ABSTRACT
Four cases of self-injected insulin overdose in nondiabetic individuals are presented. Included are two cases of presumed insulin overdose (no autopsy), one case with elevated vitreous insulin (autopsy), and one case with elevated postmortem blood insulin and low blood C peptide (autopsy). These cases demonstrate the need for a thorough scene investigation, complete autopsy, and proper collection and storage of specimens to certify a death caused by insulin intoxication as well as to determine the manner of death. Appropriate collection and preservation of postmortem blood samples are discussed.
Subject(s)
Hypoglycemic Agents/poisoning , Insulin/poisoning , Suicide , Adult , Autopsy , C-Peptide/blood , Drug Overdose/pathology , Female , Humans , Hypoglycemic Agents/administration & dosage , Injections , Insulin/administration & dosage , Insulin/blood , Male , Middle Aged , New MexicoABSTRACT
Hypoglycin is a toxic amino acid found in the fruit of the unripe ackee (Blighia sapida), and associated with Jamaican "vomiting sickness". It produces profound hypoglycaemia when administered to starved rats, and this is accompanied by gross mitochondrial swelling in liver cells. This ultrastructural change is reduced or absent in animals that have been allowed to feed ad libitum, provided that normal blood glucose levels are maintained. Mitochondrial swelling is not a feature of acute hypoglycaemia induced by insulin, under the conditions of this experiment.(AU)