Self-Induced Insulin Hypoglycemia in a Bodybuilder

Reverter, Jordi L.; Tural, Cristina; Rosell, A.; Domínguez, María García; Sanmartı́, Anna

doi:10.1001/archinte.1994.00420020149016

Cited by 21 publications

(7 citation statements)

References 5 publications

(1 reference statement)

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“…(19)) belong to the prohibited list of substances of the World Anti-Doping Agency but are banned only for athletes not suffering from insulin-dependent diabetes mellitus. The misuse of insulin in sport has been reported manifold, in particular in body building [183][184][185][186], but the question whether insulin is a performance-enhancing drug is not entirely answered yet. Several facts support this hypothesis, e.g.…”

Section: Synthetic Insulinsmentioning

confidence: 99%

Mass Spectrometry in Doping Control Analysis

Thevis¹,

Schänzer

2005

COC

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Mass spectrometry has become the most frequently employed technique in doping control analysis to identify prohibited compounds ever since their use has been banned by international federations. In combination with gas or liquid chromatography and various ionization methods such as electron or chemical ionization, electrospray, atmospheric pressure chemical ionization, atmospheric pressure photo ionization or matrix-assisted laser desorption ionization, numerous applications have been established enabling the sensitive and selective detection of prohibited drugs in matrices such as urine, blood, and hair. The classes of investigated compounds include low molecular weight drugs such as anabolic steroids, diuretics, β 2 -agonists and β-receptor blocking agents, and others as well as high molecular weight therapeutics, for instance plasma volume expanders based on polysaccharide structures (e.g. hydroxyethyl starch and dextran), hemoglobin-based oxygen therapeutics (e.g. Hemopure), or synthetic insulins. Assays for their identification are commonly based on extractive purification, chemical or enzymatic treatment (i.e. derivatization or degradation) followed by chromatographic and mass spectrometric analysis employing various modern analyzers such as quadrupole, ion trap, triple-quadrupole and magnetic-sector mass spectrometers allowing the sensitive and unambiguous qualitative as well as quantitative determination of xenobiotics in elite athletes' doping control samples. Moreover, the administration of drugs naturally occurring in human beings, for instance testosterone, is uncovered by carbon isotope ratio mass spectrometry that enables the differentiation between endogenous and exogenous sources. The comparison of δ-values obtained from endogenously produced steroids independent from testosterone and its metabolism with urinary testosterone and its metabolic products allow the determination of surreptitious applications.

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Section: Synthetic Insulinsmentioning

confidence: 99%

Mass Spectrometry in Doping Control Analysis

Thevis¹,

Schänzer

2005

COC

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“…All these facts are considered relevant also for doping control analysis as, according to regulations of the World Anti‐Doping Agency (WADA), the use of insulin is prohibited for athletes except for those suffering from insulin‐dependent diabetes mellitus (IDDM) 12. The misuse of insulin in sport has been reported manifold, in particular in body building,13–16 but the question whether insulin is a performance‐enhancing drug is not entirely answered yet. Several facts support this hypothesis, e.g.…”

Section: Methodsmentioning

confidence: 99%

Identification of oral antidiabetics and their metabolites in human urine by liquid chromatography/tandem mass spectrometry—a matter for doping control analysis

Thevis

Geyer

Schänzer

2005

Rapid Comm Mass Spectrometry

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Since 1999, insulin belongs to the list of prohibited substances of the International Olympic Committee and the World Anti-Doping Agency. Except for patients suffering from insulin-dependent diabetes mellitus, the administration of insulin is not allowed. Therapeutics developed to treat non-insulin-dependent diabetes mellitus act as releasing factors of endogenously produced insulin or improve its efficiency mediating the glucose uptake into insulin-dependent tissues. Hence, these compounds are also relevant for sports drug testing, and a fast, robust, and sensitive assay was developed to identify 12 oral antidiabetic agents or respective hydroxylated metabolites in human urine. Urine specimens are enzymatically hydrolyzed; target analytes are extracted by liquid-liquid extraction and identified by means of liquid chromatography interfaced to tandem mass spectrometry by electrospray ionization. Detection limits of respective drugs ranged between 10 and 30 ng/mL, metabolites of therapeutics were characterized by diagnostic fragmentation pathways upon collisionally activated dissociation of protonated molecules, and general fragmentation routes were proposed.

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“…Other reports also indicate that insulin abuse can lead to hypoglycaemia and even coma and death. 50,51 There are two types of IGF-I preparations: IGF-I used alone and IGF-I used with its binding protein IGFBP-3. Combining IGF-I with IGFBP-3 results in less severe sideeffects and longer half-life resulting in a sustained increase in circulating IGF-I levels.…”

Section: Insulin and Igf-imentioning

confidence: 99%

Doping in sport: effects, harm and misconceptions

Birzniece

2015

Internal Medicine Journal

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Doping in sport is a widespread problem not just among elite athletes, but even more so in recreational sports. In scientific literature, major emphasis is placed on doping detection, whereas detrimental effects of doping agents on athletes' health are seldom discussed. Androgenic anabolic steroids are well known for their positive effects on muscle mass and strength. Human growth hormone also increases muscle mass, although the majority of that is an increase in extracellular fluid and not the functional muscle mass. In recreational athletes, growth hormone does not have major effect on muscle strength, power or aerobic capacity, but stimulates anaerobic exercise capacity. Erythropoietin administration increases oxygen-carrying capacity of blood improving endurance measures, whereas systemic administration of beta-adrenergic agonists may have positive effect on sprint capacity, and beta-adrenergic antagonists reduce muscle tremor. Thus, there are certain drugs that can improve selective aspects of physical performance. However, most of the doping agents exert serious side-effects, especially when used in combination, at high doses and for a long duration. The extent of long-term health consequences is difficult to predict, but likely to be substantial, especially when gene doping is considered. This review summarises the main groups of doping agents used by athletes, with the main focus on their effects on athletic performance and adverse effects.

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Self-Induced Insulin Hypoglycemia in a Bodybuilder

Cited by 21 publications

References 5 publications

Mass Spectrometry in Doping Control Analysis

Mass Spectrometry in Doping Control Analysis

Identification of oral antidiabetics and their metabolites in human urine by liquid chromatography/tandem mass spectrometry—a matter for doping control analysis

Doping in sport: effects, harm and misconceptions

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