Hyperglycemia and diabetic coma: possible relationship to diuretic-propranolol therapy.
Two patients developed diabetic coma when taking a combination of a thiazide diuretic and propranolol. On subsequent follow-up one patient is taking no insulin and has been maintained on hydrochlorothiazide; the other patient required insulin on two occasions when challenged with a propranolol-thiazide combination, but not when the thiazide was discontinued or replaced with furosemide. These reports suggest the possibility that the risk of developing hyperglycemia and diabetic coma with this combination may be greater than when taking diuretics alone. The mechanism is probably multifactorial.
D003926:Diabetic Coma / Q000139:chemically induced*; D004232:Diuretics / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects*; D006943:Hyperglycemia / Q000139:chemically induced* / Q000188:drug therapy; D006944:Hyperglycemic Hyperosmolar Nonketotic Coma / Q000139:chemically induced* / Q000188:drug therapy; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000009:adverse effects*
D004232:Diuretics; D007328:Insulin; D006852:Hydrochlorothiazide; D011433:Propranolol