Somebody please explain me why beta-blocker medicine exacerbate diabetic condition for the patients who are already taking diabetic medicine?
and also how beta-blocker increase the risk of getting diabetes in some patients?

Thanks in advance.

It is that the bene®t of conventional
antihypertensive treatment with betablockers
will be offset amongst diabetic patients, because
some negative effects on metabolic parameters such
as insulin sensitivity and blood glucose have been
reported for these agents in some studies.moreover,
betablocking agents are often
referred to as less nephroprotective when compared
with other antihypertensive agents like ACEI. In
addition, there is still a fear of an increased risk of
severe hypoglycaemia in diabetic patients treated
with betablockers.

source:http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1365-2796.2001.00829.x?cookieSet=1

 

This review of the literature does not indicate that û1-

selective betablocking agents have adverse effects on

glucose metabolism, prolong hypoglycaemia or mask

hypoglycaemic symptoms. In diabetic nephropathy

betablockers are as nephroprotective as ACEI. Given

the proven primary and secondary cardioprotective

effect in antihypertensive treatment and after myocardial

infarction, there is no evidence-based reason

to withhold these agents from diabetic patients.

 

 

source:http://www.blackwell-synergy.com/doi/pdf/10.1046/j.1365-2796.2001.00829.x?cookieSet=1

Thank you bikash kc bro!

sorry it took me a while to reply. I was looking for direct correlation between non-selective beta-blocker drug and beta-adrenergic receptor to hypoglycemic condition. I found in one of the text books that.. beta 2 agonist will decrease the release of insulin from b2 cells of pancreas responsible for insulin production. Which means beta 2 antagonist will not suppress  insulin production.

I also found that glycogenolysis, gluconeogenesis in liver will be suppressed by the activation of alpha1 and beta2 agonist. If only B2 receptor being activated then glycogenolysis and gluconeogenesis will be diminished partly which means it will add up to hyperglycemic condition. But, since we are talking about Beta 2 antagonist, these beta 2 blockers will probably be mediating the glycogenesis and glycolysis that will lead to hypoglycemic condition.

On top of these, the issue of insulin resistance also makes sense.

A perfect condition for hypoglycemia due to prolong non selective beta blockers will be induced.

i think mechanism is a little complicated and most of it acting indirectly.

Bikash bro, i really appreciate you efforts.. thank you very much.

very interesting topic in fact which has not fully been discovered but beta blocker does not directly affect beta cells of pancreas, in fact more on insulin sensitivity.
first of all it is wrong to say beta blocker can cause diabetes becoz it seldom does.but like coffee333 said in some patienst it may increase risk of diabetes, even can cause, but only on those patients who are on the verge of diabetes but the disease itself has not yet been exposed.
  there r two types of beta blockers: a) cardioselective beta-1 receptor-blocker which works mainly in heart and b)non-selective beta-2 receptor-blocker which also works on other beta receptors for e.g. on bronchial receptors and periphere blood vessels.
 this non-selective could also have effect on pancreas which has not yet been found.but how could these blockers have caused diabetes??these blockers have negative effect on lipid metabolism and insulin sensitivity due to which the body weight may increase upto 4 kilogramms in the first 5-6 weeks.may be in this process, glycolysis gets somewhat inhibited or negatively effected.the most important thing is beta blocker lowers the concentration of HDL which means the concentration of triglycerides are high which leads to worsening of glucosetolerance and this may have caused hypoglycemic symptomps.(like sweating ,positive chronotropy, feeling of hunger etc.).

astu:

Thank you very much for your reply Highvoltage. I did not know that they would gain approx. 4 kgs in around a month. I was aware that they would gain some weight due to decrease in lipolysis but did not know how much. One of the key enzymes of glycolysis is Glucokinase whose activity is dependent upon insulin. Increasing tissue insensitivity might have negative effects on Glucokinase so that glycolysis pathway will be hindered.

we divided non-selective beta blockers as:
1. Non-selective beta blockers : like timolol or propanolol
2. Non-selective Beta antagonist +  Beta agonist = This group also have intrinsic sympathomimetic activity (ISA). Examples: carteolol, penbutolol, pindolol
3. Non-selective Beta antagonist + selective alpha1 antagonist = Carvedilol, Labetalol

And
1. Selective beta1 antagonist or cardioselective= esmolol, atenolol, or metoprolol

bro joke matra garne grenotology bhanera  help gara na yrr....

thanks bro... i have to write in context to us population and in the aspects of human services yrr.. help na yrr..coz it is  HSER 376 corse and i don't have book and i it sucks ...