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Sudden death and human insulin: is there a link?
K Borch-Johnsen1, K Helweg-Larsen
1Medical Department, Hørsholm Hospital, Denmark.
Summary
Human insulin introduction in Denmark was not linked to increased sudden deaths in younger diabetic patients. Analysis of 226 cases showed no change in annual sudden death rates, with alcohol abuse noted in many fatal hypoglycaemia cases.
Area of Science:
- Endocrinology
- Diabetology
- Public Health
Background:
- Concerns arose in 1989 from UK case reports linking human insulin introduction to increased sudden death risk in diabetic patients.
- A potential increase in sudden deaths should correlate with the rising use of human insulin.
- This study investigates the association between human insulin adoption and sudden death rates in a Danish diabetic population.
Purpose of the Study:
- To determine if the introduction of human insulin in Denmark correlated with an increased incidence of sudden death among younger insulin-treated diabetic patients.
- To analyze trends in sudden death, hypoglycaemia, and unexplained deaths in relation to human insulin consumption.
- To identify potential contributing factors, such as alcohol abuse, in sudden diabetic deaths.
Main Methods:
- Retrospective analysis of sudden death cases in insulin-treated diabetic patients under 50 years old in Denmark.
- Data collection spanned the period of human insulin introduction and increasing consumption (0.2% to 70%).
- Statistical analysis (p-value for trend) was used to assess changes in annual sudden death rates and specific causes of death.
Main Results:
- A total of 226 cases met the inclusion criteria.
- The annual number of sudden deaths among younger insulin-treated diabetic patients remained constant (p = 0.14) during the study period.
- Deaths due to hypoglycaemia and unexplained causes also showed no significant trend (p = 0.44).
- Chronic alcohol abuse or acute intoxication was prevalent in 50% of deaths from hypoglycaemia, ketoacidosis, or unknown causes.
Conclusions:
- The introduction and widespread adoption of human insulin in Denmark did not lead to an increase in sudden deaths among younger insulin-treated diabetic patients.
- Alcohol abuse emerged as a significant factor in a substantial proportion of fatal hypoglycaemia and unexplained deaths.
- Findings suggest that human insulin itself did not elevate the risk of sudden death in this population, highlighting other contributing factors.