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A Method for Mouse Pancreatic Islet Isolation and Intracellular cAMP Determination

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Insulin poisoning with suicidal intent.

Abhay Gundgurthi¹, Sandeep Kharb, M K Dutta

¹Department of Endocrinology, Army Hospital (Research & Referral), Delhi Cantt, India.

Indian Journal of Endocrinology and Metabolism

|June 16, 2012

Summary

A young paramedical professional experienced a rapid coma due to severe hypoglycemia from exogenous insulin administration. Prompt dextrose infusion led to complete recovery, highlighting the importance of considering insulin overdose in similar cases.

Keywords:

Hypoglycemic coma insulin suicide

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Area of Science:

Endocrinology
Toxicology
Emergency Medicine

Background:

Hypoglycemia, particularly severe, can lead to coma and requires prompt diagnosis and management.
Exogenous insulin administration, whether intentional or accidental, is a critical cause of profound hypoglycemia.

Observation:

A 27-year-old paramedical individual presented with sudden coma and severe hypoglycemia (35 mg/dL).
The patient required ionotropic support for bradycardia and hypotension during intensive care unit (ICU) stay.
Coma persisted for 90 hours, necessitating a total of 470g dextrose infusion.

Findings:

The clinical presentation strongly suggested exogenous insulin administration, likely with suicidal intent.
Complete neurological recovery was achieved without residual deficits after intensive treatment.
No other significant complications of insulin overdose were noted.

Implications:

Insulin overdose should be a key consideration in the differential diagnosis of coma with hypoglycemia, especially in healthcare professionals.
Early recognition and aggressive glucose replacement are crucial for favorable outcomes in insulin-induced hypoglycemia.
This case underscores the potential dangers of insulin misuse and the importance of vigilance in paramedical personnel.