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Expert offers insight on how insulin is used in treatment of diabetes after nurse accused of using it to kill 4, attempt to kill others

A woman shows her insulin kit on Jan. 17, 2020, in St. Paul, Minnesota. (Kerem Yucel/AFP via Getty Images/TNS)

If a non-diabetic patient is injected with insulin, that person’s life could be at risk, according to an expert at Allegheny Health Network.

After Heather Pressdee, a registered nurse, was accused of administering lethal doses of insulin and killing four people at two Butler County nursing homes, the vice-chief director of clinical operations in the division of endocrinology at Allegheny Health Network spoke about how insulin should be handled.

“It can be life-threatening; it can produce hypoglycemia, or extremely low blood sugar,” Dr. Amit Bhargava said. “Our bodies need blood sugar at a certain level to function, our brain needs blood sugar to function.”

Heather Pressdee
Heather Pressdee

Pressdee is accused of killing four people at two Butler County nursing homes and is linked to the deaths of six others in charges filed between May and on Thursday.

She is accused of killing two people and attempting to kill four others at Sunnyview Nursing and Rehabilitation Home in Butler Township, according to charges filed Thursday.

She was accused in May of killing two people at Quality Life Services in Donegal Township and mistreating another patient. Additional charges in November indicate she attempted to kill two others. Three others survived alleged insulin injections. Two showed signs of hypoglycemia.

She was charged with two counts of first-degree murder in relation to the two deaths.

The charges filed against Pressdee on Thursday relate to the mistreatment of 19 patients at five care facilities across Butler, Armstrong, Allegheny and Westmoreland counties. She worked at 12 facilities between October 2018 and May 2023, including The Orchards of Saxonburg, where she is not facing charges.

Treating with insulin

According to Bhargava of Allegheny Health Network, diabetes comes in two categories: Type 1 and Type 2.

Bhargava said Type 1 diabetes is often detected early, and people are born with the condition. Type-two diabetes develops in a number of ways, either through genetics, lifestyle or illness.

He said when someone’s pancreas doesn’t produce insulin, a hormone that regulates blood sugar, they are diagnosed with diabetes. A diabetic person then receives insulin medically.

“If someone has Type 1 diabetes, they continuously need insulin. Long-acting insulin is in the background and diffuses slowly through the skin throughout the day, and they need it before meals. It’s given to control rising blood sugar,” he said.

A patient with Type 2 diabetes also receives long-acting insulin to control their blood sugar at night and should take some before eating, Bhargava added.

“We advise patients to administer (insulin) 10 to 15 minutes before a meal. It’s to counteract the spike in blood sugar related to meals,” he said.

According to Bhargava, it’s harmful to a diabetic patient when they don’t receive insulin, even life threatening. They could experience thirst, increased urination and lethargy.

A non-diabetic person who is injected with insulin could experience hypoglycemia. Symptoms include irritability, shakiness, confusion, nausea, blurry vision and lethargy.

The condition is indicated when blood sugar level readings are less than 70. According to the Centers for Disease Control and Prevention, a healthy blood sugar level reading is between 70 and 100.

Anyone who “overdoses” on insulin could suffer symptoms, according to Bhargava.

“If they got too much insulin, you would look for signs of hypoglycemia,” Bhargava said. “If you have severe hypoglycemia, you’re altered. People can have seizures, for example.”

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