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Maybe the reason it doesn't stimulate insulin is because it doesn't actually need insulin

Indeed, exposure of tumor cells to elevated, yet physiologically relevant, pressure, using a pressurized cultured system that maintains a constant pH, has been found to increase or decrease cell proliferation, depending on the cancer cell type [51]

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Common withdrawal symptoms People who have consumed tramadol regularly or engaged in alcohol abuse may experience: tremors or shaking anxiety or panic sweating and chills insomnia or difficulty sleeping nausea and vomiting mood changes or irritability in severe cases, seizures or hallucinations Withdrawal and the risk of tramadol or alcohol overdose Withdrawal can also increase the risk of overdose