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[Postmortem diagnosis of exogenous insulin administration]
E Logemann1, S Pollak, A N Khalaf
1Institut für Rechtsmedizin, Universität Freiburg/Brsg.
Archiv Fur Kriminologie
|January 1, 1993
Summary
A medical practitioner
Area of Science:
- Forensic toxicology
- Endocrinology
Background:
- Case study of a deceased 51-year-old female medical practitioner.
- Investigation prompted by expressed suicidal intentions and discovery in a woodland.
Observation:
- Discovery of syringes, insulin cartridges, and diazepam ampoule near the body.
- Toxicological analysis of heart blood revealed diazepam, insulin, and C-peptide.
- Detection of insulin in tissue from the injection site.
Findings:
- Elevated insulin levels relative to C-peptide indicated exogenous insulin administration.
- Normal HbA1c and fructosamine levels, along with pancreatic histology, ruled out diabetes mellitus.
- Toxicological results suggest a fatal overdose of insulin and diazepam.
Implications:
- Highlights the potential for misuse of prescription medications, including insulin, in suicide.
- Underscores the importance of comprehensive toxicological analysis in forensic investigations.
- Demonstrates the diagnostic value of insulin/C-peptide ratios in distinguishing endogenous vs. exogenous insulin use.