**5. Insulin abuse**

An interesting, still not fully explained phenomenon, connecting toxicology, diabetology, and psychiatry, is abuse of insulin as a psychoactive substance. Intentional abuse of insulin is quite rare, but not exceptional. Pudlo et al. described an insulin abuser—the 58-year-old patient who injected himself with overdoses of insulin or consumed considerable amounts of pure sugar to increase its dose [53]. No other reason for his insulin abuse was found than pleasure seeking. According to the patient, he felt "pleasure" after insulin. Sheehy has counted 55 cases of patients developing hypoglycemic episodes by intentional insulin injecting [54]. Sometimes people suffering from Munchausen syndrome can also apply themselves an excessive dose of the drug to cause factitious hypoglycemia and get to the hospital [7, 55]. In the case of Munchausen syndrome by proxy (per procuram), the victims may be the relatives, most often children [56].
