Warning on insulin misuse by bodybuilders

Insulin is being misused by bodybuilders as a performance and image enhancing drug, a coroner has warned after an inquest found a 31-year old man died of hypoglycaemia in a Sydney gym.

When found unconscious, the man had a glucose level of 1.2mmol/L and his bag was found to contain a rapid-acting insulin pen that had been bought illicitly online, according to investigators.

Giving expert evidence, endocrinologist Professor John Carter said bodybuilders might be using insulin because it helps muscles replenish their glycogen stores, and hypoglycaemia can increase output of growth hormone from the pituitary gland. Professor Carter noted that the man was also using a thyroid hormone analogue which ultimately increases blood supply to the peripheral tissues, which could increase the rate of absorption of insulin induced by exercise.

The inquest heard that the man had visited several GPs and an endocrinologist, who had counselled him to stop using anabolic steroids and other supplements, but he never disclosed his use of insulin.

Osteoporosis risk with DFU

The immobility resulting from diabetes-related foot ulceration (DFU) puts people at risk of osteoporosis and falls, Australian research has shown.

A study of 22 people hospitalised for DFU showed they had a significant decline in bilateral total hip and femoral neck bone mineral density over a 12 week period.

There were no changes in total lean and fat mass, muscle strength, or physical activity, but the findings nevertheless have implications for fracture risk, said researchers from the University of WA.

“Whilst further research is required, people hospitalised for DFUs may benefit from BMD monitoring and evaluation of falls risk,” they wrote in Nature Scientific Reports.

Tobacco sales ban is next step for smoke-free Australia

The government must set an ‘end date’ to phase out retail sales of tobacco altogether if it is to meet its goal of reducing smoking to below 5% by 2030, public health advocates say.

Writing in the MJA, Associate Professor Coral Gartner of the University of Queensland says the continuing availability of tobacco from retail outlets normalises smoking as a behaviour for young people and the only realistic action plan to reduce consumption is to reduce the number of retail outlets.

The authors say industry self‐regulation and other voluntary approaches will not reduce tobacco retailing, and there is a need to adopt approaches such as a restricting sales to a limited number of licensed dealers or putting tobacco on prescription.

Setting an end date for tobacco sales will also focus efforts on smoking cessation and force the government to plan for an end to tobacco tax revenue, they write.