This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Marks, V. Search for Related Content Social Bookmarking                         What's this?

Hypoglycaemia: insulin and conflicts with the law

Oriel House, Derby Road, Haslemere, GU27 1BP, UK, vincentmarks{at}bigfoot.com

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.

Key Words: hypoglycaemia • law • offence • defence • crime • murder • Munchausen by proxy • immunoassay.

References

• McCrimmon RJ, Frier BM Hypoglycaemia, the most feared complication of insulin therapy. Diabetes Metab 1994;20:503-12.[Web of Science]
• Adlersberg D., Dolger H. Medico-legal problems of hypoglycaemic reactions in diabetes. Ann Intern Med 1938-9;12:1804-15.
• Court of Appeal; Mansfield v Weetabix Ltd. 1997; PIQR Pt 6;526-30; Sweet & Maxwell.
• Marks V., Rose FC Hypoglycaemia, 1st edition Blackwell Oxford 1965.
• Marks V. Murder by insulin. Med Leg J 1999;67(Pt 4):147-63.
• Cryer PE Hypoglycemia; pathophysiology, diagnosis and treatment. New York Oxford University Press, 1997.
• Kernbach-Wighton G., Sprung R., Puschel K. On the diagnosis of hypoglycemia in car drivers-including a review of the literature. Forensic Sci Int 2001;115(1-2):89-94.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Tattersall RB Unexplained deaths of type 1 diabetic patients. Diabet Med 1991;8:49-58.[Web of Science][Medline] [Order article via Infotrieve]
• Dahlquist G., Kallen B. Mortality in childhood-onset type 1 diabetes: a population-based study. Diabetes Care 2005;28:2384-7.[Abstract/Free Full Text]
• Kinsey JL Incidence and cause of death in shock therapy. Arch Neurol Psych 1941;46:55-8.
• Myers RE, Kahn KJ Insulin induced hypoglycaemia in the non-human primate: II Long term neuropathological consequences. Clinics in Developmental Medicine 1971;39/40:195-206.
• McLaren EH, Somerville JM Early warning symptoms of hypoglycaemia in ambulant diabetics. Practical Diabetes 1988;5:207-08.[CrossRef]
• Heller SR, Macdonald IA The measurement of cognitive function during avcute hypoglycaemia; experimental limitations and their effect on the study of hypoglycaemia unawareness. Diabet Med 1996;13:607-15.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• The Diabetes Control and Complications Research Group. Epidemiology of severe hypoglycaemia in the diabetes control and complications trial. Am J Med 1991;90:450-59.[Web of Science][Medline] [Order article via Infotrieve]
• Richter RB, Neises G. "Human" insulin versus animal insulin in people with diabetes mellitus in The Cochrane Library, Issue 3, 2002. Oxford; Update Software.
• MacLeod KM Hypoglycaemia unawareness; causes, consequences and treatment. J R Coll Phys (Lond) 2000;34:245-50.[Web of Science][Medline] [Order article via Infotrieve]
• Cox DJ, Penberthy JK, Zrebiec J. et al. Diabetes and driving mishaps: frequency and correlation from a multinational survey. Diabetes Care 2003;26:2329-34.[Abstract/Free Full Text]
• Graveling AJ, Warren RE, Frier BM Hypoglycaemia and driving in people with insulin-treated diabetes: adherence to recommendations for avoidance. Diabet Med 2004;21:1014-19.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Chelsea Girl; Limits of defence of automatism following hypoglycaemia; The Personal and Medical Injuries Law Letter 1995;11(1):1-4.
• Kerr D., Macdonald IA, Heller SR, Tattersall RB Alcohol causes hypoglycaemic unawareness in healthy volunteers and patients with type 1 (insulin-dependent) diabetes. Diabetologia 1990;33:216-21.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Brahams D. Hypoglycaemia and intent; Medicine and the Law. Lancet 1991;337:1030.[Medline] [Order article via Infotrieve]
• Marks V., Hypoglycaemia - real and unreal, lawful and unlawful: the 1994: Banting Lecture. Diabetic Medicine 1995;12:850-64.[Web of Science][Medline] [Order article via Infotrieve]
• Marks V., Richmond C. 2007; The Insulin Murders; RSM Press (in press).
• Selby C. Interference in immunoassays. Ann Clin Biochem 1999;36:704-21.[Web of Science][Medline] [Order article via Infotrieve]
• 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 Chem 2002;48:2008-16.[Abstract/Free Full Text]
• 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 Care 1991;14:544-7.[Abstract]
• 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. Diabetes 1997;46(1):44-50.[Abstract]
• Ben Ayed S., Benkirane A., Godet, Foglietti M, Bernard MA Analytical interference in hCG immunoassays: an in vivo and in vitro study. Clin Chem 2000;46;(suppl Abstract 36).
• Spitz IM, Rubenstein AH, Bersohn I. et al. Urine insulin in renal disease. J Lab Clin Med 1970;75:998-1005.[Web of Science][Medline] [Order article via Infotrieve]
• 0. DeFronzo RA, Ferrannini E. Influence of plasma glucose and insulin concentration on plasma glucose clearance in man. Diabetes 1982;31: 683-8.[Medline] [Order article via Infotrieve]

The British Journal of Diabetes & Vascular Disease, Vol. 6, No. 6, 281-285 (2006)
DOI: 10.1177/14746514060060060501


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Marks, V. Search for Related Content Social Bookmarking                         What's this?