Review of the lethal mechanism of insulin poisoning and the characteristic of forensic identification

•We concluded that the potential causes of death from insulin poisoning were hypoglycemic brain injury and cardiac death.•The forensic pathological manifestations and forensic identification of bodies with insulin poisoning were presented.•A variety of testing methods and samples are listed for forensic identification of related cases. Insulin, as the only hypoglycemic hormone in the body, plays a key role in blood sugar control. However, excessive insulin intake can lead to insulin poisoning and even death, which often occurs in clinical and forensic work. At present, some researches on insulin poisoning have been carried out at home and abroad, however, it seems that the mechanism and forensic characteristics of insulin poisoning are not clear and complete. Therefore, in this paper, we reviewed the potential mechanism of insulin poisoning, the methods of insulin detection and the forensic identification of poisoning cases, aiming at providing services for the forensic identification of insulin poisoning.