24-Hour Crisis Hotline: (877)SAFEGBC or (877)723-3422 Mental Health & Substance Abuse Issues

6502 Nursery Drive, Suite 100
Victoria, TX 77904
(361)575-0611
(800)421-8825

Diabetes
Resources
Basic InformationLatest News
Diabetes Ups Risk of MACE in Acute Coronary SyndromesLifestyle, Metformin Interventions Have Variable EffectsHealth Tip: Best Grains And Starchy Veggies for DiabeticsGlycemic Control Up With Oral Semaglutide in Type 2 DiabetesCommercial Weight Management Program May Help Prevent T2DDiabetes Pill Might Replace Injection to Control Blood SugarNew Screening Tool Can Identify Diabetic RetinopathyRisk Conferred by T2D Modified by HbA1c in Heart FailureNo Causal Link Between Plasma Lipids, Diabetic RetinopathyBetter Glycemic Control With Insulin Pump for Youth With T1DPump May Beat Shots for Type 1 DiabetesWhere There's Type 1 Diabetes, Celiac Disease May FollowFlu Shot Key for People With DiabetesMaking Halloween a Treat for Kids With DiabetesPay for Performance Cuts Mortality in Diabetes PatientsAddition of DPP4i to AGI Reduces HbA1c in T2DMRare Tumor May Point the Way to Diabetes TreatmentInsulinomas May Hold Key to Diabetes Drug DevelopmentFDA: New Glucose Monitoring System Eliminates Finger PricksFDA Approves New Continuous Glucose Monitor for DiabetesInsulin Dose Not Tied to Cardiovascular OutcomesDiabetes Treatment Failure May Actually Be NonadherenceArtificial Intelligence Can Detect Diabetic RetinopathyMore Than 1 in 10 Patients May Be Overtreated for DiabetesPioglitazone Has Limited Effect in Lipoatrophic DiabetesFracture Risk Higher for Seniors With DiabetesCGM Use in Pregnancy Improves Neonatal OutcomesClosed-Loop Control Benefits T1DM in Prolonged Winter SportHeath Tip: Dining Out If You Have DiabetesExenatide Doesn't Up Cardiovascular Risk in T2DMIncreasing Salt Intake Tied to Diabetes RiskSotagliflozin Linked to Improved Glycemic Control in T1DMGreater Awareness Needed for Potential of T2DM RemissionCan Coffee or Tea Extend Survival With Diabetes?Could Artificial Sweeteners Raise Your Diabetes Risk?Could Swine Flu Be Linked to Type 1 Diabetes?'Upside' to Diabetes Really Isn'tLifestyle Tips for Better Diabetes ControlDiabetes Threatens Kidneys, Vision of Millions of Americans2017 Standards of Medical Care in Diabetes ReleasedBiomarkers Can Predict Rapid Drop in Renal Function in T2DMMany Teens With Type 1 Diabetes Report Disordered EatingCognitive Test Predicts Elderly Insulin Injection SuccessHigher Event Rate of T2DM in Polycystic Ovary SyndromeNovel Genetic Variant in IGF2 Linked to Reduced T2DM RiskFatty Acid Remodeling Seen in T2DM Remission Post Bariatric SxDiacerein Reduces Mean Hemoglobin A1c Levels in T2DMHealth Tip: Risk Factors for PrediabetesTablet Use Encourages Patients to Explore Diabetes RiskOnce-Yearly Counseling Tied to More Physical Activity in T2DM
Links
Related Topics

Medical Disorders

Suicide by Insulin?

HealthDay News
by By Serena Gordon
HealthDay Reporter
Updated: May 19th 2017

new article illustration

THURSDAY, May 18, 2017 (HealthDay News) -- Insulin typically saves the lives of those with diabetes, but it can also be a way for some people to kill themselves, a new review warns.

People with the blood sugar disease tend to suffer higher rates of depression, the researchers explained. And suicide or suicide attempts using insulin or other diabetes medications that lower blood sugar levels may not always be an easy-to-spot attempt at self-harm, they added.

"Some suicides with insulin are likely missed in people with diabetes, just as [suicide may be missed] in people without diabetes using other medications or after a car accident. Could a suicide using insulin be missed? Absolutely," said Alicia McAuliffe-Fogarty, vice president of lifestyle management at the American Diabetes Association.

Insulin is a natural hormone produced by the body. Its job is to help usher the sugar from foods into the body's cells to provide fuel for those cells. But insulin is also a complex medication.

People with type 1 diabetes no longer make enough insulin and must give themselves insulin to stay alive. People with type 2 diabetes don't use insulin efficiently -- this is called insulin resistance -- and eventually don't make enough insulin to keep up with the body's demands. At this point, people with type 2 diabetes also need to take insulin.

Insulin can be given by multiple injections every day or via an insulin pump. Insulin pumps deliver insulin through a small tube that's inserted under the skin. The site of the insulin pump must be changed every few days. But once the tube is in, someone who uses an insulin pump only needs to push a few buttons to deliver a dose of insulin.

However, getting the right amount of insulin is no easy task. Many factors affect the body's need for insulin. Exercise decreases the need. Foods that are higher in carbohydrates increase the need. Stress and other moods can affect the need for insulin, as can illness or hormonal shifts, such as those that occur with menstruation.

People with diabetes often have to make adjustments to their insulin doses. If they make a mistake and take too much, an extremely low blood sugar level (hypoglycemia) can occur. If they give themselves too little insulin, their blood sugar levels rise (hyperglycemia). Either condition can be very dangerous.

According to Dr. Alyson Myers, director of inpatient diabetes at North Shore University Hospital, in Manhasset, N.Y., "If someone comes in with hypoglycemia, you think, 'Oh, they overdid it.' And, sometimes when people come in with hyperglycemia or DKA (a complication of hyperglycemia), the intention to self-harm can be missed."

Myers is also the lead author of the review, published recently in the journal Current Diabetes Reviews.

It's not clear exactly how high the rates of suicide are in people with diabetes, though Myers said the rates are higher than in the general population.

Plus, an attempt at suicide using insulin or other blood sugar-lowering medications may ultimately fail. "The body is a resilient thing," Myers said, explaining that the body has ways to protect itself, such as releasing a natural form of sugar from the liver.

Instead of automatically assuming there was an error in care, Myers recommended that physicians consider the possibility of a suicide attempt or self-harm through the use of insulin and other medications.

She suggested that doctors follow the guidelines from the diabetes association on psychosocial care for people with diabetes that includes a multi-disciplinary team, including a behavioral health specialist.

McAuliffe-Fogarty agreed that when doctors see patients -- whether it's in the hospital or for an office visit -- they should screen for psychosocial concerns.

If a doctor identifies a potential concern, "refer to a mental health care provider so people can get the help they need to live a full and happy life," she said.

Given that 20 percent to 25 percent of people with diabetes screen positive for depressive symptoms at some point, people may need help sometimes.

"If you see signs of depression, changes in people's sleep patterns or eating behaviors, a loss of interest in things they once enjoyed; if they say things like, 'when I'm not here things will be better,' or express an intention to self-harm, make an appointment with a mental health-care provider. People often need some help coping and figuring out how to deal with things," McAuliffe-Fogarty said.

"If you're very nervous that they might harm themselves, call their doctor or bring them to the hospital. Or call 911 if you think they're in immediate trouble," she advised.

If you're concerned that a loved one or friend may be considering suicide, McAuliffe-Fogarty said it's OK to ask, though some people consider the word suicide to be taboo. "Ask, 'Are you thinking of hurting yourself or thinking of not being here?' Sometimes people are relieved and will open up."

But McAuliffe-Fogarty also cautioned that every misuse of insulin may not be a deliberate act of self-harm.

"It's not always self-harm or a suicide attempt," she stressed.

One such example, "Some people use insulin omission to lose weight. It's a type of disordered eating, but they're not trying to hurt themselves," she explained.

More information

Learn more about how to identify someone who may be thinking about suicide and ways to help them from the National Suicide Prevention Lifeline.