Abstract
In a double-blind crossover study the symptomatic and metabolic effects of propranolol, acebutolol, and atenolol were studied during insulin-induced hypoglycaemia in diabetics treated with diet or hypoglycaemic tablets. All the drugs prevented tachycardia, but did not affect the other symptoms of hypoglycaemia. Propranolol delayed the recovery of the blood glucose concentration and impaired the secondary rise in the concentrations of blood lactate and non-esterified fatty acids in diet-treated diabetics. Acebutolol potentiated the hypoglycaemic effect of insulin in tablet-treated diabetics (mean difference of blood glucose concentration 0.7 mmol/l (12.6 mg/100 ml)) and this difference was maintained during the recovery phase4 the blood lactate response was also impaired. Atenolol did not differ perceptibly from placebo in its effect on the metabolic responses to acute hypoglycaemia. The results may be explained by differences in the known pharmacological actions of these drugs. They support the hypothesis that beta-adrenoreceptor blocking drugs that are highly beta1 specific and without membrane-stabilising activity should be safer than the non-selective drugs when used in diabetic patients at risk from hypoglycaemia.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abramson E. A., Arky R. A., Woeber K. A. Effects of propranolol on the hormonal and metabolic responses to insulin-induced hypoglycaemia. Lancet. 1966 Dec 24;2(7478):1386–1388. doi: 10.1016/s0140-6736(66)90422-3. [DOI] [PubMed] [Google Scholar]
- Deacon S. P., Barnett D. Comparison of atenolol and propranolol during insulin-induced hypoglycaemia. Br Med J. 1976 Jul 31;2(6030):272–273. doi: 10.1136/bmj.2.6030.272. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kotler M. N., Berman L., Rubenstein A. H. Hypoglycaemia precipitated by propranolol. Lancet. 1966 Dec 24;2(7478):1389–1390. doi: 10.1016/s0140-6736(66)90423-5. [DOI] [PubMed] [Google Scholar]
- Linton S. P., Scott P. H., Kendall M. J. Blood sugar and beta-blockers. Br Med J. 1976 Oct 9;2(6040):877–878. doi: 10.1136/bmj.2.6040.877-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pogátsa G., Káldor A., Vizi E. S. The role of local-anesthetic effect in the inhibition of glycogenolysis in the liver of the rat. Arzneimittelforschung. 1973 Aug;23(8):1085–1087. [PubMed] [Google Scholar]
- TROUT D. L., ESTES E. H., Jr, FRIEDBERG S. J. Titration of free fatty acids of plasma: a study of current methods and a new modification. J Lipid Res. 1960 Apr;1:199–202. [PubMed] [Google Scholar]