POSTMORTEM INSULIN OVERDOSE Josh deGuzman
POSTMORTEM INSULIN OVERDOSEJosh deGuzman
Blood Glucose• Blood glucose – sugar within the bloodstream that
provides energy for the cells of the body• Postmortem blood glucose levels fluctuate; variable
decrease in glucose after death• Can be synthesized in vitreous humor in
decomposed/embalmed bodies
Insulin• Hormone produced by pancreas• Secreted by beta cells• Lowers blood sugar (glucose) levels • Induces muscle and liver cells to take up glucose and
store it as glycogen for later use• Stimulates anabolic processes (fat and protein synthesis)
Types of InsulinEndogenous:
• Originating within the body• Insulin made by the pancreas
Exogenous:• Originating outside of the body• Insulin injected or infused by insulin pump
Half-life of Insulin• Insulin aspart: 81 minutes• Insulin aspart mix: 8 – 9 hours• Insulin determir: 5 – 7 hours• Insulin glulisine: 13 minutes (after IV administration),
42 minutes (after subcutaneous administration)• Insulin lispro: 1 hour
Connecting Peptide (C-Peptide)• C-peptide – byproduct of insulin production by the
pancreas• Levels gauge amount of insulin being produced• Endogenous insulin production corresponds with an
increase in c-peptide levels• Exogenous insulin administration is not associated with an
increase in c-peptide levels• C-peptide levels fall after approximately 24 hours post
mortem
Postmortem Analysis• All dead bodies have low blood glucose levels; cannot
accurately diagnose hypoglycemia from postmortem analysis of vitreous humor glucose
• Must test soon after death due to fast half-life of insulin• Cannot calculate the dose of insulin administered
exogenously from postmortem blood analysis• Testing c-peptide not useful since it’s levels are not
associated with exogenous insulin
Sources• http://www.diabetesselfmanagement.com/diabetes-resour
ces/definitions/endogenousexogenous/
• http://www.drugs.com/ppa/insulin-analogs.html• http://www.forensicmed.co.uk/science/toxicology/post-mor
tem-biochemistry/
• http://www.medicalnewstoday.com/articles/249413.php• http://www.medicinenet.com/script/main/art.asp?articlekey
=12467