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Forensic Science, Medicine and Pathology
Published in: Forensic Science, Medicine and Pathology 4/2022

Open Access 09-08-2022 | Suicide | Original Article

Characteristics of fatal insulin overdoses

Authors: Lilli Stephenson, Corinna van den Heuvel, Melissa Humphries, Roger W. Byard

Published in: Forensic Science, Medicine and Pathology | Issue 4/2022

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Abstract

This study was undertaken to review fatal cases of insulin overdose in South Australia (SA) over a 20-year period to assess rates and characteristics of insulin-related deaths among insulin-dependent diabetics and non-diabetics for all manners of death. Records from the National Coronial Information System (NCIS) and Forensic Science SA (FSSA) were searched for all cases of fatal insulin overdose in South Australia (SA) between 2000 and 2019. Collected variables included age, sex, cause of death, scene findings, manner of death, decedent medical and personal histories, biochemistry, toxicology, histopathology, and autopsy findings. Statistical analyses were performed using R (version 4.1.2). Forty cases of insulin overdose were identified in SA between 2000 and 2019. Twenty-nine cases (72.5%) were suicides, with the remaining cases classified as accidental or undetermined intent. Thirteen of the 22 insulin-dependent diabetics (59%) had a history of depression, 10 of whom had previously demonstrated suicidal ideation. The current study has shown that suicides using insulin among insulin-dependent diabetics are equally as prevalent, if not more so than fatal accidental insulin overdoses. This can largely be attributed to insulin-dependent diabetic access to a potentially lethal substance. Suicide prevention strategies should focus on insulin-dependent diabetics with a history of depression, particularly for those with access to rapid-acting insulin.
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Metadata
Title
Characteristics of fatal insulin overdoses
Authors
Lilli Stephenson
Corinna van den Heuvel
Melissa Humphries
Roger W. Byard
Publication date
09-08-2022
Publisher
Springer US
Published in
Forensic Science, Medicine and Pathology / Issue 4/2022
Print ISSN: 1547-769X
Electronic ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-022-00511-3

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