Identification, measurement, and evaluation of blood concentrations of insulin glargine and insulin lispro by UPLC-MS-MS in a dead body suspected of insulin overdose.
LC-MS/MS
insulin glargine
insulin lispro
intoxication
multivalent ion analysis
Journal
Journal of forensic sciences
ISSN: 1556-4029
Titre abrégé: J Forensic Sci
Pays: United States
ID NLM: 0375370
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
25
01
2023
received:
27
09
2022
accepted:
25
01
2023
pubmed:
11
2
2023
medline:
4
3
2023
entrez:
10
2
2023
Statut:
ppublish
Résumé
Insulin preparations, which are drug treatments for diabetes, cause fatal hypoglycemia when an overdose is administered. Cases of homicide and suicide using these preparations have been reported and are of great forensic interest. However, there are few reports assessing the postmortem concentration of insulin preparations, and it is often difficult to determine the cause of death. In the present study, we report a case of a suspected insulin glargine and insulin lispro overdose for suicide. A woman in her 30s had a history of mental illness and diabetes. The day before her death, she reported to her boyfriend that she had taken large doses of insulin preparations and prescription drugs. An autopsy revealed no fatal injuries or lesions. Drug screening tests revealed several prescription drugs, none of which showed toxic concentrations. Analysis using LC-MS/MS detected insulin glargine in the peripheral and cardiac blood at 429 μU/mL and 1362 μU/mL, respectively, whereas insulin lispro was detected in both the peripheral and cardiac blood at levels below the lower limit of quantification (LLOQ; <50 μU/mL). The cause of death was considered likely to be hypoglycemia caused by an overdose of insulin glargine. Insulin glargine is rapidly metabolized after subcutaneous administration and is rarely detected in the blood when used at therapeutic doses. There are no other reports on the quantification of insulin glargine parent compounds in postmortem samples, and this case provides important data on postmortem blood concentrations of insulin glargine intoxication.
Identifiants
pubmed: 36762764
doi: 10.1111/1556-4029.15219
doi:
Substances chimiques
Insulin Glargine
2ZM8CX04RZ
Insulin Lispro
0
Hypoglycemic Agents
0
Insulin, Long-Acting
0
Blood Glucose
0
Insulin
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
704-710Subventions
Organisme : Japan Society for the Promotion of Science
ID : 19K19481
Informations de copyright
© 2023 American Academy of Forensic Sciences.
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