Adrenergic blockade and hypoglycaemia.
The metabolic effects of beta-adrenoceptor blocking agents during hypoglycaemia in patients prone to hypoglycaemia are of interest as diabetics are often treated with these drugs because of hypertension or angina pectoris. Compared with non-diabetics these patients also have impaired glucose compensation after hypoglycaemia, partly secondary to deficient release of glucagon. This makes the diabetics more dependent on adrenergic mechanisms to recover from low blood glucose concentrations. Non-selective beta-adrenoceptor blockade (propranolol) significantly impairs the glucose recovery rate after hypoglycaemia in insulin dependent diabetics, whereas selective beta-adrenoceptor blockade (metoprolol) does not have this side effect. The mechanism of the effect of propranolol is probably an attenuation of the gluconeogenesis secondary to deficient release of the important gluconeogenic substrates lactate and glycerol.
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D005934:Glucagon / Q000378:metabolism; D005943:Gluconeogenesis; D005990:Glycerol / Q000378:metabolism; D006003:Glycogen / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007003:Hypoglycemia / Q000139:chemically induced*; D007328:Insulin / Q000009:adverse effects; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008099:Liver / Q000378:metabolism; D008790:Metoprolol / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D007328:Insulin; D007773:Lactates; D019344:Lactic Acid; D006003:Glycogen; D005934:Glucagon; D011433:Propranolol; D008790:Metoprolol; D005990:Glycerol