Do Thiazides And Beta-blockers Promote Diabetes?
Do Thiazides and Beta-Blockers Promote Diabetes? AS Brett reviewing Gress TW et al. N Engl J Med 2000 Mar 30 Some clinicians are reluctant to prescribe thiazide diuretics or beta-blockers to patients at high risk for diabetes, as these drugs may promote glucose intolerance. In ... Some clinicians are reluctant to prescribe thiazide diuretics or beta-blockers to patients at high risk for diabetes, as these drugs may promote glucose intolerance. In this prospective cohort study, researchers followed 12,550 nondiabetic adults (3804 of whom had hypertension) from 4 U.S. communities to determine whether hypertension and antihypertensive drugs increase the risk for diabetes. During 6 years of follow-up, the risk for developing diabetes was more than twice as high in hypertensive subjects as in nonhypertensive subjects (29 vs. 12 cases per 1000 person-years). This increased risk was noted even among hypertensive patients not taking blood pressure medications. Among hypertensive patients, those taking beta-blockers had a 28 percent higher risk for diabetes than those not taking antihypertensive drugs; this difference was significant. In contrast, patients taking thiazide diuretics, angiotensin-converting-enzyme inhibitors, or calcium-channel blockers did not have an increased risk for developing diabetes. These results suggest that hypertension itself -- independent of drug therapies -- is associated with an increased risk for diabetes. Of the main classes of antihypertensive drugs, only beta-blockers further increased the risk for diabetes in this study. Nevertheless, the authors do not believe that these findings should discourage the use of beta-blockers, which have been shown to prevent cardiovascular events in both diabetic and nondiabetic patients. Gress TW et al. Hypert Continue reading >>
Newer Beta-blocker Doesn't Up Weight In Diabetics
Newer beta-blocker doesn't up weight in diabetics NEW YORK (Reuters Health) - Unlike earlier beta-blocker drugs used to treat high blood pressure, the newer drug carvedilol does not cause weight gain in people with diabetes, according to findings from a new study. Increases in body weight have been documented with long-term therapy of traditional beta-blockers, Dr. Franz H. Messerli, of St. Lukes-Roosevelt Hospital Center, New York, and colleagues write in the American Journal of Medicine. Any weight gain is of concern in patients with type 2 diabetes because of the rise in insulin resistance associated with excess weight and obesity. The researchers evaluated the effects of carvedilol as compared to the older beta-blocker metoprolol on weight gain in about 1100 patients with type 2 diabetes and high blood pressure. Changes in body weight were tracked from the beginning of treatment over 5 months. On average, participants taking metoprolol gained 1.19 kg after 5 months, whereas there was a small and insignificant average gain of 0.17 kg among those given carvedilol. A gain of at least 7 percent in body weight occurred in 4.5 percent of metoprolol-treated patients but in only 1.1 percent of those treated with carvedilol, the team reports. The results would indicate that with regard to weight gain ...not all beta-blockers are created equal, Messerli told Reuters Health. He advised doctors to avoid traditional beta-blockers such as atenolol and metoprolol in the diabetic hypertensive patient or in the hypertensive patient at risk for diabetes, and to use a beta-blocker such as carvedilol that has no detrimental effects. SOURCE: American Journal of Medicine, July 2007. Continue reading >>
Are The Beta Blockers Cause Of Diabetis?
Are the Beta Blockers cause of Diabetis? - Diabetes India Betablockers like Atenolol are used for Hypertension. Are they the cause of destroying the beta cells of pancreas? Is diabetes caused due to that effect? Prolonged use of betablockers is known to cause diabetes. If that medicine is meant for destroying the betacells to block their function to reduce BP, is it not the main cause of diabetes? If so, how has it been approved for treating BP? Atenol is an Beta blocker used to reduce the HNP of the person 1 Whether if taken the blood sugar level may spike ? or long using this tablet beta cells may be damages ? 2 You are taken now the tablets is Cilacar. ? It is not Beta blocker and it is Cacium channel blocker. Please share your expert opinion about these two may be taken good to control HBP ? this ay be not spike the blood sugar level for longer use 3 the combination of Cilica and Atenol may not found in market. It may be available in Amlodipine and Atenol combination only ? 4 Why you are taken Cilacar tablets your Bp is higher range . As per Doctors advise above age of 6o years upto 150/90 no tablets required . O K your Doctor changed the drug envas to clicar. So your are HBP more than 160/95 Please take care of your health. Donot taken too tension. You are already a good expert by studing medical outlook and inlook also. i amnot able to guide as your knowledge is excllant you know all thing. I prayto god give you good health and your services to this forum is necessary most of them learn from you too kuch. Indiacatus what is your statement of posting i can not understand. What purposes you have used the word Agraharm is cluster of peoples lived. By the mean your opinion is Agaharm living peoples not educated? and they are poor itself ? it is a proper Name word it Continue reading >>
What's The Best Beta Blocker For Heart Failure?
Whats the Best Beta Blocker for Heart Failure? Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC. Beta blockers save lives after heart attack and improve mortality for heart failure patients. They also work well to control blood pressure. Carvedilol ( Coreg was the brand name) has beenknown as the heart failure beta blockerbut now it appears that metoprolol ( Lopressor ) may share that title. Many of my patients are asking: which is better? Lets look at the recent evidence. Whats the difference between carvedilol and metoprolol ? Carvedilol is known as a non-selective beta blocker meaning it blocks all beta receptors throughout the body. Metoprolol is known as a selective beta blocker and blocks primarily specific (1) receptors which affect the heart, and heart rate. Why does this matter? Well youd think you only want a medication that affects the heart, but carvedilol alsoinhibits2 receptors and the effects of norepinephrine (similar to adrenaline) throughout the body. Turns out thats important for heart failure. Is carvedilol or metoprolol better for saving lives from heart failure? Well, a JAMA (Journal of the American Medical Association)2014 article looked at mortality rates in heart failure patients and found the effectiveness for prevention of death was similar for carvedilol and metoprolol . However, a very recent VA study found that metoprolol resulted in less frequent hospital admissions for heart failure, and that metoprolol hada slightly lower risk of death than carvedilol . Id say they are about the same, or evidence tips in favor of metoprolol . Which is better for survival after a heart attack? Theyre kind of the same. A recent 2015 stud Continue reading >>
Senior Cardiac Nurse Christopher Allen talks to Dr Amanda Adler about oral medications that can control your blood glucose levels, which is critical to managing type 2 diabetes. Why have I been given these medications? Type 2 diabetes causes high levels of glucose (a type of sugar) in your blood. This is because your pancreas isn’t making enough insulin to lower your blood glucose levels, or because your body has become resistant to insulin. Insulin allows glucose in your bloodstream to move into cells, giving you energy. If you have a high blood glucose level, your cells aren’t getting enough energy to function properly. Over time, an excess of glucose in your blood causes damage to blood vessels, which can lead to cardiovascular disease. This increases your risk of having a heart attack or stroke. It can also lead to problems with your vision and damage your kidneys. More than three million people in the UK have been diagnosed with type 2 diabetes, but it’s predicted that hundreds of thousands more are still undiagnosed. Medications can help control blood glucose levels and keep them in a normal range. In the UK, the National Institute for Health and Care Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) offer guidance on which drug is appropriate. Are there interactions with heart medications? Most common heart medications are safe to take with medications for type 2 diabetes. Others are used with caution, such as beta-blockers. They may mask the symptoms of low blood glucose, which can include shaking and sweating, caused by adrenaline trying to increase blood glucose levels. You may not get these symptoms as beta-blockers can block the action of adrenaline. Are there any foods or drinks I should avoid? Following a healthy, balanced diet Continue reading >>
Hypoglycemia [tusom | Pharmwiki]
Figure 1: Hypoglycemia related symptoms in patients who are either aware or have attenuated sympathetic neural response (hypoglycemia unawareness) that can develop in older patients, patients suffering from recurrent hypoglycemia, or those with diabetic autonomic neuropathy (Holt & Hanley, 2007; Cryer & Davis, 2012). In patients who are hypoglycemic aware, a fall in blood glucose below ~3.8 mM results in an acute release of counter-regulatory hormones including glucagon & norepinephrine. The release of norepinephrine results from a CNS-mediated sympathetic discharge triggered by hypoglycemia. The sympathetic discharge produces adrenergic symptoms produced by the release of norepinephrine (and possibly by epinephrine release from the adrenals) such as palpitations, tremor & anxiety. Cholinergic symptoms such as sweating & hunger occur from the release of acetylcholine from sympathetic postganglionic (cholinergic) neurons (Cryer & Davis, 2012). Cognitive dysfunction begins to deteriorate when blood glucose falls to ~ 3 mM. The onset of autonomic symptoms (Table 1) is important because it makes the patient aware of their condition & enables them to take appropriate corrective action before cognitive impairment occurs. However in patients who are hypoglycemic unaware this early phase of sympathetic discharge (with associated warning signs) does not occur until after cognitive impairment begins, which increases the likelihood that they can become severely hypoglycemic. The threshold for cognitive impairment does not change when patients develop hypoglycemia unawareness. (Modified from Holt & Hanley, 2007). Beta-blockers should be used with caution (have a relative contraindication) in diabetics because of their ability to block these sympathetic increases and thus make prop Continue reading >>
Beta Blockers Used In Type 1s For Bgl Control?
Beta blockers used in type 1s for BGL control? Beta blockers used in type 1s for BGL control? I recently heard about the use of beta blockers in type 1s for preventing highs associated with Adrenalin. Im wondering about their application to my work in teaching and teacher training (which involves public speaking, which I innately fear, but have to do ) . Interested to hear if and how they have worked for other type 1 diabetics . Also, I know that the dawn phenomenon is still not well understood .... my own understanding and observation monitoring sugars... is that liver dumps or glucose due to fasting state . My rise generally happens after I get up so I wonder if it is the act of becoming active at the start of the day without food fuel that prompts the release of glucose stores.... therefore is it Adrenalin based and therefore ...could beta blockers also help with DP rise ? Im in no way scientific... but just getting a little excited here , and perhaps a little carried away, at least about the potential for preventing Adrenalin-induced spikes from my work. Already eating extremely low carb and monitoring BGLs closely before during and after events so and able to quite confidently conclude the cause of these spikes. Continue reading >>
How Diabetics Taking Beta Blockers Still Sweat With Hypoglycemia
There are 23.6 million children and adults (7.8 percent of the population) in the United States alone that have diabetes mellitus (DM).1 Unfortunately, 65 percent of the deaths in diabetic patients are due to heart disease and stroke. In fact, adults with DM are 2 to 4 times more likely to have heart disease and/or a stroke than adults without diabetes.2 The elevated cardiovascular risk in diabetics is partially due to the high prevalence (about 73 percent of all diabetics) of hypertension (defined as > 130/80 mm Hg) for which treatment with beta blockers is indicated. 2 Thus, the use of beta blocking agents is relatively common in those living with DM. Beta blockers, such as atenolol (Tenormin), metoprolol (Toprol; Toprol XL), carvedilol (Coreg; Coreg CR) and many others, are known to be antagonists of the noradrenergic response that results from the release of catecholamines by the sympathetic nervous system.4-6 The sympathetic branch of the autonomic system is activated primarily during an acute stress response ("fight or flight") and releases the predominant neurotransmitter, norepinephrine, from post-ganglionic sympathetic nerve fibers.7,8 In addition, the sympathetic nervous system also causes the adrenal glands to release both epinephrine (80%) and norepinephrine (20%). Norepinephrine and epinephrine may then activate the adrenergic receptors of various organs, such as beta-1 receptors in the heart which results in tachycardia (increase pulse).7,8 This acute stress response can be activated by hypoglycemia (low blood sugar) which may occur episodically in diabetic patients. Hypoglycemia generally occurs in diabetics when the blood glucose level falls below 70 mg/dL and is most often observed in patients receiving insulin or those being treated with tight glucose Continue reading >>
Beta Blockers And High Blood Sugar Readings
Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Beta Blockers and high blood sugar readings I am a 5' 8" female who weighs 135lbs. I exercise routinely, but love my chocolate! lol! I have been on a beta blocker for the past 11 years for a fast heart rate. Over the course of the past 5 years, during routine blood work, my FBS has been ranging anywhere from 102 to 128. (It should also be noted that I checked my own blood sugars one and two hours after eating on a few occasions and found that my readings went in excess of 200. On my most recent blood work a few months ago, my family doctor voiced his concern that I was indeed pre-diabetic and that I should watch what I eat. I ask him about my beta blocker and if it could cause this. He did not feel that it could, as it is a cardo select version. I decided, (with his approval) that I would wean myself off of the beta blocker and see if my blood sugars improved at all. I needed to prove this to myself...is it the medication OR do I in fact have pre-diabetes. If so, I wanted to get "on the ball" and watch my diet better. I have been off of the medication fully now for the past 12 days. My blood sugar readings have DRAMATICALLY lowered, back to the normal range! I was taking a very low dose of beta blocker, Zebeta (bisoprolol) 2.5 mg daily. This was a very welcome surprise as you can imagine. My point....I want people out there to know that this can happen. So many people are placed on beta blockers for high blood pressure etc, and may be diagnosed with diabetes. Perhaps some folks out there in this world may NOT indeed have it! Please talk to your doctor if you take one of these meds! I know that in most people it does not effect readings. This is shown Continue reading >>
Beta Blockers And Diabetes
If this is your first visit, be sure to check out the FAQ in HCMA Announcements. You may have to register before you can post: click the register link above to proceed. To start viewing messages, select the forum that you want to visit from the selection below. Your Participation in this message board is strictly voluntary. Information and comments on the message board do not necessarily reflect the feelings, opinions, or positions of the Hypertrophic Cardiomyopathy Association. At no time should participants to this board substitute information within for individual medical advice. The Hypertrophic Cardiomyopathy Association shall not be liable for any information provided herein. All participants in this board should conduct themselves in a professional and respectful manner. Failure to do so will result in suspension or termination. The moderators of the message board working with the HCMA will be responsible for notifying participants if they have violated the rules of conduct for the board. Moderators or HCMA staff may edit any post to ensure it conforms with the rules of the board or may delete it. This community is welcoming to all those with HCM we ask that you remember each user comes to the board with information and a point of view that may differ from that which you hold, respect is critical, please post respectfully. Thank you Continue reading >>
Use Of Beta-blockers And Risk Of New Onset Diabetes
You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Use of Beta-blockers and Risk of New Onset Diabetes The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT01587638 Information provided by (Responsible Party): Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information This study used an observational, retrospective cohort design to compare the presence and timing of new-onset diabetes (NOD) between hypertensive patients initiating therapy with carvedilol immediate-release (IR) and carvedilol controlled-release (CR) vs the following cardioselective beta blockers (BBs): atenolol, metoprolol succinate, and metoprolol tartrate (referred to hereafter as 'other BB'). The aim of the study was to investigate the likelihood of developing NOD among hypertensive patients initiating carvedilol therapy vs other BB therapy in a real world setting derived from data contained in a large United States (US) managed care database. Drug: carvedilol Drug: cardio selective betablocker Use of Beta-blockers and Risk of New Onset Diabetes Patients aged 18 years and at least 1 diagnosis of hypertension (ICD-9-CM: 401.xx-405.xx) during this time frame in a US Managed care population carvedilol immediate-release (IR) and carvedilol controlled-release (CR) Other Name: carvedilol immediate-release (IR) and carvedilol controlled-release atenolol, metoprolol succinate, and metoprolol tartrate Study Description Study Design Groups and Cohorts Outcome Measures Eligibi Continue reading >>
Beta Blockers Are Diabetogenic
From this article: "Beta blockers have been shown to reduce cardiovascular risk; however, because of their diabetogenic potential, JNC VI classifies beta blockers as agents that 'may have unfavorable effects' in patients with diabetes." Apparently ACE inhibitors are the preferred treatment for those with diabetes and hypertension. Here's a quote from the above article: ACE inhibitors have proved beneficial in patients who have had a myocardial infarction or congestive heart failure, or who have diabetic renal disease (early or established). 6 These agents are considered preferred therapy in patients with hypertension and diabetes, according to guidelines from the ADA, the NKF, the World Health Organization, and the JNC VI." Of course, I wonder how scientific this report is, since it comes from a government that tells lies 24/7, has some medical guidelines that are proven to be not based on science, and serves the interests of corporations rather than citizens. Still, I'm asking my PA to take me off beta blockers and put me on ACE inhibitors, and I will hope that I'm not jumping out of the frying pan and into the fire. 1000 mg Metformin morning and night (total 2000) Stopped this med July 9, '17 5 mg Glipizide morning Stopped this med July 9, '17 10 mg Glipizide night Stopped this med July 9, '17 testing post meal spikes since May 28, 2017 D.D. Family diabetic since 1997, on insulin 2000 Dear Patrick thanks for the BP med article will read very carefully later it is an area that I don't know much about. Of course ACE inhibitor is the best and I share this dogma so it will be interesting to see if there is any science to back this up. The problem is the cough, 10 years ago it started first 15 minutes then up to 2 hours and I had to give it up. We tried many different ACE Continue reading >>
Diabetic hypoglycemia is a low blood glucose level occurring in a person with diabetes mellitus. It is one of the most common types of hypoglycemia seen in emergency departments and hospitals. According to the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP), and based on a sample examined between 2004 and 2005, an estimated 55,819 cases (8.0% of total admissions) involved insulin, and severe hypoglycemia is likely the single most common event. In general, hypoglycemia occurs when a treatment to lower the elevated blood glucose of diabetes inaccurately matches the body's physiological need, and therefore causes the glucose to fall to a below-normal level. Definition A commonly used "number" to define the lower limit of normal glucose is 70 mg/dl (3.9 mmol/l), though in someone with diabetes, hypoglycemic symptoms can sometimes occur at higher glucose levels, or may fail to occur at lower. Some textbooks for nursing and pre-hospital care use the range 80 mg/dl to 120 mg/dl (4.4 mmol/l to 6.7 mmol/l). This variability is further compounded by the imprecision of glucose meter measurements at low levels, or the ability of glucose levels to change rapidly. Signs and symptoms Diabetic hypoglycemia can be mild, recognized easily by the patient, and reversed with a small amount of carbohydrates eaten or drunk, or it may be severe enough to cause unconsciousness requiring intravenous dextrose or an injection of glucagon. Severe hypoglycemic unconsciousness is one form of diabetic coma. A common medical definition of severe hypoglycemia is "hypoglycemia severe enough that the person needs assistance in dealing with it". A co-morbidity is the issue of hypoglycemia unawareness. Recent research using machine learning methods have proved to Continue reading >>
Use Of Beta Blockers In The Patient With Diabetes
Use of Beta Blockers in the Patient With Diabetes Beta blockers are even more powerful in reducing cardiac events in the patient with diabetes, than they are in others. This is because that in addition to lowering blood pressure, lowering heart rate, and acting as an anti-inflammatory, beta blockers, in the patient with diabetes, shift the metabolism of the myocardium away from fatty acid utilization and toward glucose utilization, which decreases the cardiac workload and reduces ischemia. Furthermore, hyperglycemia is a stimulus to myocardial remodeling, which is not only prevented but is reversed by beta blockade, and the incidence of heart failure that would otherwise be increased in the patient with diabetes, is reduced. The first and second generation beta blockers induce peripheral vasoconstriction and increase insulin resistance, causing an increase in serum glucose and triglycerides, and a decrease in HDL levels. These problems can be circumvented by using a third generation beta blocker, which are vasodilatory and reduce serum glucose and triglycerides, and increase HDL cholesterol. Therefore, the traditional and long-standing reluctance of endocrinologists to utilize beta blockade in the diabetic patient is unfounded and outdated due to the availability of later-generation beta blockers. * Discuss the vulnerability of diabetic patients to heart disease and the rationale for administering beta-blockers to these patients. * Relate the indications for, and the timing of beta-blocker treatment in type 2 diabetics with regard to coronary artery disease and heart failure. * Summarize the risks of beta-blockade in diabetic patients and how they may be minimized. Professor of Medicine and Director of Clinical Research, Division of Endocrinology and Metabolism, the Un Continue reading >>
Beta Blockers And Diabetes: Mechanism And Risks
Beta Blockers and Diabetes: Mechanism and Risks Watch short & fun videos Start Your Free Trial Today Alyssa is an active RN and teaches Nursing and Leadership university courses. She also has a Doctorate in Nursing Practice and a Master's in Business Administration. Log in or sign up to add this lesson to a Custom Course. Custom Courses are courses that you create from Study.com lessons. Use them just like other courses to track progress, access quizzes and exams, and share content. Organize and share selected lessons with your class. Make planning easier by creating your own custom course. Create a new course from any lesson page or your dashboard. Click "Add to" located below the video player and follow the prompts to name your course and save your lesson. Click on the "Custom Courses" tab, then click "Create course". Next, go to any lesson page and begin adding lessons. Edit your Custom Course directly from your dashboard. Name your Custom Course and add an optional description or learning objective. Create chapters to group lesson within your course. Remove and reorder chapters and lessons at any time. Share your Custom Course or assign lessons and chapters. Share or assign lessons and chapters by clicking the "Teacher" tab on the lesson or chapter page you want to assign. Students' quiz scores and video views will be trackable in your "Teacher" tab. You can share your Custom Course by copying and pasting the course URL. Only Study.com members will be able to access the entire course. Beta-blockers are common medications used to control high blood pressure, but can block dangerous signs of low blood sugar in people with diabetes. Read this lesson to learn more about how diabetes is affected by this class of medication. Diabetes occurs when the body creates little t Continue reading >>