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Updated: May 22, 2025
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Homogeneous Time-resolved Förster Resonance Energy Transfer-based Assay for Detection of Insulin Secretion
Published on: May 10, 2018
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Insulinoma Mimic: Tramadol-induced Hypoglycemia
Shannon O'Hara1, Tyler Hinshaw1, Mathew McKenzie1
1Department of Internal Medicine, West Virginia University School of Medicine, Morgantown, WV 26506, USA.
JCEM Case Reports
|March 14, 2025
Summary
Severe hyperinsulinemic hypoglycemia can be caused by tramadol, a common pain reliever. This case highlights the importance of considering medications when diagnosing the cause of hypoglycemia.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Endogenous hyperinsulinemic hypoglycemia presents with diverse causes.
- Identifying the etiology is crucial for effective patient management.
Observation:
- A patient presented with severe hyperinsulinemic hypoglycemia and altered mental status.
- Initial investigations, including a negative sulfonylurea screen and non-diagnostic imaging, ruled out common causes like insulinoma.
- The patient had recently started tramadol for back pain.
Findings:
- Hypoglycemia resolved after discontinuing tramadol.
- Tramadol is a potential cause of hypoglycemia, particularly in the elderly.
- Tramadol may stimulate insulin secretion via μ-opioid receptors on pancreatic beta cells.
Implications:
- Clinicians should consider tramadol and other analgesics in the differential diagnosis of endogenous hyperinsulinemia.
- This case underscores the need for comprehensive medication review in patients with unexplained hypoglycemia.
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