![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by saturn on May 2, 2006, at 19:13:43
****Below is an excerpt from an article titled, "Study Finds Beta Blockers Can Increase Patients' Risk Of Type 2 Diabetes":
In the six-year Johns Hopkins' study, 12,550 adults ages 45-64 who did not have diabetes were studied. Those with high blood pressure who took beta-blockers had a 28 percent higher risk of eventually developing type 2 diabetes than did those who took no medication. In contrast, those who took one of the other types of drugs used to treat high blood pressure — thiazide diuretic, angiotensin-converting-enzyme (ACE) inhibitors or calcium-channel antagonists — were found to have no increased risk of developing diabetes
****This is not news, but 28% is pretty high...and that's only over a 6 year period. I also found the following article:
Advantages of a third-generation beta-blocker in patients with diabetes mellitus.
Am J Cardiol. 2004; 93(9A):49B-52B (ISSN: 0002-9149)
Bell DS
Department of Medicine, University of Alabama at Birmingham Medical School, Birmingham, Alabama 35294, USA. dbell@endo.dom.uab.edubeta-Blocker use improves outcomes even more for the patient with diabetes mellitus than for the patient without diabetes with a history of acute myocardial infarction or coronary artery disease. beta-Blockers facilitate shifting the metabolism of the myocardium away from free fatty acid toward glucose utilization, thereby reducing the cardiac workload and myocardial ischemia. beta-Blockers are also able to reverse the fetal gene induction program to reverse myocardial remodeling and improve ventricular function. Side effects of beta-blockers in the patient with diabetes include increased insulin resistance with worsening glycemic control, elevated triglyceride levels, and lowered levels of high-density lipoprotein cholesterol. Increased frequency of hypoglycemia and its lack of recognition can also be a problem in the insulin-deficient patient but is a minimal problem with the patient with type 2 diabetes. In addition, vasoconstriction, caused by unopposed alpha-activity, can worsen peripheral vascular disease. However, carvedilol, a nonselective beta-blocker with vasodilating and insulin-sensitizing properties, can largely circumvent these problems and is the ideal beta-blocker for the patient with diabetes.
****Can this be so... that Coreg/Carvedilol has "insulin-sensitizing" properties? I've heard of it's antioxidant properties, but not this? Do they measure insulin resistance by measuring actual insulin levels (the study only mentions glycemic control and HbA1C)?
I had thought that all beta blockers carry the risk of insulin resistance and diabetes. Does this mean that Coreg does not? Can anyone comment any further on this?
thanks, peace
--sat
Posted by saturn on May 2, 2006, at 21:41:12
In reply to Coreg: insulin-sensitizing properties?, posted by saturn on May 2, 2006, at 19:13:43
I've read that unlike other beta blockers, Coreg has "insulin sensitizing" properties. Does this mean Coreg does not increase the risk of diabetes like other beta blockers?How can they measure insulin resistance (I suspect just measuring glucose and HBA1C is insufficient)?
Posted by ed_uk on May 3, 2006, at 9:59:30
In reply to Coreg: insulin-sensitizing properties?, posted by saturn on May 2, 2006, at 19:13:43
Hi Saturn
Perhaps surprisingly, cardioselective beta blockers such as atenolol, metoprolol and bisoprolol are actually very useful in diabetic patients! Here is some information......
Non-cardioselective beta blockers are in some cases more problematic in diabetic patients - they can mask the warning signs of hypoglycemia.
>I had thought that all beta blockers carry the risk of insulin resistance and diabetes. Does this mean that Coreg does not?
Apparantly :) I've read that before. It may be due to carvedilol's activity as an alpha blocker. Although carvedilol is not cardioselective, it is clearly a useful drug for some patients with diabetes complicated by hypertension, angina or heart failure.
Regards
Ed
Posted by saturn on May 3, 2006, at 22:13:42
In reply to Re: Coreg: insulin-sensitizing properties? » saturn, posted by ed_uk on May 3, 2006, at 9:59:30
> Hi Saturn
Hey back Ed!
> Perhaps surprisingly, cardioselective beta blockers such as atenolol, metoprolol and bisoprolol are actually very useful in diabetic patients! Here is some information......
>
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12652116&query_hl=5&itool=pubmed_docsumI really appreciate the link--this is very helpful info.
> Non-cardioselective beta blockers are in some cases more problematic in diabetic patients - they can mask the warning signs of hypoglycemia.
> >I had thought that all beta blockers carry the risk of insulin resistance and diabetes. Does this mean that Coreg does not?
>
> Apparantly :) I've read that before. It may be due to carvedilol's activity as an alpha blocker. Although carvedilol is not cardioselective, it is clearly a useful drug for some patients with diabetes complicated by hypertension, angina or heart failure.Perhaps you could get the best of both worlds by taking a cardioselective beta blocker and also an alpa blocker.
I'm going to talk w/ my doc about these options. I'll let ya know how it goes. By the way, how goes it w/you?
Take care,
"sat"
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.