{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T10:54:17Z","timestamp":1777114457890,"version":"3.51.4"},"reference-count":23,"publisher":"The Endocrine Society","issue":"4","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hypoglycemic disorders in nondiabetic patients are rare. In the setting of concomitant illicit opioid abuse, hypoglycemia is highly unusual, and an underlying cause should be systematically investigated. We report 2 unique admissions (separated by a decade in time) to the intensive care unit for critical hypoglycemia secondary unintentional sulfonylurea exposure after heroin use. A thorough history, including illicit drug use and critical blood samples at the time of hypoglycemia, was obtained. These subjects had a common exposure: insufflation of heroin mixed with an additive shortly before their admissions with critical hypoglycemia and testing positive for unknown sulfonylurea exposure. A review of the literature was performed for cases of illicit drugs adulterated with sulfonylureas. The diagnosis and management of sulfonylurea-induced hypoglycemia are discussed. One case of sulfonylurea-positive hypoglycemia associated with inhalation of heroin was previously presented as a poster presentation at the Endocrine Society. Within 3 months of this presentation, the second case was seen. These cases highlight the importance of obtaining a detailed clinical history, acquiring timely laboratory samples for toxicologic analysis, interpreting the findings, and sharing cases like these with trainees in many disciplines to curb a potentially deadly epidemic.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag023","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T08:38:19Z","timestamp":1773909499000},"source":"Crossref","is-referenced-by-count":1,"title":["Two cases (a decade apart) of severe sulfonylurea-positive hypoglycemia associated with inhaled heroin use"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0053-5547","authenticated-orcid":false,"given":"Brittany","family":"Weisbrot","sequence":"first","affiliation":[{"name":"Department of Medicine, Loyola University Medical Center , Maywood, IL 60153 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keun Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, Rush University Medical Center , Chicago, IL 60612 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Zacharia","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, Rush University Medical Center , Chicago, IL 60612 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica L","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Edward Hines Jr VA Hospital , Hines, IL 60141 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