More and more athletes may be taking insulin to boost their performance illegally, Ā鶹“«Ć½ has learned. Insulin is almost impossible to detect using dope tests. Worse still, the hormone could kill if wrongly administered.
Doctors in Britain are increasingly worried by anecdotal reports that athletes are taking insulin, the life-saving drug used by many diabetics. Bodybuilders pioneered the illegal use of insulin several years ago, but evidence that the habit is spreading to other sports has remained sketchy.
Harder evidence that insulin is being abused in sport has now emerged from a confidential needle exchange scheme for bodybuilders and other sports enthusiasts, run in the north of England by family doctor Rob Dawson.
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He says that at least 10 per cent of his 450 regular patients have admitted to using the drug ā an increasing number of them non-bodybuilders. āItās spreading outside bodybuilding,ā he says. Most get it from friends who are diabetics.
āIncorrectly administered, it could kill you stone-dead or leave you as a vegetable,ā says Peter Sonksen, a specialist in the study of insulin at Guyās, Kingās and St Thomasā School of Medicine in London.
Muscle and staying power
His warnings come as the athletics world championships draw to a close in Edmonton, Canada. Asked if insulin might have been used there illegally, Sonksen said: āIf you believe the street talk, itās inevitable.ā
āI would think itās highly likely,ā agrees Dawson. āIād be extremely surprised if there are not elite athletes using insulin.ā
Insulin helps athletes in two ways. In bodybuilders, it works alongside anabolic steroids such as testosterone or human growth hormone to consolidate muscle tissue. Steroids spawn new muscle, and insulin prevents it from being broken down.
Insulin also bolsters stamina in middle-distance runners and other track performers by enabling them to load their muscles with glycogen āfuelā before and between events. To do this, athletes would need to take insulin and glucose simultaneously for a couple of hours, infusing them using a technique called a hyperinsulinaemic clamp.
In the long term, taking anabolic steroids for non-medical uses can damage reproductive health. But an overdose of insulin can quickly trigger a fatal coma by clearing so much sugar from the blood that the brain is starved of energy and oxygen.
Undetectable
The temptation for sportsmen and women is obvious, however. Insulin vanishes rapidly from the body, with half of it gone in as little as four minutes. Even if it was detected, thereād be no way to distinguish it from a personās own insulin. āThe chance of catching it is just about zero,ā says Sonksen. āInsulin is a complete nightmare, and thereās no way I can dream of that you could pick it up in a dope test.ā
āThereās no documental proof that this technique is being used, but informed āstreet talkā indicates that it is not uncommon,ā writes Sonksen in the current issue of Journal of Endocrinology (vol 170, p 13).
Experiments by Sonksen and others have suggested that hyperinsulinaemic clamps can increase the rate of glucose metabolism up to twelvefold. āYou can use it to pump up muscle glycogen,ā he says.
Sports and government authorities acknowledge that thereās a growing problem, but are at a loss over how to deal with it. āOne of the general concerns is that itās easily obtainable,ā says Michele Verroken, head of the anti-doping programme at UK Sport, Britainās sports governing body. āThese things are entirely feasible, and weāre trying to close as many loopholes as we can.ā
Prohibited substance
Since August 1998, partly because of fears that black-market insulin was finding its way into bodybuilders, insulin has been a prohibited substance in Britain, obtainable only on prescription. But Verroken admits that athletes can and do get it.
Insulin was banned by the International Olympic Committee in 1998. But the ban doesnāt apply to diabetic athletes, whose health depends on insulin. Verroken says this is not a problem, however. āWe shouldnāt say that people who are diabetic are gaining an advantage,ā she says.
Diabetes UK, which represents the countryās diabetics, acknowledges that there might be a temptation for some diabetics to supply insulin to athletes who are friends. But it sees no point advising diabetics not to do this. āWeāve never warned people not to sell on their insulin because we feel thereās little we can do if people want to do that,ā says a spokeswoman.
Meanwhile, the only possible solution in the locker room is to catch people red-handed with the drugs. āOnly by using police tactics such as searching and detaining could you stop it, but thatās a controversial area,ā says Sonksen.
