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Review
. 2022 Jul;22(7):301-310.
doi: 10.1007/s11892-022-01473-0. Epub 2022 May 20.

The Clash of Two Epidemics: the Relationship Between Opioids and Glucose Metabolism

Laura L Koekkoek  1   2   3 , Luna L van der Gun  1   2   3 , Mireille J Serlie  2 , Susanne E la Fleur  4   5   6
Affiliations
Review

The Clash of Two Epidemics: the Relationship Between Opioids and Glucose Metabolism

Laura L Koekkoek et al. Curr Diab Rep. 2022 Jul.

Abstract

Purpose of review: We are currently in the midst of a global opioid epidemic. Opioids affect many physiological processes, but one side effect that is not often taken into consideration is the opioid-induced alteration in blood glucose levels.

Recent findings: This review shows that the vast majority of studies report that opioid stimulation increases blood glucose levels. In addition, plasma levels of the endogenous opioid β-endorphin rise in response to low blood glucose. In contrast, in hyperglycaemic baseline conditions such as in patients with type 2 diabetes mellitus (T2DM), opioid stimulation lowers blood glucose levels. Furthermore, obesity itself alters sensitivity to opioids, changes opioid receptor expression and increases plasma β-endorphin levels. Thus, opioid stimulation can have various side effects on glycaemia that should be taken into consideration upon prescribing opioid-based medication, and more research is needed to unravel the interaction between obesity, glycaemia and opioid use.

Keywords: Blood glucose; Diabetes mellitus; Hyperglycaemia; Obesity; Opioids; β-endorphin.

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Conflict of interest statement

The authors do not have any existing conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Physiological effects of opioid stimulation, resulting in hyperglycaemia. CNS = central nervous system
See this image and copyright information in PMC

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