title: [Alleged suicide by insulin].
abstract: A 26-year-old man, who was on probation, was found dead in his home by his mother. Insulin vials and 2 insulin pens, which the man's stepfather (an insulin-dependent diabetic) had been missing for over a week, were found next to the deceased. The circumstances suggested suicide by an injected insulin overdose. At the time of the autopsy, the corpse showed already marked signs of autolysis. Clinical chemical tests confirmed the injection of insulin, but indicated hyperglycemia at the time of death. Toxicological analyses revealed that the man had consumed amphetamine, cannabinoids, and tramadol in the recent past. Histological examination finally revealed extensive bronchopneumonia as the cause of death. The most plausible explanation for the results of the autopsy and the additional examinations was an injection of insulin as a failed attempt of self-treatment. It is conceivable that the man had discovered by a rapid test that he was a diabetic, but had decided not to go to a doctor to avoid disclosure of parole violation due to continued drug abuse. He may have misinterpreted the symptoms caused by his worsening bronchitis and the developing bronchopneumonia as symptoms of a diabetic metabolic status and may have felt compelled to treat himself with insulin.
authors.forename: Christoph G
authors.initials: CG
authors.lastname: Birngruber
authors.forename: Ralf
authors.initials: R
authors.lastname: Krüll
authors.forename: Reinhard
authors.initials: R
authors.lastname: Dettmeyer
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Verhoff
mesh_terms: D000328:Adult; D001344:Autopsy; D001996:Bronchopneumonia / Q000473:pathology*; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000473:pathology*; D003937:Diagnosis, Differential; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects*; D008168:Lung / Q000473:pathology; D008297:Male; D011180:Postmortem Changes; D012651:Self Medication; D019966:Substance-Related Disorders / Q000473:pathology*; D013405:Suicide / Q000331:legislation & jurisprudence*
chemical_list: D013287:Illicit Drugs; D007328:Insulin