Why does beta blockers mask hypoglycemia

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Nutr Metab Cardiovasc Dis. Severe hypoglycemia-induced lethal cardiac arrhythmias are mediated by sympathoadrenal activation. Download references.

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KD developed the study protocol, obtained data, performed the statistical analysis. JM assisted in obtaining the dataset and prepared the final text for submission, CL assisted with data analysis and manuscript review, PB edited and revised the final text. All authors read and approved the final manuscript. Correspondence to Kathleen Dungan. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Reprints and Permissions. Dungan, K. Effect of beta blocker use and type on hypoglycemia risk among hospitalized insulin requiring patients. Cardiovasc Diabetol 18, Download citation. Received : 04 September Accepted : 10 November Published : 27 November Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Although beta blockers could increase the risk of hypoglycemia, the difference between subtypes on hypoglycemia and mortality have not been studied. Methods We retrospectively identified non-critically ill hospitalized insulin requiring patients who were undergoing bedside glucose monitoring and received either carvedilol or a selective beta blocker metoprolol or atenolol. Results There were patients on carvedilol, on selective beta blockers, and 10, on no beta blocker at admission.

Conclusions 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.

Clinical and laboratory variables Demographics, body mass index, Hemoglobin A1c during or within 30 days prior to admission, BB at admission, initial serum creatinine, service type medical, surgical, cardiac , and concomitant medications were collected. Glucose management At the study institution, patients with diabetes are generally managed with subcutaneous basal bolus insulin. Results Patient characteristics A total of 13, unique admissions met the initial inclusion criteria, of which were patients who started BB after admission, patients who switched BB after admission, and patients who received nonselective BB other than carvedilol were excluded patients may have been excluded for more than one reason.

Table 1 Baseline characteristics by BB status Full size table. Table 2 Relationship between beta blocker use and hypoglycemia Full size table.

Table 3 Relationship between hypoglycemia and mortality in beta blocker subgroups Full size table. Discussion Major findings In this analysis, the adjusted odds of hypoglycemia within the first 24 h of admission and total or severe hypoglycemia throughout the admission were increased with BB use.

BB and hypoglycemia risk There are few data describing risk of hypoglycemia among hospitalized BB recipients who are receiving insulin. Mortality Hypoglycemia was associated with increased mortality in non-BB patients and SBB users, but not in carvedilol users. Conclusions This study indicates that BB use is associated with increased odds of hypoglycemia in hospitalized insulin requiring patients but this was limited to patients who were not receiving basal insulin.

Availability of data and materials In accordance with institution policy on sharing data and research resources, the final research data from this study may be made available for research purposes under a limited data use agreement specifying criteria for data access, conditions for research use, privacy and confidentiality standards to ensure data security and prohibitions for manipulating data for the purposes of identifying subjects.

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This site is intended for healthcare professionals. Sign in. Sign in Register. Beta-1 selective blockers are a subclass of beta blockers that are commonly used to treat high blood pressure. Drugs in this class include atenolol Tenormin , metoprolol Lopressor , nebivolol Bystolic and bisoprolol Zebeta, Monocor. Which beta blocker is best for diabetics? Does omeprazole increase blood sugar? It is possible that the lower maximal glucose increase after the 2 hr GTT may be explained by improved insulin sensitivity, delayed gastric emptying, or an effect of omeprazole on a mediator of glucose or insulin metabolism; however, these mechanisms would not explain the improved insulin and C-peptide secretions.

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