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Journal of Diabetes & Metabolic Disorders

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Open Access 01-12-2017 | Research article

Hypoglycemic effects of tramadol analgesia in hospitalized patients: a case-control study

Authors: Larry K. Golightly, Bonita A. Simendinger, Gerard R. Barber, Nancy M. Stolpman, Steven D. Kick, Michael T. McDermott

Published in: Journal of Diabetes & Metabolic Disorders | Issue 1/2017

Abstract

Background

In outpatient populations, hypoglycemia has been associated with tramadol. We sought to determine the magnitude of risk for hypoglycemia associated with tramadol use in hospitalized patients.

Methods

During a 2-year period of observation, adult inpatients who received ≥1 dose of tramadol were identified and their medical records were reviewed. Patients were included if they had blood or plasma glucose (BG) concentrations measured on at least two occasions within five days after the initial administration of tramadol. A contemporary comparator group of hospitalized oxycodone recipients was similarly reviewed.

Results

Tramadol was administered to 2927 patients who met inclusion criteria. Among these, hypoglycemia (BG ≤70 mg/dL) was documented in 22 (46.8%) of 47 patients with type 1 diabetes, 113 (16.8%) of 673 patients with type 2 diabetes, and 103 (4.7%) of 2207 patients who did not have a diabetes mellitus diagnosis. In those without a diabetes diagnosis, the causality association between hypoglycemia and tramadol use was probable in 77 patients (3.5%). By comparison, hypoglycemia was documented in 8 (1.1%) of 716 matched oxycodone recipients without diabetes (p = 0.002). As compared with tramadol recipients who did not develop low BG concentrations, those who experienced tramadol-related hypoglycemia were relatively young (mean age 52.0 versus 59.8 years; p = 0.027) and predominantly female (74.0% versus 59.8%; p = 0.012).

Conclusions

Tramadol use was causally associated with hypoglycemia in hospitalized patients. The proportion of patients without diabetes who developed hypoglycemia was higher among those who received tramadol than among those who received oxycodone.

Trial registration

Colorado Multiple Institutional Review Board Protocol № 15–2215. Registered/approved 8 December 2015.

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Title: Hypoglycemic effects of tramadol analgesia in hospitalized patients: a case-control study
Authors: Larry K. Golightly
Bonita A. Simendinger
Gerard R. Barber
Nancy M. Stolpman
Steven D. Kick
Michael T. McDermott
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Journal of Diabetes & Metabolic Disorders / Issue 1/2017
Electronic ISSN: 2251-6581
DOI: https://doi.org/10.1186/s40200-017-0311-9

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