ypoglycaemia can bring patients into contact with the law in a variety of ways. It can be used as a defence against almost any criminal charge especially those involved with driving or with violence. It has also been used as an offensive weapon. Allegations of murder by insulin are easy to make but difficult to substantiate as methods of analysis that are appropriate for clinical use are not necessarily adequate for forensic purposes.
McCrimmon RJ , Frier BMHypoglycaemia, the most feared complication of insulin therapy. Diabetes Metab1994;20:503-12.
2.
Adlersberg D. , Dolger H.Medico-legal problems of hypoglycaemic reactions in diabetes. Ann Intern Med1938-9;12:1804-15.
3.
Court of Appeal; Mansfield v Weetabix Ltd.1997; PIQR Pt 6;526-30; Sweet & Maxwell.
4.
Marks V., Rose FCHypoglycaemia, 1st edition BlackwellOxford1965.
5.
Marks V.Murder by insulin. Med Leg J1999;67(Pt 4):147-63.
6.
Cryer PEHypoglycemia; pathophysiology, diagnosis and treatment. New YorkOxford University Press, 1997.
7.
Kernbach-Wighton G., Sprung R., Puschel K.On the diagnosis of hypoglycemia in car drivers-including a review of the literature. Forensic Sci Int2001;115(1-2):89-94.
8.
Tattersall RBUnexplained deaths of type 1 diabetic patients . Diabet Med1991;8:49-58.
9.
Dahlquist G. , Kallen B.Mortality in childhood-onset type 1 diabetes: a population-based study. Diabetes Care2005 ;28:2384-7.
10.
Kinsey JLIncidence and cause of death in shock therapy. Arch Neurol Psych1941;46:55-8.
11.
Myers RE, Kahn KJInsulin induced hypoglycaemia in the non-human primate: II Long term neuropathological consequences. Clinics in Developmental Medicine1971;39/40:195-206.
12.
McLaren EH, Somerville JMEarly warning symptoms of hypoglycaemia in ambulant diabetics. Practical Diabetes1988;5:207-08.
13.
Heller SR, Macdonald IAThe measurement of cognitive function during avcute hypoglycaemia; experimental limitations and their effect on the study of hypoglycaemia unawareness. Diabet Med1996;13:607-15.
14.
The Diabetes Control and Complications Research Group.Epidemiology of severe hypoglycaemia in the diabetes control and complications trial. Am J Med1991;90:450-59.
15.
Richter RB, Neises G. "Human" insulin versus animal insulin in people with diabetes mellitus in The Cochrane Library, Issue 3, 2002. Oxford ; Update Software.
16.
MacLeod KMHypoglycaemia unawareness; causes, consequences and treatment. J R Coll Phys (Lond)2000;34:245-50.
17.
Cox DJ, Penberthy JK, Zrebiec J. et al. Diabetes and driving mishaps: frequency and correlation from a multinational survey. Diabetes Care2003 ;26:2329-34.
18.
Graveling AJ , Warren RE, Frier BMHypoglycaemia and driving in people with insulin-treated diabetes: adherence to recommendations for avoidance. Diabet Med2004;21:1014-19.
19.
Chelsea Girl ; Limits of defence of automatism following hypoglycaemia ; The Personal and Medical Injuries Law Letter1995;11(1):1-4.
20.
Kerr D., Macdonald IA, Heller SR, Tattersall RBAlcohol causes hypoglycaemic unawareness in healthy volunteers and patients with type 1 (insulin-dependent) diabetes. Diabetologia1990;33:216-21.
21.
Brahams D.Hypoglycaemia and intent; Medicine and the Law. Lancet1991;337:1030.
22.
Marks V., Hypoglycaemia - real and unreal, lawful and unlawful: the 1994: Banting Lecture . Diabetic Medicine1995;12:850-64.
23.
Marks V., Richmond C.2007; The Insulin Murders; RSM Press (in press).
24.
Selby C.Interference in immunoassays. Ann Clin Biochem1999;36:704-21.
25.
Marks V.False-positive immunoassay results; a multicenter survey of erroneous immunoassay results from assays for 74 analytes in 10 donors from 66 laboratories in seven countries. Clin Chem2002;48:2008-16.
26.
Given BD, Ostrega DM, Polonsky KS et al. Hypoglycemia due to surreptitious injection of insulin. Identification of insulin species by high-performance liquid chromatography. Diabetes Care1991;14:544-7.
27.
Stocklin R. , Vu L., Vadas L. et al. A stable isotope dilution assay for the in vivo determination of insulin levels in humans by mass spectrometry . Diabetes1997;46(1):44-50.
28.
Ben Ayed S. , Benkirane A., Godet, Foglietti M, Bernard MAAnalytical interference in hCG immunoassays: an in vivo and in vitro study. Clin Chem2000;46;(suppl Abstract 36).
29.
Spitz IM, Rubenstein AH, Bersohn I. et al. Urine insulin in renal disease. J Lab Clin Med1970;75:998-1005.
30.
0. DeFronzo RA, Ferrannini E.Influence of plasma glucose and insulin concentration on plasma glucose clearance in man. Diabetes1982;31: 683-8.