INS and Hypoglycemia: Retrospective studies showed that methadone lowered the average blood glucose levels by 5.7 mg/dL [13]. Nevertheless, even though our patients had another risk factor in developing hypoglycemia, such as ESRD, patients with ESRD developed hypoglycemia in the setting of poor oral intake, after hemodialysis, or because they are still using insulin as part of their diabetes treatment [17,18].