Mad honey intoxication: what is wrong with the blood glucose? a study on 46 patients

H. Uzun, H. Narci, I. Tayfur, K.U. Karabulut, O. Karcioglu

Department of Emergency Medicine, Numune Training and Research Hospital, Trabzon, Turkey. hsnnarci@gmail.com

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• Toxicology

OBJECTIVE: This study was designed to analyze the characteristics of adult patients with mad honey intoxication, with special emphasis on its effects on vital signs and blood glucose levels.

METHODS: Patients admitted to the Emergency Department of urban hospital in the Black Sea region of Turkey over the 16-months study period due to mad honey intoxication were included. Patients’ demographic and clinical characteristics, including age, sex, systolic and diastolic blood pressure, rhythm at ECG, heart rate, blood glucose levels and clinical outcomes were recorded and analyzed.

RESULTS: Forty-six patients with a presumptive diagnosis of mad honey poisoning were recruited. Mean age was 52.2 (±17.2). Blood glucose level was normal in 28 cases (60.9%) and high in 18 (39.1%). Systolic blood pressure (SBP) was low in 40 patients (87%) and normal in six (13%). Diastolic blood pressure (DBP) was low in 42 cases (91.3%) and normal in four (8.7%). Mean glucose level in patients with low SBP was 116.1 (±52.9) mg/dL, vs. 120.7 (±23.0) mg/dL in those with normal or high SBP (p = 0.389). Mean glucose level in patients with low DBP was 118.7 (±51.4) mg/dL, compared to 96.0 (±22.8) mg/dL in those with normal or high DBP (p = 0.146). Heart rate was below or equal to 45 bpm in 28 patients (60.9%). Complete (third degree) heart block was diagnosed in one case.

CONCLUSION: Mad honey was found not to cause significant decreases in blood glucose levels in humans. Hypotension, bradycardia and related clinical consequences are commonly encountered in patients diagnosed with mad honey or grayanotoxin poisoning.

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