Related Experiment Video

Updated: Feb 27, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

19.4K

A case report of methadone-associated hypoglycemia in an 11-month-old male

Michael S Toce1, Margaret A Stefater2, David T Breault2

  • 1a Harvard Medical Toxicology Program , Boston Children's Hospital , Boston , MA , USA.

Clinical Toxicology (Philadelphia, Pa.)
|June 27, 2017
PubMed
Abstract

Insights

An 11-month-old experienced severe hypoglycemia after unintentional methadone exposure. This case suggests methadone can induce hyperinsulinism, leading to low blood sugar and requiring differential diagnosis consideration.

Area of Science:

  • Pediatric Endocrinology
  • Toxicology
  • Pharmacology

Background:

  • Methadone, a synthetic opioid agonist, is used for pain and opioid dependence management.
  • Overdose can lead to respiratory depression, CNS depression, and miosis.
  • Hypoglycemia is a rare but reported adverse effect of methadone.

Observation:

  • An 11-month-old male presented with respiratory failure and miosis after unintentional methadone exposure.
  • Lab results revealed severe hypoglycemia (17 mg/dL), elevated insulin, and suppressed beta-hydroxybutyrate.
  • Other causes of hypoglycemia were ruled out, and a fasting study confirmed normal glucose regulation.

Findings:

  • The patient developed hypoketotic, hyperinsulinemic hypoglycemia following acute methadone exposure.
  • Methadone levels were significantly elevated.
  • This presentation suggests methadone-induced insulin secretion as the cause of hypoglycemia.

Implications:

  • Hyperinsulinism is proposed as the mechanism for methadone-associated hypoglycemia.
  • Methadone exposure should be considered in the differential diagnosis of new-onset hypoglycemia.
  • This finding is crucial for pediatric emergency medicine and toxicology.
Keywords:
Pediatrichyperinsulinismopioidoverdose

More Related Videos

Biochemical Measurement of Neonatal Hypoxia13:13

Biochemical Measurement of Neonatal Hypoxia

Published on: August 24, 2011

14.4K
Inducing Post-Traumatic Epilepsy in a Mouse Model of Repetitive Diffuse Traumatic Brain Injury07:07

Inducing Post-Traumatic Epilepsy in a Mouse Model of Repetitive Diffuse Traumatic Brain Injury

Published on: February 10, 2020

11.4K

Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
1.1K
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
957
SBAR II: Application of SBAR01:14

SBAR II: Application of SBAR

SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
6.3K
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
289
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
5.2K
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
948