Trend of Blood Glucose Level Alteration During the First Day of Hospitalization due to Acute Tramadol Poisoning

The frequency of tramadol poisoning is on the rise in numerous countries. This study aimed to assess changes in blood glucose concentrations during the first day of hospitalization among tramadol-intoxicated patients. Tramadol-intoxicated patients were evaluated over a 1-year period in a referral poisoning center. Blood glucose was investigated upon admission, 6 h after admission, and 24 h after admission. The study excluded patients with diabetes or other medical conditions and those taking additional medications or substances. A total of 150 patients, comprising 116 males (77.3%), were included in the study, with a mean age of 22.7 ± 10.16 years. The most common manner of poisoning was suicide attempts (42.7%) and tramadol abuse for premature ejaculation. Seizures (35.3%) and altered consciousness (22%) were the most prevalent symptoms. A gradual decreasing trend in blood sugar levels at the 6th and 24th hours after admission (P < 0.001) was found. The mean blood sugar levels of conscious tramadol-intoxicated patients were significantly higher than those of altered consciousness cases at all evaluation times, while there was no difference between patients with seizures and those without seizures. This study clinically confirms that tramadol overdose leads to a continuous decrease in blood glucose levels for at least 1 day after intoxication. Therefore, clinicians should be mindful of the risk of delayed hypoglycemia in tramadol-intoxicated patients and be cautious about discharging them too early from the emergency room.