Beta-blockers can mask the symptoms of hypoglycemia
Hypoglycemia
A condition resulting when the blood glucose levels drop below the specified limits (4 mmol/L or 72mg/dL).
Norepinephrine
Norepinephrine, also called noradrenaline or noradrenalin, is an organic chemical in the catecholamine family that functions in the brain and body as a hormone and neurotransmitter. The name "noradrenaline", derived from Latin roots meaning "at/alongside the kidneys", is more com…
Why is hypoglycemia caused by beta blockers?
The mechanism responsible for β-blocker–induced hypoglycemia involves inhibition of hepatic glucose production, which is promoted by sympathetic nervous stimulation. Non-cardioselective β-blockers such as propranolol are more likely to cause hypoglycemia than cardioselective ones such as atenolol and metoprolol.
Can beta blockers induce hypoglycemia?
Beta blocker use is associated with increased odds of hypoglycemia among hospitalized patients not requiring basal insulin, and odds are greater for selective beta blockers than for carvedilol. The odds of hypoglycemia-associated mortality are increased with selective beta blocker use or nonusers but not in carvedilol users, warranting further study.
Can beta blockers make your blood pressure too low?
There are some medicines that may interfere with the way that beta blockers, including beta blocker eyedrops, work. Tell your doctor if you're taking: other medicines for high blood pressure. The combination with beta blockers can sometimes lower your blood pressure too much. This may make you feel dizzy or faint
How do beta blockers affect blood glucose?
Non-selective and to a lesser extent selective beta-blockers are known to slightly deteriorate glucose metabolism. This may be of clinical relevance, since patients with essential hypertension suffer from reduced insulin-sensitivity and some studies showed an increased incidence of diabetes type II with beta-blocker-treated hypertensive patients.
How does beta blocker cause hypoglycemia?
β-blockers The mechanism responsible for β-blocker–induced hypoglycemia involves inhibition of hepatic glucose production, which is promoted by sympathetic nervous stimulation. In addition, adrenergic counterregulation is diminished, resulting in a reduction in glycogenolysis.
Do beta blockers cause hypoglycemia unawareness?
1) Nonselective beta-adrenergic blockade does not cause absolute hypoglycemia unawareness but shifts the glycemic thresholds for symptoms to lower plasma glucose concentrations in patients with IDDM.
Is hypoglycemia a side effect of beta blockers?
Beta blocker use is associated with increased odds of hypoglycemia among hospitalized patients not requiring basal insulin, and odds are greater for selective beta blockers than for carvedilol.
Which drug may mask the signs and symptoms of hypoglycemia?
Which drug therapy may mask the signs of hypoglycemia? Answer Explanation : Answer a is correct. β-Blockers have been known to mask signs or symptoms of hypoglycemia.
How do beta-blockers affect blood sugar?
In insulin-dependent diabetics, beta-blockers can prolong, enhance, or alter the symptoms of hypoglycemia, while hyperglycemia appears to be the major risk in noninsulin-dependent diabetics. beta-blockers can potentially increase blood glucose concentrations and antagonize the action of oral hypoglycemic drugs.
What do beta-blockers do to blood sugar?
In people who have diabetes, beta blockers may block signs of low blood sugar, such as rapid heartbeat. It's important to check your blood sugar regularly if you have diabetes and you're taking a beta blocker. Beta blockers can also affect cholesterol and triglyceride levels.
How does beta-blockers delay the recovery from hypoglycemic episodes?
The beta-adrenergic blocking agents may inhibit insulin secretion, but few patients will experience clinically important elevations in blood glucose. Rather than producing glucose intolerance, these agents may delay recovery from hypoglycemic episodes and may mask catecholamine-induced symptoms of hypoglycemia.
Which of the following symptoms of hypoglycemia is not masked by beta-blockers?
Answer C is correct because beta blockers can mask tachycardia during a hypoglycemic episode. It is important to counsel patients with diabetes who take beta blockers that these symptoms of hypoglycemia may be masked, but sweating is not masked by beta blockers.
Why does propranolol cause hypoglycemia?
Thus, propranolol may interfere with glucose recovery after insulin-induced hypoglycemia in diabetic patients by blocking epinephrine's inhibition of glucose utilization whereas, in normals, propranolol's effect is largely accounted for by blockade of epinephrine-induced hepatic glucose production.
Can beta-blockers mask diabetes?
Therefore, beta-blockers are not able to inhibit sweating, but can still inhibit tachycardia and tremors, thus "masking" important signs and symptoms that diabetic patients use to recognize hypoglycemic episodes.
How do beta-blockers work?
Beta blockers work mainly by slowing down the heart. They do this by blocking the action of hormones like adrenaline. Beta blockers usually come as tablets. They are prescription-only medicines, which means they can only be prescribed by a GP or another suitably qualified healthcare professional.
What medications cause hypoglycemia unawareness?
Non-selective beta-blockers used to manage high blood pressure, like Inderal (see here for a complete list), may reduce your ability to recognize hypoglycemia. Selective serotonin reuptake inhibitors (SSRIs) used to treat depression may also have this effect. Common SSRIs include Lexapro, Prozac, and Zoloft.
Can beta blockers lower blood pressure?
Beta-blockers are the other major class of blood-pressure-lowering drugs that have been implicated in causing diabetes or worsening diabetes control. But beta-blockers also block the release of insulin by interacting with nerve signals to the pancreas and can thus lower insulin levels even when blood glucose is high.
Can hypoglycemia cause palpitations?
Hence, if hypoglycemia occurs in someone who is using this type of drug, he/she may not experience the typical adrenergic warning symptoms such as tremor and palpitations. Again, the result is hypoglycemic unawareness. Click to see full answer.
Does beta blocker affect insulin sensitivity?
Many groups have shown that conventional antihypertensive treatment, both with beta-blockers and/or diuretics, decreases insulin sensitivity by various mechanisms. While low-dose diuretics seem to be free of these metabolic effects, there is no evidence for this in the beta-adrenergic blockers.
Can beta blockers cause hypoglycemia?
Likewise, how do beta blockers cause hypoglycemia? The mechanism responsible for β-blocker–induced hypoglycemia involves inhibition of hepatic glucose production, which is promoted by sympathetic nervous stimulation. Non-cardioselective β-blockers such as propranolol are more likely to cause hypoglycemia than cardioselective ones such as atenolol ...
Why do people take beta blockers?
They’re also used to treat heart failure and high blood pressure. High blood pressure can increase your risk for heart disease and stroke. Beta-blockers stop the effects of the hormone norepinephrine (adrenaline). This slows the nerve impulses in your heart, which causes your heart to beat slower.
What is the top number of blood pressure for beta blockers?
A 2015 systemic review recommends drug therapy to lower your systolic blood pressure (top number) if it’s above 130 mm Hg.
Why do people with diabetes have high blood pressure?
One reason for this is that high glucose levels increase your risk of high blood pressure (hypertension). According to the American Diabetes Association (ADA), almost 1 in 3 American adults has high blood pressure.
How to control high blood pressure?
If your blood pressure is elevated, catching it early may help you delay or avoid the need for medications to control it. Limit your alcohol consumption. If you smoke, consider quitting. Work with your doctor and dietitian to maintain a healthy diet and exercise program. Last medically reviewed on May 24, 2019.
Why does beta blocker help your heart beat faster?
This slows the nerve impulses in your heart, which causes your heart to beat slower. Your heart doesn’t have to work as hard. It beats with less pressure. Beta-blockers can also help open up blood vessels, which improves blood flow.
How do you know if your blood sugar is low?
One of the symptoms of low blood sugar is rapid heartbeat. Since beta-blockers slow your heartbeat, your heart’s response to low blood sugar may not be as obvious. You may not be able to rely on symptoms to tell you that your blood sugar is low. That can be dangerous. You’ll have to check your blood sugar levels frequently and eat consistently, ...
Can diabetes cause high blood pressure?
For people living with diabetes, 2 out of 3 have high blood pressure. High blood pressure doesn’t necessarily cause symptoms. You may feel fine. However, don’t let that fool you. Your heart is working harder than it should. It’s a serious condition, especially for people with diabetes.
Question
I am rather surprised that beta-blockers are being advocated for use in diabetes, especially in type 1 disease. I am under the distinct impression that they tend to reduce the patient's awareness of warning symptoms of hypoglycemia.
Response from Rudy W. Bilous, MD, FRCP
This question was raised about my advice in a previous response on the use of beta-blockers in patients with diabetes because of the risk of hypoglycemia and blunting of hypoglycemic symptoms. The evidence for this really relates to older noncardioselective drugs and is in any case not too robust.