Forensic Hypoglycaemia & Neuroglycopenia — A Clinical Legal Social Endocrinology Challenge for 2024, Forensic Law in Hypoglycaemia 4
Authors: Beatty Derek C , Yap Christina G 
Published: April 2024

The author, Derek Beatty, was diagnosed with T1D Diabetes 45 years ago when living in High Wycombe, Buckinghamshire, England. Symptoms of thirst, tiredness, difficulty in reading small print, led to GP doctor consultation with fasting blood glucose Biochemistry tests. Possible Genetic Inheritance may have contributed to reduced Immunogenic resistance to infection possibly triggered from business travel to several African Countries including Kenya, Zambia, Nigeria, Sudan, Egypt, South Africa. Add the trauma as witness to a fatal car crash in Bricket Wood, St Albans, when a driver of a Rolls Royce crashed into the rear of a lorry in the dark on an October afternoon. With a natural Adrenalin trigger to help in an emergency and First Aid training when in a Scout Group in Edinburgh, to stop and assist, comfort the car driver, shout for an ambulance when others appeared. An ambulance arrived promptly (before the era of Mobile Phones), Paramedics took over with hospital transfer. This frightening event has left a vivid memory flashback scar along with near fatal Hypoglycaemia with Neuroglycopenia scars. The Police called 3 days later and requested a witness statement. There was no hesitation to be able to help. When asked about the car driver welfare the answer was that he had suffered severe neurological injury and sadly died. What followed was a correct Fatal Accident Inquiry before a Coroner identifying Accidental Death. With courage the wife and family spoke after to thank me for doing my best to help save the driver, but sadly he had passed. We hope and pray he rests in peace. This tragic experience has left a strong sense of courage and determination in the belief that prevention is better than cure. When, and if tragedy occurs, what might have been the cause always helps in learning and education and often offers future opportunity to enable prevention. We can learn from tragedy and take steps to forensically identify cause and seek to prevent recurrence. The experience of near fatal Diabetes Hypoglycaemia and Neuroglycopenia caused by ignorance and failure to educate a family what to do in a diabetes hypoglycaemia emergency involving the Hormone Insulin with NHS GP mismanagement and Gross Negligence in Public Office cover up, when combined with an Addisonian Adrenalin Crisis, both with Neuroglycopenia and Simultaneous, has led to 30 years forensic research of the event cause with identified errors in Law justifying disclosure and loss recovery from those responsible for legal errors. Today with global interest and helpful personal clinical support from an excellent Diabetes Endocrinology Team of Clinicians and Nurses in Edinburgh and recognition with interest from many clinicians and nurses worldwide of the importance of this work has enhanced personal positivity to succeed and Win in Insulin Chicanes when at the same time treating an incurable long term health condition requiring daily injections of the hormone Insulin platformed with dose adjustment to target normoglycaemia and accommodate lifestyle while addressing insulin dose and type; exercise; diet; differences in carbohydrate and fat content in foods; interest in Keto style diet; fruit; vegetables; food sugar content; adverse stress: happiness; family and friendship encouragement and support; education of damage of excess alcohol; smoking; recreational drugs; and the link to the medical mystery. Summary review of Virological attack associated with Obesity, Overeating, Alcohol, risk of Foetal Alcohol Spectrum Disorder, Smoking, triggers for Parkinson’s Disease, Dyslexia, certain Ophthalmic conditions with possible links e.g., Nystagmus linked to Dyslexic, Genetically Inherited Addison’s Disease possibly from India after discovery by Thomas Addison in 1860 and add the Insulin Journey from discovery Banting, Best, Macleod, Collip, 1922, and the World’s First Hypoglycaemia Event with Neuroglycopenia experienced as a Clinical Event by Dr Jim Gilchrist and in L:aw recognised as Such by Banting, Best, Macleod, Collip, and Toronto Police, Canada at the time. Yes, Insulin can be used as a Poison, but it is a lifesaving Hormone for which today in 2024 all T1D Diabetes patients are exceedingly grateful for the research of over 100 years ago. One must never describe in Law Insulin as a Poison without good cause and reason. Insulin is a Hormone. This is important especially in tragic cases in pregnancy when Gestational Diabetes can occur leading to neonate and young baby infection and on occasion fatality. In 2023 I have experienced Blue Toe Syndrome associated with negative test Long COVID caused by vascular disturbance at toe extremity and Quinsi, very rare in long term Diabetes, sometimes in Tonsilitis during teenage and early adult life, but likely identified as Virological infection caused by Long COVID. Was prevention of Hypoglycaemia Unawareness in 1987–1994 possible? How do we discover? We need to research. We need social recognition and understanding in 2024 as we use this experience to better understand Clinical Hypoglycaemia and Neuroglycopenia in Law. 2023 published awareness of Hypoglycaemia, IDF INTERNATIONAL DIABETES FEDERATION with Immunogenic Issues in Diabetes and Addison’s Disease, has identified implications for COVID-19 Public Health Inquiry Investigation in Scotland. Forensic Aspects of Hypoglycaemia 4, now explores CPS Crown Prosecution Service and Court Reference Redacted in St Albans, Hertfordshire, England, to Correct Errors in Law identified from 1989 when a Law Society registered solicitor in Knutsford, Cheshire, who on the balance of probability, was aware that the Law Society in England at the time had allocated £500,000 in Public Funds to assess whether a case existed to identify Marketing and Safety adverse experience of Hypoglycaemia Unawareness? Investigation led to instances of personal injury and cases of unexplained death in bed syndrome to address a claim for damage experience against the Pharmaceutical Industry. A licence to market BHI Insulin on 26 August 1982 was given after close forensic safety consideration by application to the MHRA at the Department of Health, London. The Licence was granted with provisions that prescribing GP General Practitioner doctors reduced the Insulin dose by up to 20% when prescribed to T1D diabetes patients treated with Porcine or Beef Insulin, prescribed BG Blood Glucose monitoring medical devices to the patient, and provide clear education to the Patient and family members living with the Diabetes Patient, providing care for the patient, and knowing exactly what to do in a Diabetes Hypoglycaemia Emergency, and by default an Endocrine Red Alert Adrenalin Addisonian Crisis. On all counts the GP Practice in St Albans and Bricket Wood, Hertfordshire, failed miserably. When consulted in 1989 by the patient’s wife and sister-in-law the Knutsford solicitor firm failed to disclose known Law Society Investigation update involving Hypoglycaemia and education to the solicitor clients, the patient’s Wife and Sister-in-Law, and instead sent a libelous letter to the patient in 1989 with redisclosure in 1994. Character defamation of the patient in 1989 and 1994 is forensically identified in 2024 as clinical behavioural temporary mental health when in a state of hypoglycaemia unawareness and can be demonstrated in the animal rat model showing inferior quality Purkinje Cell Environmental Enrichment with insulin overdose or underdose leading to hyperglycaemia which when under corrected can lead to diagnose of T2D Type 2 Diabetes often associated with diet, lack of exercise, poor keto diet experience, alcohol abuse leading to obesity. In 2000, a request to the Court for medical notes disclosure was described as a ‘Fishing Trip’. Again in 2005 an Insurance Broker completely ignorant of Diabetes and Hypoglycaemia misled the court. Disclosure December 2020 by a Transaction Director, London, of the Firm EY, is identified as failure to identify and seek NHS help to address likely Genetically Inherited Addison’s Disease in an NHS patient, first suspected in 1994 when the GP Practice failed to act, then in March 1996 when the Official Solicitor was invited to investigate with referral failure. 2024 Forensic Analysis has identified opportunities to act and correct errors in law, nothing was done, why? In 2024 we investigate the cause of Suicide on 11 October 2020 in Alban Manor Nursing Home, St Albans, during COVID-19 Pandemic of Addison’s Disease Patient. Despite aged 79 her life could have been saved but alleged negligence in breach of the Mental Health Act 1983 caused the death with failure to take into account warnings from the Banting Lecture 1994 Hypoglycaemia, Real or Unreal, Lawful or Unlawful with Addison’s Disease Suicide. Under European Human Rights Law, The Human Rights Act 1998, and European Convention on Human Rights, a Public Immunity Argument exists to publish to learn from experience to prevent reoccurrence with implications to assist COVID-19 Public Health Inquiry Investigation.