The usual response is to measure insulin & C-peptide. Exogenous insulin comes without C-peptide, so a high insulin with low C-peptide is suspicious.
TIM
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Prof. T. Reynolds,
Clinical Chemistry Dept,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFS,
DE13 0RB.
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Tel: +44 (0)1283 511511 ext. 4035
Fax: +44 (0)1283 593064
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-----Original Message-----
From: c=GB;a=NHS;p=NHS NATIONAL INT;dda:RFC-822=acb-clin-chem-gen-request(a)mailbase.ac.uk;
Sent: Thursday, May 18, 2000 4:14 PM
To: c=GB;a=NHS;p=NHS NATIONAL INT;dda:RFC-822=acb-clin-chem-gen(a)mailbase.ac.uk;
Subject: Deliberate insulin injection?
I was asked by an ER physician (is that A&E in the UK?)
if it is possible to distinguish endogenous insulin from
injected insulin in a non-diabetic patient.
A baby was brought to the ER in severe hypoglycemia, and
within hours made a full recovery. No cause of the
hypoglycemia could be determined; blood drawn after eight
hours showed both glucose and insulin in the normal
range. (This is the only blood remaining for further
analysis.) The child had been in the care of a baby
sitter at the time of the onset of hypoglycemia; the baby
sitter is known to be a diabetic. Deliberate injection
of insulin is considered a possibility.
Given the short half life of insulin and the 8 hour
interval, can any analysis be done to suggest or to rule
out insulin injection? Thanks for any suggestions.
Robert Murray, Ph.D.
Lutheran General Hospital
Park Ridge, IL 60068
USA
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