A Naltrexone-Induced Increase in Insulin Requirement

Abstract

Nalurexone was used in an experimental treatment of anorexia nervosa in a patient who also had insulin.dependent type I diabetes. Naltrexone increased the insulin requirement, in this longitudinally controlled case study, the daily mean blood glucose and insulin requirement were followed through four periods (5 days each) no drug, drug, no drug and drug. There were no significant differences in blood glucose (p<0,05), but the daily insulin dose was higher in the drug than the non-drug periods being 52.8 + 1.8 and 61.4 + 3.3 units/day for control periods ! and 3 and 7 i.4 :!: 5.9 and 76.0 + 6.9 units/day for naltrexone periods 2 and 4, respectively, The differences between naltrexone and control periods were statistically significant at ix0.005 and<0.01. This interaction should be considered when using naltrexone in any diabetic patient, whatever the disorder being treated by the naltrexone. Moreover, since there was no endogenous insulin secretion in this patient, the effect must have been on insulin action rather than release. Opiate modulation of insulin action has not been previously, reported, although a number of effects of opiates on insulin release are known.