Forensic aspects of insulin

Post Graduate Medical School, University of Surrey, Guildford, UK. Electronic address: .
Diabetes research and clinical practice (Impact Factor: 2.54). 06/2013; 101(3). DOI: 10.1016/j.diabres.2013.05.002
Source: PubMed


Insulin or, more appropriately, hypoglycaemia gives rise to a wide variety of interactions with the law. In most cases its role is not seriously open to question occasionally however, it is. This is especially true of situations in which insulin is suspected of having been used inappropriately or maliciously. The major differences between investigation of hypoglycaemia in clinical and forensic situation are that in the latter the history is often unreliable, appropriate samples for analysis were not collected, preserved or labelled correctly and analytical results are likely to be challenged on grounds of specificity, accuracy and interpretation. Immunoassay remains the mainstay of clinical investigation of hypoglycaemia but likely to become displaced by mass-spectrometry in the forensic situation especially now that human insulin is being replaced by synthetic insulin analogues for the treatment of diabetes.

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Available from: Vincent Marks, Oct 09, 2014
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    • "Surreptitious or malicious exogenous insulin administration is rare but should be considered in patients with unexplained spontaneous hypoglycaemia particularly those with access to anti-diabetic drugs. It is critical to identify these cases, as hypoglycaemia resulting from insulin overdose can cause neurological injury, coma or death [3] [4] [5] [6]. "
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