Differential effect of chronic treatment with two beta-blocking agents on insulin sensitivity

Jacob, Stephan; Rett, K.; Wicklmayr, M.; Agrawal, Bhuwnesh; Augustin, Hans J.; Dietze, G??nther-J.

doi:10.1097/00004872-199604000-00012

Cited by 204 publications

(154 citation statements)

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“…The overall magnitude of FBG increase appears to be minor (0.6 mmol/L for pooled endpoint FBG) based on a meta-analysis of data from 1889 patients with DM [21]. Non-selective βB had a greater effect than selective βB (1.3 mmol/L and 0.15 mmol/L increases, respectively) in this meta-analysis although the literature as a whole is inconsistent [10,[21][22][23][24]. Data are also inconsistent for NODM with βB use.…”

Section: Beta Blockers (βB)mentioning

confidence: 71%

Medications affecting glycemic control

Korayem¹

2017

Int Clin Med

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Section: Beta Blockers (βB)mentioning

confidence: 71%

Medications affecting glycemic control

Korayem¹

2017

Int Clin Med

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“…Carvedilol, for instance, is a highly nonselective lipophilic β-blocker with α 1 -blocking activity and no ISA [51]. Its pharmacologic properties may be associated with a more comprehensive treatment of AI since they can improve insulin sensitivity in T2D patients [52][53][54]. This mechanism, although very intriguing, needs further support from more complete (possibly longitudinal) studies and opens a new and stimulating field towards pharmacology intervention focusing the improvement of autonomic imbalance in T2D patients in order to optimize glucose metabolism in addition to BP control in RHTN patients.…”

Section: Pharmacologic Perspectives For Rhtn and T2d Treatmentmentioning

confidence: 99%

Relationship of Autonomic Imbalance and Circadian Disruption With Obesity and Type 2 Diabetes in Resistant Hypertensive Patients

Boer-Martins¹,

Figueiredo²,

Martins³

et al. 2011

Journal of Hypertension

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Background: Hypertension, diabetes and obesity are not isolated findings, but a series of interacting interactive physiologic derangements. Taking into account genetic background and lifestyle behavior, AI (autonomic imbalance) could be a common root for RHTN (resistant hypertension) or RHTN plus type 2 diabetes (T2D) comorbidity development. Moreover, circadian disruption can lead to metabolic and vasomotor impairments such as obesity, insulin resistance and resistant hypertension. In order to better understand the triggered emergence of obesity and T2D comorbidity in resistant hypertension, we investigated the pattern of autonomic activity in the circadian rhythm in RHTN with and without type 2 diabetes (T2D), and its relationship with serum adiponectin concentration.

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“…Studies have shown that metoprolol reduces insulin sensitivity (S I ) when used to treat essential hypertension in otherwise healthy individuals (Jacob et al, 1996, Pollare et al, 1989. However, to the authors' knowledge there is no data about whether this effect extends to critically ill patients.…”

Section: Introductionmentioning

confidence: 98%

“…Three studies have investigated the effects of metoprolol on insulin sensitivity using the gold-standard euglycaemichyperinsulinaemic clamp method (Falkner et al, 2008, Jacob et al, 1996, Pollare et al, 1989. Two of the studies (Jacob et al, 1996, Pollare et al, 1989 reported reductions in insulin sensitivity of 14-27% associated with metoprolol in nondiabetic individuals when used to treat hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Impact of metoprolol on insulin sensitivity in the ICU

Pretty

Chase

Compte

et al. 2011

IFAC Proceedings Volumes

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Metoprolol (a cardio-selective β1-blocker) has been shown to reduce insulin sensitivity in 'healthy' individuals by 14-27%. It is regularly used in the Christchurch Hospital intensive care unit (ICU), but may unintentionally reduce insulin sensitivity and thus exacerbate stress-hyperglycaemia. This study used model-based methods to quantify the effect of metoprolol on insulin sensitivity in critically ill patients.A model-based measure of insulin sensitivity was used to quantify changes between two matched retrospective cohorts of 17 ICU patients. All patients were admitted to the Christchurch hospital ICU between 2005 and 2007 and spent at least 24 hours on the SPRINT glycaemic control protocol.A 9.7% reduction in whole-cohort median insulin sensitivity was seen between the control cohort and patients receiving metoprolol with a median dose of 100mg/d per patient. Comparing percentile patients as a surrogate for matched patients, reductions in median insulin sensitivity of less than 4% were observed for the 25 th , 50 th and 75 th -percentile patients. These cohort and percentile patient reductions are less than the 14-27% reductions reported in 'healthy' subjects.The limited reduction of insulin sensitivity in critically ill patients could be a result of moderation of the physiological impact of metoprolol due to already reduced levels of peripheral glucose uptake and insulin receptor sensitivity. This limited reduction is not expected to have any clinical impact on the level of tight glycaemic control achieved with the SPRINT protocol.

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Differential effect of chronic treatment with two beta-blocking agents on insulin sensitivity

Cited by 204 publications

References 0 publications

Medications affecting glycemic control

Medications affecting glycemic control

Relationship of Autonomic Imbalance and Circadian Disruption With Obesity and Type 2 Diabetes in Resistant Hypertensive Patients

Impact of metoprolol on insulin sensitivity in the ICU

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