PMID: 11454137Jul 17, 2001Paper

Betablocker treatment in diabetes mellitus

Journal of Internal Medicine
P T Sawicki, A Siebenhofer


Betablockers have been convincingly shown to reduce total and cardiovascular morbidity and mortality of hypertensive diabetic patients. In diabetic patients, after myocardial infarction, these agents confer a twice as high protective effect when compared to non-diabetic patients. However, most paradoxically, betablocking agents are used less frequently in diabetes. Control of hypertension is insufficient in most of the diabetic patients, probably because a combination of antihypertensive agents including betablockers is frequently needed to sufficiently control blood pressure but is not used in these patients. The fear of betablocker-associated side effects in diabetes may be partly responsible for the frequent antihypertensive mono-therapy and the resulting poor quality of blood pressure control among diabetic patients. We have performed an analysis of the literature to assess whether possible adverse metabolic effects, a higher risk of hypoglycaemia or less nephroprotective effects of beta1-selective betablocking agents could justify the reticence in prescribing these antihypertensive agents to diabetic patients. A thorough review of the literature does not indicate that beta1-selective betablocking agents have important adve...Continue Reading


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