title: Characteristics of suicide among diabetes patients: a population based study of suicide victims in Northern Finland.
abstract: OBJECTIVE
  Recent case reports of insulin suicides have raised the need to study in detail the suicides among diabetes patients.
  
  
  METHODS
  The data consisted of 2489 suicides (2030 men, 459 women) in Northern Finland during 1988 to 2010. The suicide victims with hospital-treated type 1 (n=27) or type 2 diabetes (n=51) were compared with those without diabetes (n=2411).
  
  
  RESULTS
  Of all suicide victims, 3.1% had diabetes (34.6% type 1 and 65.4% type 2 diabetes). 24.0% of victims with type 2 diabetes were under the influence of alcohol when they died from suicide, while the proportion was 44.4% in type 1 diabetes and 46.6% in victims without diabetes (P=0.007). Compared to those with type 2 diabetes or without diabetes, victims with type 1 diabetes had suffered more commonly from depression (44.4%, 23.5%, 19.9%, respectively) (P=0.006) and chosen self-poisoning as suicide method (48.1%, 31.4%, and 18.0%) (P<0.001). In victims with type 1 diabetes insulin as a suicide method covered half of the self-poisoning cases, while the proportion in type 2 diabetes was 13%.
  
  
  CONCLUSIONS
  We suggest that physicians who treat diabetes patients should evaluate co-occurring depression and substance abuse, both of which are major risk factors of suicide.
authors.affiliation: Department of Psychiatry, Institute of Clinical Medicine, University of Oulu, Oulu, Finland. sanna.lofman@oulu.fi
authors.forename: Sanna
authors.initials: S
authors.lastname: Löfman
authors.forename: Helinä
authors.initials: H
authors.lastname: Hakko
authors.forename: Arja
authors.initials: A
authors.lastname: Mainio
authors.forename: Markku
authors.initials: M
authors.lastname: Timonen
authors.forename: Pirkko
authors.initials: P
authors.lastname: Räsänen
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology*; D005260:Female; D005387:Finland; D006801:Humans; D007328:Insulin / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013405:Suicide / Q000523:psychology*
chemical_list: D007328:Insulin