ON THE PHENOMENOLOGY OF LETHAL APPLICATIONS OF INSULIN

This study deals with the postmortem findings in cases of lethal hypog lycaemia due to injections of insulin. In 12 cases (four female; eight male; mean age 42 years) the following aspects were evaluated retrosp ectively: circumstances of life, scene of death, pathomorphological fi ndings and postmortem biochemistry on cerebrospinal fluid, vitreous hu mour, blood, and urine (levels of glucose, lactate, hemoglobin A(lc) a nd insulin). Furthermore, analyses of ethanol in blood and urine as we ll as toxicological and histological examinations were performed. Unex pectedly, the dead persons rarely represented diabetics, relatives of diabetics, or medical personnel. It is concluded, that the diagnosis o f fatal hypoglycaemia can only be established by a synopsis of postmor tem biochemistry, pathomorphological alterations and anamnesis. Beside s, this diagnosis must always be made ''per exclusionem''. (C) 1998 El sevier Science Ireland Ltd.