In persons with diabetes, factitious disease may take the form of surreptitious insulin administration that causes unexplained hypo glycemia. Factitious disease is the desperate plea for help by a person who has been unable to devise a better solution for his or her emotional problems. This case report discusses a diabetic patient lost to factitious disease— in the hope that, in shar ing his story with other diabetes educators, some lives may be saved. A high index of suspicion should be maintained by the diabetes educator when he or she is asked to evaluate or reeducate a person with brittle diabetes or unexplained hypoglycemia.
Get full access to this article
View all access options for this article.
References
1.
Beardwood J. : A case of attempted suicide with insulin. JAMA102(10):765, 1934.
2.
Shade DS, Drumm DA, Eaton RP, et al: Factitious brittle diabetes mellitus. Am J Med78(5):777-784, 1985.
3.
Rynearson EH : Hyperinsulinism among malingerers. Med Clin North Am32:477, 1947.
4.
Scarlett JA, Mako M., Rubenstein AH, et al : Factitious hypoglycemia: Diagnosis by measurement of serum C-peptide immunoreactivity and insulin-binding antibodies. N Engl J Med297(19):1029-1032, 1977.
5.
Moore GL, McBumey PL, Service FJ: Self-induced hypoglycemia: A review of the psychiatric aspects and report of three cases. Psychiatry Med4(3):301-311, 1973.
6.
Wedel KR: A therapeutic confrontation approach to treating patients with factitious illness. Soc Work16(2):69-73, 1971.
7.
Shade DS, Drumm DA, Duckworth WC, et al : The etiology of incapacitating, brittle diabetes. Diabetes Care8(1):12-20, 1985.
8.
Cantor B., Morgan L., Buhi WC, et al: Factitious hyperglycemia in pregnancy. Lancet2(8099):1109, 1978.
