detection. A case of fatal suicidal hyperinsulinaemia in a non-diabetic is reported here, and in whom only a retrospective biochemical analysis provided an explanatory cause of death. A quantitative radioimmuno assay (RIA) estimation of the refrigerated postmortem blood sample stored at 4 degrees C for three weeks gave a positive insulin yield. It reiterates the need, in forensic cases, for a very low threshold of suspicion and a good back-up for the appropriate body fluid analysis or tissue microexamination, especially when full details of the circumstances surrounding the death are not available at the autopsy. A brief résumé on insulin is presented as a background to the current forensic interest in the apparent increase in sudden deaths in young diabetics amidst the controversy about the bio-designed 'human' insulin and subjective unawareness of severe hypoglycaemia.
authors.affiliation: Guy's Medical School (University of London), England.
authors.forename: F
authors.initials: F
authors.lastname: Patel
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced / Q000401:mortality* / Q000473:pathology; D006946:Hyperinsulinism / Q000139:chemically induced* / Q000150:complications / Q000473:pathology; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D011863:Radioimmunoassay / Q000379:methods; D012651:Self Medication / Q000009:adverse effects / Q000523:psychology; D013405:Suicide / Q000523:psychology*; D013997:Time Factors
chemical_list: D007328:Insulin