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clinical pharmacology

CARDIOSELECTIVE ~,-BLOCKERS MAY BE PREFERABLE FOR DIABETICS

They seem to have less effect on glucose tolerance tests Non-selective ~-blockers in the usual doses seem to influence glucose tolerance in adult diabetics to a greater extent than cardioselective ~I-blockers, according to a study in 10 adult diabetics. They were given in crossover fashion for at least 3 weeks, a non-selective ~-blocker, alprenolol, or a cardioselective ~I-blocker, metoprolol. They were on a controlled diet for 3 days before the study. Fasting blood glucose levels were higher in most patients while they were on alprenolol than on metoprolol. Two patients had significantly higher blood glucose levels on alprenolol than on metoprolol. Glucose tolerance (IV and oral) was also considerably reduced in these 2 patients when on alprenolol. This was associated with reduced insulin release during the load. The response to glucose tolerance tests did not differ significantly between the 2 drugs in the other patients, although mean blood glucose levels tended to be higher on alprenolol. The mean insulin levels for all 10 patients were not significantly different in the 2 treatment periods.

'Since cardioselective ~I-blockers not only influence glucose tolerance less but also . .. recovery from hypoglycemia, it appears that these agents are preferable when a beta-blocker is required in diabetics.'

Holm. G. et al.: Acta Medica Scandinavica 208: 187 (No 3, 1980)

0156-2703/80/1101-0013 $00.50/0 ©ADIS Press INPHARMA 1 Nov 1980 13