Hypoglycemia Due to Surreptitious Injection of Insulin: Identification of Insulin Species by High-Performance Liquid Chromatography
- Burce D Given, MD,
- Diane M Ostrega, MD,
- Kenneth S Polonsky, MD,
- David Baldwin Jr, MD,
- Richard I Kelley, MD PhD and
- Arthur H Rubenstein, MD
- Department of Medicine, University of Chicago, Pritzker School of Medicine, Illinois and the Department of Pediatrics, Children's Hospital of Pennsylvania Philadelphia, Pennsylvania
- Address correspondence and reprint requests to Kenneth S. Polonsky, MD, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, IL 60637.
Abstract
Objective To identify the circulating species of insulin after separation by high-performance liquid chromatography (HPLC) in patients with factitious hypoglycemia.
Research Design and Methods In three of four patients presented, the diagnosis of surreptitious insulin injection was made by documenting the presence of animal insulin in the circulation after separation of the circulating insulin forms by HPLC.
Results Animal insulin was identified.
Conclusions Thus, the identification of the circulating form of insulin in the circulation by HPLC may be a useful adjunct in the diagnosis of factitious hypoglycemia if animal insulin has been injected and if the simultaneously measured concentrations of insulin and C-peptide are inconclusive.
- Received September 12, 1990.
- Accepted February 25, 1991.
- Copyright © 1991 by the American Diabetes Association
