title: Aggravation by propranolol of hyperglycaemic effect of hydrochlorothiazide in type II diabetics without alteration of insulin secretion.
abstract: 14 hypertensive men with type II diabetes sequentially received, in random order, hydrochlorothiazide 50 mg twice a day, propranolol 80 mg twice a day, and both drugs in combination. The 3-week treatment periods were separated by a 1-week washout period. Hydrochlorothiazide significantly increased fasting glucose by 31% (p less than 0.05) and glycosylated haemoglobin (HbA1c) by 6.0% (p less than 0.10). A similar treatment period of propranolol 80 mg twice a day caused no significant increases. However, when both drugs were taken in combination, fasting glucose rose by 56% and HbA1c by 14.7% (p less than 0.01). The hyperglycaemic effect of hydrochlorothiazide and its potentiation by propranolol were independent of serum potassium and of endogenous insulin secretion as measured by urine C-peptide excretion. The combination of hydrochlorothiazide and propranolol thus seems to cause serious disturbances in glycaemic control in type II diabetics by mechanisms independent of insulin secretion.
authors.forename: A
authors.initials: A
authors.lastname: Dornhorst
authors.forename: S H
authors.initials: SH
authors.lastname: Powell
authors.forename: J
authors.initials: J
authors.lastname: Pensky
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002986:Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D006943:Hyperglycemia / Q000139:chemically induced*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D007328:Insulin / Q000378:metabolism*; D000078790:Insulin Secretion; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D011897:Random Allocation
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D006852:Hydrochlorothiazide; D007328:Insulin; D011188:Potassium; D011433:Propranolol