Suicide by Combined Insulin and Glipizide Overdose in a Non-Insulin Dependent Diabetes Mellitus Physician

A case of self-injected insulin intoxication with an oral hypoglycaemic agent glipizide overdose in a type-II/non-insulin dependent diabetes mellitus (NIDDM) individual, a physician by profession, is presented with a review of the literature. The case demonstrates the need for thorough scene investigation, perusal of clinical details and complete autopsy to certify the death caused by combined insulin and glipizide overdose, and the manner of death. A meticulous search in the English literature reveals that hardly any fatal cases of combined insulin and glipizide overdose have been reported, with almost no cases from India, thus making this case report relevant and unique.

[1]  P. Kann,et al.  Epidemiological assessment of 160 cases of insulin overdose recorded in a regional poisons unit. , 2004, International journal of clinical pharmacology and therapeutics.

[2]  B. Knight.  Poisoning by medicines , 2004 .

[3]  M. Tsokos,et al.  Suicide by insulin injection in combination with β-blocker application , 2000 .

[4]  D C Winston,et al.  Suicide via insulin overdose in nondiabetics: the New Mexico experience. , 2000, The American journal of forensic medicine and pathology.

[5]  Y. Shibutani,et al.  Suicidal insulin overdose in a type 1 diabetic patient: relation of serum insulin concentrations to the duration of hypoglycemia. , 2000, Journal of diabetes and its complications.

[6]  R. Mattern,et al.  Insulin injection sites: morphology and immunohistochemistry. , 1997, Forensic science international.

[7]  E. Otten.  Ellenhorn's medical toxicology: Diagnosis and treatment of human poisoning, 2nd ed , 1997 .

[8]  I. H. Gibson,et al.  3. Successful Suicide by Insulin Injection in a Non-Diabetic , 1995, Medicine, science, and the law.

[9]  J I Coe,et al.  Postmortem Chemistry Update Emphasis on Forensic Application , 1993, The American journal of forensic medicine and pathology.

[10]  F. Patel.  Fatal Self-Induced Hyperinsulinaemia: A Delayed Post-Mortem Analytical Detection , 1992, Medicine, science, and the law.

[11]  K. Polonsky,et al.  Hypoglycemia Due to Surreptitious Injection of Insulin: Identification of Insulin Species by High-Performance Liquid Chromatography , 1991, Diabetes Care.

[12]  Y. Kaminer,et al.  Attempted suicide by insulin overdose in insulin-dependent diabetic adolescents. , 1988, Pediatrics.

[13]  H Haibach,et al.  Homicide by insulin administration. , 1987, Journal of forensic sciences.

[14]  E. Donoghue,et al.  Dispensing error causing fatal chlorpropamide intoxication in a nondiabetic. , 1986, Journal of forensic sciences.

[15]  R. Turner,et al.  THE HALF‐LIFE OF ENDOGENOUS INSULIN AND C‐PEPTIDE IN MAN ASSESSED BY SOMATOSTATIN SUPPRESSION , 1985, Clinical endocrinology.

[16]  G. Volans,et al.  Self Poisoning in Diabetic Patients , 1983, Human toxicology.

[17]  W. Bauman,et al.  Insulin as a lethal weapon. , 1981, Journal of forensic sciences.

[18]  W. Bobzien.  Suicidal overdoses with hypoglycemic agents. , 1979, JACEP.

[19]  F. Martin,et al.  ATTEMPTED SUICIDE BY INSULIN OVERDOSE IN INSULIN‐REQUIRING DIABETICS , 1977, The Medical journal of Australia.

[20]  S. Dickson,et al.  The isolation and quantitation of insulin in post-mortem specimens--a case report. , 1977, Forensic science.