Effects of Naloxone and Diazepam on Blood Glucose Levels in Tramadol Overdose using Generalized Estimating Equation (GEE) Model; (An Experimental Study)

Abstract

Background:Tramadol poisoning is increasing around the world day by day. Tramadol is a synthetic opioid. Also, various treatments are applied for tramadol poisoning. Due to the unknown effects of tramadol poisoning and some of its treatments on blood glucose, this study was conducted to investigate the overdose of tramadol and its common treatments (naloxone, diazepam) and their combination on blood glucose in male rats. Methods: This study was conducted in 45 male Wistar rats. The animals were randomly divided into five groups of 9 rats. They received a 75 mg/kg dose of tramadol alone with naloxone, diazepam, and a combination of these two drugs. On the last day, animals' tail vein blood glucose levels (BGL) were measured using a glucometer at different times, including before the tramadol injection (baseline), one hour, three hours, and six hours after the tramadol injection. The rats were anesthetized and sacrificed 24 hours after the last injection. Blood samples were then taken, and the serum obtained was used to verify the fasting glucose concentration. Data were analyzed using SPSS software at a significance level of 0.05 using a one-way analysis of variance (ANOVA) and a generalized estimating equation (GEE).Results: According to the GEE model results, the diazepam and naloxone-diazepam groups showed blood glucose levels five units higher than the tramadol group (p <0.05). The diazepam group had significantly higher blood glucose levels than the naloxone group (p <0.05). The mean blood glucose levels before the intervention, three hours and six hours after the injection of tramadol did not differ between the groups, but the blood glucose levels one hour after the injection of tramadol in the group of naloxone were significantly lower than in the control group (p <0.05). Blood glucose levels did not differ between the groups 24 hours after injection of tramadol.Conclusion: The results of the present study showed that tramadol overdose does not affect blood glucose levels. Diazepam alone and in combination with naloxone caused an increase in blood glucose levels in the tramadol overdose.