Abstract：
OBJECTIVE: To summarize recent cases of fatal insulin poisoning both domestically and internationally, thereby offering valuable insights for the forensic identification of insulin overdose cases.
METHODS: Literature published since 2000 on fatal insulin overdose were systematically searched and screened. Data encompassing variables such as year, age, sex, cause of death, scene conditions, occupations, medical histories of victims and perpetrators, autopsy timing, dosage and administration methods, forensic pathology, and toxicological analysis, were compiled for rigorous statistical analysis.
RESULTS: Among the 29 fatal cases of insulin poisoning, suicides and homicides accounted for 55.2 % and 41.4 %, respectively. Precisely 34.5 % of victims or perpetrators were associated with the medical industry, 27.6 % had diabetes, and 24.1 % had mental illnesses such as depression. Intravenous injection resulted in quicker death than did subcutaneous injection. In some cases, immunohistochemical staining of insulin and protamine at injection sites yielded positive results. The average molar ratio of insulin to C-peptide in post-mortem blood was 13.76 ± 5.167, indicating a significant diagnostic value for insulin poisoning.
CONCLUSIONS: Assessment of cases of fatal insulin overdose should be thorough, incorporating case investigation, scene examination, medical records review, autopsy findings, pathological examinations, and laboratory tests, alongside considering the condition of the body and timing of death autopsy. Using mass spectrometry to detect insulin proves valuable, particularly in cases of poor body preservation.
METHODS: Literature published since 2000 on fatal insulin overdose were systematically searched and screened. Data encompassing variables such as year, age, sex, cause of death, scene conditions, occupations, medical histories of victims and perpetrators, autopsy timing, dosage and administration methods, forensic pathology, and toxicological analysis, were compiled for rigorous statistical analysis.
RESULTS: Among the 29 fatal cases of insulin poisoning, suicides and homicides accounted for 55.2 % and 41.4 %, respectively. Precisely 34.5 % of victims or perpetrators were associated with the medical industry, 27.6 % had diabetes, and 24.1 % had mental illnesses such as depression. Intravenous injection resulted in quicker death than did subcutaneous injection. In some cases, immunohistochemical staining of insulin and protamine at injection sites yielded positive results. The average molar ratio of insulin to C-peptide in post-mortem blood was 13.76 ± 5.167, indicating a significant diagnostic value for insulin poisoning.
CONCLUSIONS: Assessment of cases of fatal insulin overdose should be thorough, incorporating case investigation, scene examination, medical records review, autopsy findings, pathological examinations, and laboratory tests, alongside considering the condition of the body and timing of death autopsy. Using mass spectrometry to detect insulin proves valuable, particularly in cases of poor body preservation.
摘要：
目的：总结国内外近期发生的致命性胰岛素中毒病例，从而为法医鉴定胰岛素过量病例提供有价值的见解。
方法：系统搜索并筛选了自2000年以来发表的关于致命胰岛素过量的文献。包含变量的数据，如年份、年龄,性别,死因,现场条件,职业,受害者和肇事者的病史，尸检时间,剂量和给药方法，法医病理学,和毒理学分析，是为严格的统计分析而编制的。
结果：在29例胰岛素中毒致死病例中，自杀和凶杀案分别占55.2%和41.4%，分别。准确地说，34.5%的受害者或肇事者与医疗行业有关，27.6%患有糖尿病，24.1%患有抑郁症等精神疾病。静脉注射比皮下注射导致更快的死亡。在某些情况下,注射部位的胰岛素和鱼精蛋白的免疫组织化学染色产生阳性结果。死后血液中胰岛素与C肽的平均摩尔比为13.76±5.167，表明对胰岛素中毒具有重要的诊断价值。
结论：对致命的胰岛素过量病例的评估应该是彻底的，结合案件调查，现场检查,病历审查，尸检结果,病理检查,和实验室测试，同时考虑身体的状况和死亡尸检的时机。使用质谱检测胰岛素被证明是有价值的，特别是在身体保存不良的情况下。
方法：系统搜索并筛选了自2000年以来发表的关于致命胰岛素过量的文献。包含变量的数据，如年份、年龄,性别,死因,现场条件,职业,受害者和肇事者的病史，尸检时间,剂量和给药方法，法医病理学,和毒理学分析，是为严格的统计分析而编制的。
结果：在29例胰岛素中毒致死病例中，自杀和凶杀案分别占55.2%和41.4%，分别。准确地说，34.5%的受害者或肇事者与医疗行业有关，27.6%患有糖尿病，24.1%患有抑郁症等精神疾病。静脉注射比皮下注射导致更快的死亡。在某些情况下,注射部位的胰岛素和鱼精蛋白的免疫组织化学染色产生阳性结果。死后血液中胰岛素与C肽的平均摩尔比为13.76±5.167，表明对胰岛素中毒具有重要的诊断价值。
结论：对致命的胰岛素过量病例的评估应该是彻底的，结合案件调查，现场检查,病历审查，尸检结果,病理检查,和实验室测试，同时考虑身体的状况和死亡尸检的时机。使用质谱检测胰岛素被证明是有价值的，特别是在身体保存不良的情况下。
