The death of a bodybuilder who used non-prescribed insulin to build muscle bulk has exposed a lack of guidelines for GPs when managing patients who use performance enhancing drugs, a coroner says.

Jesse Drabsch, 31, was found unconscious on 16 November 2017, some 20 hours after he collapsed in a Sydney gym bathroom following a workout.

His glucose level was just 1.2mmol/L and a rapid-acting insulin 300 IU pen was later discovered in his gym bag. Subsequent investigations revealed that he had very recently purchased two pens online using bitcoin.

He died after his life support was removed due to severe brain damage that doctors attributed to his critically low glucose levels.