Influence of carvedilol on blood glucose and glycohaemoglobin A1 in non-insulin-dependent diabetics.
Pharmacological treatment of hypertension can, cause clinically significant alterations in endocrine function and glucose homeostasis. The aim of this study was to investigate the antihypertensive efficacy and the influence on carbohydrate metabolism of carvedilol and metoprolol in non-insulin-dependent diabetics with mild to moderate hypertension. The patients received either carvedilol 25mg twice daily or metoprolol 50mg twice daily for a period of 4 weeks; if diastolic blood pressure was over 90mm Hg at this time, the dosage was doubled for the subsequent 4 weeks. 49 of 89 enrolled patients completed the trial according to the protocol and were statistically evaluated. After 4 weeks of carvedilol treatment, 23 of 25 patients (92%) showed a good response to therapy (reduction of diastolic blood pressure below 90mm Hg). Doubling of dosage in the carvedilol group did not further increase the response rate after another month of treatment. The response rate after 4 and 8 weeks of metroprolol treatment was 79 and 83%, respectively. In both treatment groups, blood glucose concentrations were maintained within narrow limits. Glycated haemoglobin A1, which provides a profile of the mean blood glucose levels present during the preceding weeks, also remained unchanged. Oral antidiabetic medication taken by the patient remained constant and no hypoglycaemia was reported. When used in therapeutic doses in non-insulin-dependent diabetics, carvedilol is thus unlikely to cause a deterioration of carbohydrate metabolism.
Ehmer
B
B
Department of Cardiology and Angiology, Boehringer Mannheim GmbH, Federal Republic of Germany.
van der Does
R
R
Rudorf
J
J
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D011412:Propanolamines / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D002227:Carbazoles; D000077261:Carvedilol; D002784:Cholesterol; D006442:Glycated Hemoglobin; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D011412:Propanolamines; D014280:Triglycerides