Association of tanning injection with hypercortisolism, hyperglycaemia and ketosis in type 1 diabetes mellitus
DOI:
https://doi.org/10.15277/bjd.2025.475Keywords:
tanning injection (Melanotan 2), hypercortisolism, hyperglycaemia, ketosis, type 1 diabetes mellitusAbstract
A 39-year-old man with type 1 diabetes mellitus (T1DM) presented with vomiting, hypertension, a tanned appearance, diabetic ketosis without acidosis, and hypercortisolism. It was found that he had been using TruTan (Melanotan 2) for a prolonged period. Melanotan 2 is a non-selective melanocortin-receptor agonist that induces skin and hair pigmentation but also has the potential to cause side effects such as nausea, vomiting, weight loss, spontaneous penile erections and increased sexual arousal. This case report highlights the potential for endocrine and metabolic complications associated with the unlicensed use of TruTan (Melanotan 2), in people with T1DM, emphasizing the need for awareness of these risks in clinical practice.
References
Harno E, Gali Ramamoorthy T, Coll AP, White A. POMC: the physiological power of hormone processing. Physiol Rev 2018; 98(4):2381-2430. https://doi.org/10.1152/physrev.00024.2017. PMID: 30156493; PMCID: PMC6170974.
Markov DD, Dolotov OV, Grivennikov IA. The melanocortin system: a promising target for the development of new antidepressant drugs. Int J Mol Sci 2023;24(7):6664. https://doi.org/10.3390/ijms24076664. PMID: 37047638; PMCID: PMC10094937.
Dall'Olmo L, Papa N, Surdo NC, Marigo I, Mocellin S. Alpha- melanocyte stimulating hormone (α-MSH): biology, clinical relevance and implication in melanoma. J Transl Med 2023;21(1):562. https://doi.org/10.1186/s12967-023-04405-y. PMID: 37608347; PMCID: PMC10463388.
Micioni Di Bonaventura E, Botticelli L, Tomassoni D, et al. The melanocortin system behind the dysfunctional eating behaviors. Nutrients 2020;12(11):3502. https://doi.org/10.3390/nu12113502. PMID: 33202557; PMCID: PMC7696960.
Wallis N, Raffan E. The genetic basis of obesity and related metabolic diseases in humans and companion animals. Genes 2020; 11(11):1378. https://doi.org/10.3390/genes11111378.
Thurston L, Hunjan T, Mills EG, et al. Melanocortin 4 receptor agonism enhances sexual brain processing in women with hypoactive sexual desire disorder. J Clin Invest 2022; 132(19):e152341. https://doi.org/10.1172/JCI152341. PMID: 36189794; PMCID: PMC9525110.
Brennan R, Wells JG, Claire M, Hout V. An unhealthy glow? A review of melanotan use and associated clinical outcomes. Perform Enhanc Health 2019;3:78–92. https://doi.org/10.1016/j.peh.2015.06.001
Evans-Brown M, Dawson RT, Chandler M, McVeigh J. Use of melanotan I and II in the general population. BMJ 2009;338:b566. https://doi.org/ 10.1136/bmj.b566. PMID: 19224885.
Bernasconi S, Torresani T, Illig R. The effect of alpha-MSH on plasma growth hormone, cortisol and TSH in children. J Clin Endocrinol Metab 1975;40(5):759-63. https://doi.org/10.1210/jcem-40-5-759. PMID: 165218.
Peters B, Hadimeri H, Wahlberg R, & Afghahi H. Melanotan II: a possible cause of renal infarction: review of the literature and case report. CEN Case Reports 2020;9(2):159–161. https://doi.org/10.1007/s13730-020-00447-z
Habbema L, Halk AB, Neumann M, Bergman W. Risks of unregulated use of alpha-melanocyte-stimulating hormone analogues: a review. Int J Dermatol 2017;56(10):975-80. https://doi.org/10.1111/ijd.13585. Epub 2017 Mar 7. PMID: 28266027.
Paurobally D, Jason F, Dezfoulian B, Nikkels AF. Melanotan- associated melanoma. Br J Dermatol 2011;164(6):1403-5. https://doi.org/10.1111/j.1365-2133.2011.10273.x. Epub 2011 May 13.
Kaski D, Stafford N, Mehta A, Jenkins IH, Malhotra P. Melanotan and the posterior reversible encephalopathy syndrome. Ann Intern Med 2013;158(9):707-8. https://doi.org/10.7326/0003-4819-158-9-201305070-00020. PMID: 23648958.
DermNet (2023, June 27). Melanotan II. DermNet®. https://dermnetnz.org/topics/melanotan-ii
Faulkner LD, Dowling A, Stuart RC, Nillni EA, Hill JW. Reduced melanocortin production causes sexual dysfunction in male mice with POMC neuronal insulin and leptin insensitivity. Endocrinology 2015;156(4):1372–85. https://doi.org/10.1210/en.2014-1788
Hadley ME, Dorr RT. Melanocortin peptide therapeutics: historical milestones, clinical studies and commercialization. Peptides 2006;27(4):921-30. https://doi.org/10.1016/j.peptides.2005.01.029. Epub 2006 Jan 18. PMID: 16412534.
King SH, Mayorov AV, Balse-Srinivasan P, Hruby VJ, Vanderah TW, Wessells H. Melanocortin receptors, melanotropic peptides and penile erection. Current Topics in Medicinal Chemistry 2007;7(11): 1098–1106. https://pubmed.ncbi.nlm.nih.gov/17584130/
Hussain A, Farzam K. (2023). Setmelanotide. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK589641/
Gilhooley E, Daly S, McKenna D. Melanotan II user experience: a qualitative study of online discussion forums. Dermatology 2021;237(6):995-999. https://doi.org/10.1159/000514492. Epub 2021 Aug 31. PMID: 34464955.
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