Growth Hormone Deficiency (GHD) and Other Indications for Growth Hormone Therapy – Adult and Transition from Childhood
29 de março de 2021Neuropathic Pain
29 de março de 2021Checklist for Therapeutic Use Exemption (TUE) Application:
Diabetes
Prohibited Substances: Insulin
This Checklist is to guide the athlete and their physician on the requirements for a TUE application that will allow the TUE Committee to assess whether the relevant ISTUE Criteria are met.
| • | TUE Application form must include: | |
| • | All sections completed in legible handwriting | |
| • | All information submitted in [language] | |
| • | A signature from the applying physician | |
| • | The Athlete’s signature | |
| • | Medical report should include details of: | |
| • | Medical history: symptoms, age at onset, course of disease, start of treatment,
hypoglycaemia, diabetic ketoacidosis, diabetes-related complications (where applicable) |
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| • | Interpretation of symptoms, signs and test results by physician | |
| • | Diagnosis based on international criteria (fasting blood glucose/glucose tolerance test/ A1C or random blood glucose) |
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| • | Type of insulin prescribed including dosage, frequency, administration route | |
| • | Diagnostic test results should include copies of: | |
| • | Laboratory tests (e.g., A1C profile, blood glucose) | |
| • | Oral glucose tolerance test results (if done) | |
| • | Additional information included | |
| • | As per ADO specification | |
Please note that the completed TUE application form alone is not sufficient; supporting documents MUST be provided. A completed application and checklist DO NOT guarantee the granting of a TUE. Conversely, in some situations a legitimate application may not include every element on the checklist.
