Effect of non-selective beta blocker on insulin sensitivity in insulin dependent diabetic patients

ABSTRACT

Insulin sensitivity test has been performed before and after propranolol administration in 15 insulin dependent diabetic patient and 10 control subjects of matched age and sex. Recovery from hypoglycaemia was delayed after propranolol administration with a significant lowering of the plasma glucose level all through, the test period in all patients and control subjects. Tachycardia was replaced by bradycardia at the lowest hypoglycaemic level after propranolol in 13 patients and all controls. One patient developed heart block and another patient developed clinical as well as ECG manifestations of myocardial ischaemia at the lowest hypoglycaemic level after propranolol. Systolic blood pressure was elevated at the same level before while both systolic and diastolic pressures were elevated after propranolol administration at the lowest hypoglycaemic level. All these findings were discussed. It is concluded that hypoglycaemia is hazardous in diabetic patients on propranolol for cardiovascular diabetic complications, not only because of elucidation of subclinical myocardial ischaemia or conduction abnormalities, but also for the masked hypoglycaemic manifestations experienced before by the patient