Strong diabetes.

Area of Science:

• Endocrinology
• Sports Medicine
• Toxicology

Background:

• A 36-year-old male professional bodybuilder with a 15-year history of anabolic steroid and human growth hormone (hGH) misuse presented with right upper quadrant pain.
• The patient had a history of significant substance misuse, indicating long-term exposure to performance-enhancing drugs.

Observation:

• Physical examination revealed mild hepatomegaly (enlarged liver) and significantly elevated random blood sugar levels (30.2 mmol/l).
• Biochemical tests indicated hepatitis and acute renal failure, but no ketonuria or acidosis was present.
• The patient's presentation was acute, suggesting a rapid onset of severe metabolic and organ dysfunction.

Findings:

• The patient was diagnosed with hepatitis and acute renal failure, alongside severe hyperglycemia.
• Conservative treatment, including insulin therapy and intravenous fluids, successfully resolved the hepatitis and hyperglycemia.
• This case represents the first reported instance of overt diabetes mellitus directly caused by supraphysiological recreational use of human growth hormone.

Implications:

• Supraphysiological doses of human growth hormone can precipitate frank diabetes mellitus, even in the absence of other diabetic risk factors.
• This case underscores the critical need for medical monitoring and awareness of the severe endocrine and metabolic complications associated with non-prescribed use of growth hormone.
• Healthcare professionals should be vigilant for these potential complications in individuals misusing performance-enhancing drugs, particularly bodybuilders.