No doubt whoever broke into my buddy R.R.'s hotel room thought they’d hit the jackpot: 3 syringes filled to the brim. They must’ve thought so, because the thief made off with all R.R’s insulin. He’s a diabetic, obviously, and takes syringes with him wherever he goes. Just a few weeks ago he got pulled over for a traffic stop, and the cops started squirting the insulin out of the syringes, trying to figure out what it was.
I guess if anyone O.D’s on insulin in the next few days, we’ll know who the thief was. Can a non-diabetic die if they shoot up 3 syringes of insulin? Doesn’t sound like a good idea.
Longer answer: depends on the type of insulin, but any type is bound to cause major hypoglycemia, possible coma, and death. You don’t OD so much as lose your blood sugar entirely. I have seen blood sugars as low as 19 (normal is 60-100)–but that pt died. Survival also depends on prompt diagnosis and treatment of the hypoglycemia.
Nimrod–(the thief). I hope your friend has access to more while travelling.
Nah, they won’t die. They’ll be brain-damaged and unable to remember much of their past, for a few weeks. Pyschiatrists used insulin shock to treat patients; loss of memory was usually a result. Similar to ECT.
Oh yeah, no problem, his daughter drove up and brought some more insulin for him. R.R. will be fine. Whoever’s got 3 syringes of insulin, well, hopefully the brain damage won’t be permanent.
Gotta disagree with the above. elanorigby has it right.
Death is a definite possibility when abusing insulin. Many mechanisms come into play: Brain death from starvation (those neurons gotta eat regularly!), followed by bodily death; fatal arrhythmia due to low blood sugar (usually on the basis of low serum potassium); seizure causing respiratory arrest and death; and other.
IMO, the loss of memory is the thereaputic “benefit” of insulin shock. That is directly linked to destruction of hippocampal neurons. Luckily(for the thief), those are the brain cells that are most likely to regenerate. Unluckily, an overdose of insulin is a systemic poison. Some damage would be permanent.
Thank you, kind sir! I did not know you were an MD.
eleanorigby RN <shakes hands with> Qadgop the Mercotan*
Plus, I have treated pts with sugars as low as 23 that DID survive w/o brain damage–but they were hospitalized and treatment was immediate and repeated. Don’t ever mess with insulin–it is not a forgiving drug. <lecture over>
Maybe it was that low in the later years, but I doubt it was that low in the 20’s when it was introduced. I would have a paper cite, but I just moved and all my books are packed away. In the meantime, this PBS page says it was 1-10% (probably varied with the date).
Ya know, World Eater, that’s excellent advice, just in general. One day when I have children, I’ll set 'em down and give them some good life advice. It’ll include:
Play nicely with the other kids.
Share your toys.
Don’t steal syringes and inject unknown substances into yourself.
Dumb question maybe, but what were the circumstances surrounding this? Were the cops searching his car for some other reason and came across his syringes? Were they filled and unrefrigerated sitting on the seat? I’m trying to imagine this scene and just can’t.
Not rare. Every doc or nurse sees it a few times in their career. Rare is a term reserved for Eosinophilic fasciitis, or Carbuncular Trollopsy, which most practitioners will never encounter.
And the reason death was so uncommon in the Insulin “shock” therapy treatments was generally because they had IV access and an amp of D50 ready to push! The good practitioners did, anyway. Those that didn’t take such precautions had mortality rates around 10% or higher.
(I currently practice at what was formerly the “Central State Hospital for the Criminally Insane”. Neat place. I got a tour of the former lobotomy rooms, the ECT rooms, and the insulin shock wing. Also the guy who inspired “Psycho”, “Silence of the Lambs”, and “The Texas Chain Saw Massecre”'s old room.)
I recently had a patient who tried to suicide by giving himself about 1000 units of Lantus. That stuff lasts for 24 hours!
elanorigby, if you hunt around at the SDMB, you can find what my name means. Its A Riddle Wrapped In a Mystery Inside an Enigma. A neutronium-plated Enigma!
In the meantime, this 