Insulin: Baseball's Newest PED by Will Caroll

guy swinging batFor the last year and especially over the last few months since the Mitchell Report was unleashed, baseball has been atwitter with how to deal with human growth hormone, or HGH. I’ve been on TV and radio countless times over the last few weeks and they all ask me what can baseball do? I simply shake my head and say “Why do anything? HGH is expensive, ineffective, and isn’t being used any more.” What are they using? It appears that baseball players are learning that insulin can help more than just diabetics.

Athletes tend to be early adopters. While baseball lags behind bodybuilding and football in the use of PEDs, mostly due to the structure of the game and the athletic demands more than any reluctance to use whatever’s handy, they may be ahead of the curve in the use of insulin. Of course, baseball’s testers are also noticing. As early as 2004, Dr. Gary Green, Bud Selig’s handpicked steroid expert, has been noting the use of insulin in sport. While there’s some academic discussion of insulin’s anabolic properties that can be found online, it’s still the cutting-edge musclehead scientists that are staying ahead of the curve.

The problem for MLB and for any sport where insulin can be used as a PED is that it’s difficult to police, impossible to test for, and most importantly, very difficult to change perceptions about. Sports, led by WADA and the Olympic movement, have made “steroids” a bad word, a generic concept that’s associated with cheating. Few if any sports fans know that steroids have valid medical uses or that they can be used safely and effectively for what some have no come to call “cosmetic usage.” For baseball players, especially pitchers, it is insulin’s effect on muscle breakdown that offers the most positives.

HGH was thought to help speed recovery, a must for a player returning from injury or just recovering from a back-to-back usage out of the bullpen. Players are often seen losing not only weight but muscle mass over the course of a season due to high temperatures and an inability to keep up a normal workout schedule. While the explosive anabolic gains that many expect to see from a potent substance like insulin aren’t going to be visible, the reduction of losses is just as important to many players.

The upside for players is that “hacking” insulin sensitivity is relatively easy. Popular diets like Atkins are rough ways of changing the body’s sensitivity and use of insulin. As well, the cheap access to insulin, needles, and monitoring supplies are a far cry from the shady online pharmacies, gym sources, and questionable vial contents that are necessary for HGH in most cases. In both cases, the scientific process by which “bio-identical” substances are created makes both HGH and insulin nearly impossible to test for in urine.

While there is some progress being made for both a blood and urine test for HGH, As well, there’s a natural acceptance of insulin usage. Ron Santo, the Cubs great that is now a beloved announcer, has fought diabetes and has raised millions for diabetes research. Pitcher Jason Johnson wears his insulin pump on his uniform belt to help manage his diabetes. While there’s a far cry from the need for insulin that Johnson and other diabetics have, the perception of insulin as a helpful, necessary drug is a benefit. The broad usage of insulin and more advanced insulin controlling substances, such as Avandia and Byetta, in the general public makes it easier to get and use these drugs for other purposes.

The downside to insulin usage aside from diabetics is the chance of that an inexact dosage could lead to physical problems or even death. This is an extreme case, but since non-diabetics aren’t used to the physical signs of insulin overdose, these individuals seldom know how to deal with it. They are also reluctant to seek professional help. Even so, there are no recorded deaths or even adverse events through the off-label usage of insulin or other diabetes control drugs. This, to me, is interesting in that the risk seems much higher than necessary to see some adverse events. I sense that the broad usage of insulin in the general population and its relatively unknown status as a PED is keeping this from being reported. Even so, the dangers may simply be overblown. Insulin overdoses are rare and easily dealt with in most situations. Baseball players aren’t beating down the door of their local diabetic or learning to fake the symptoms the way they did in order to move to Adderall when their greenies were banned.

Insulin, like most PEDs, is being used by a relative few athletes who believe they’re merely getting an edge by using a substance that can be effective and is not banned. The question now is whether they’ll see enough gains that we’ll get a “halo effect”, getting other people to seek out that same edge when they see results. That’s almost always followed by a cat and mouse game of panic and testing. Instead of dealing with the real problems, Baseball is often happy to seek out targets to demonize. While MLB is wasting its time working on HGH, players are figuring out the right dosage of insulin and chemists are looking for the next new hot thing.

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