A Metabolic Storm: Clinical Warburg Effect in Poorly Differentiated Colorectal Adenocarcinoma

Several theories have been proposed to explain the Warburg effect, a metabolic phenomenon increasingly recognized across both hematological and solid malignancies. We report a case in which both asymptomatic hypoglycemia and type B lactic acidosis developed a few months following the diagnosis of metastatic poorly differentiated colorectal adenocarcinoma. The patient had no symptoms despite having severely low blood glucose levels reaching the 20s (mg/dL), which could not be corrected by standard medical management and only responded to the chemotherapy regimen. The possible mechanisms underlying the hypoglycemia and lactic acidosis in the patient, the diagnostic criteria that define the Warburg effect and asymptomatic hypoglycemia, as well as the importance of exclusion of endocrinological disorders, sepsis, or ischemia, are discussed. This case highlights the significance of urgent diagnosis and management of this life-threatening metabolic disorder and raises awareness of this condition globally. Extensive research is required to determine the optimal therapeutic approach and to develop standardized guidelines for the management of such cases.