How Can Insulin Kill You

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Insulin Poisoning With Suicidal Intent

Go to: A 27-year-old paramedical personnel without any comorbidities, working as an assistant in the operation theater, was found to be drowsy and drenched in sweat with bradycardia (34 beats/min) and hypotension (80/50 mm of Hg). She was immediately shifted to ICU. She was pale and there was no cyanosis, icterus, clubbing, lymphadenopathy, or any evidence of external injury. Temperature was 99.0°F, with a respiratory rate of 20/min and cold peripheries. Pupils were bilateral 3 mm, reactive to light, and oculocephalic reflex was preserved. Deep tendon reflexes were brisk and plantars were flexor. Meningeal signs were absent. Her systemic examination was unremarkable. An electrocardiogram showed sinus bradycardia. Atropine was given intravenously and normal saline infusion started. Blood pressure remained low which prompted initiation of norepinephrine drip. Capillary blood glucose (CBG) was 35 mg/dL, hence 50 mL of 50% dextrose bolus was given and 5% dextrose infusion started. Her neurological status started deteriorating and she rapidly lapsed into coma, 90 minutes from her initial presentation. At this stage, pupils were bilateral 2 mm and nonreactive, with loss of occulocephali Continue reading >>

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  1. ArgonV

    Today at the university, I had a discussion with a few students from other disciplines. At a certain point we ended up talking about insulin. The question was: If you accidentally ingest insulin, you need direct medical attention.
    Two of us, a chemistry and a physics student, thought you would need to call an ambulance. The biologist and me said that you'd be ok, as long as you ate a few sweet items, like a few cubes of sugar, a couple of candy bars or something similar.
    We're talking about healthy, non-diabetic people here, and the quantity of insulin is just one or two units that (Type 1) diabetics use.
    So? Who's right?

  2. LTK

    Well, I'm guessing that insulin, being a hormone, would be rendered inactive by the low pH in the stomach acid, and further broken up in the digestive system so that by the time it reaches the cells with insulin receptors it's harmless. I'd have to have a graph of the hormone functionality against the pH to confirm that, though.

    Wikipedia on insulin wrote:Insulin is produced and stored in the body as a hexamer (a unit of six insulin molecules), while the active form is the monomer. The hexamer is an inactive form with long-term stability which serves as a way to keep the highly reactive insulin protected, yet readily available. The hexamer-monomer conversion is one of the central aspects of insulin formulations for injection. The hexamer is far more stable than the monomer, which is desirable for practical reasons, however the monomer is a much faster reacting drug because diffusion rate is inversely related to particle size.

    We also used the method to investigate the self-association properties of insulin over a wide pH range. The equilibrium constant for the formation of dimers decreased only 6-fold over a 9.2 pH unit increase from pH 2 to 11.2 but almost 200-fold for the additional 1.5 pH unit increase from pH 11.2 to 12.7. We conclude that a residue of pK 12 is critical to the maintenance of the quaternary structure of insulin. We assign this role to the single B22-arginyl residue in insulin.
    From http://diabetes.diabetesjournals.org/co ... 1.abstract . I'm not entirely sure what this implies, but I think they're saying that insulin in a hexagon, the stable form, is much more predominant in higher pH, which could mean that it's easily digested in acidic conditions.

  3. ArgonV

    Yes, I agree that insulin would be destroyed in the stomach. That's why there aren't any insulin pills. I think
    Ingesting was misleading, I agree. Let's just say, for whatever reason tickles your fancy, you inject 1-2 units of insulin into your bloodstream?

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