Can metoprolol raise blood sugar

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Can Metoprolol Raise Blood Sugar?

Introduction to Metoprolol and Blood Sugar Levels

Metoprolol, a beta-blocker commonly used to treat hypertension and other cardiovascular conditions, has been studied for its effects on blood sugar levels. Understanding these effects is crucial, especially for patients with diabetes or those at risk of developing diabetes.

Metoprolol and Insulin Sensitivity

Several studies have investigated the impact of metoprolol on insulin sensitivity. Research indicates that metoprolol can decrease insulin sensitivity, leading to higher blood glucose levels. For instance, a study involving hypertensive patients found that glucose uptake mediated by insulin decreased significantly when patients were treated with metoprolol . This reduction in insulin sensitivity can contribute to elevated blood sugar levels.

Blood Sugar Control in Diabetic Patients

In diabetic patients, the use of metoprolol has been shown to affect blood sugar control. A study comparing metoprolol with propranolol in hypertensive diabetic patients found that both drugs caused a rise in fasting, noon, and mid-afternoon blood sugar concentrations by 1.0-1.5 mmol/l (18-27 mg/100 ml) . Although the rise was not significantly greater with metoprolol compared to propranolol, it was clinically important in some patients, indicating that metoprolol can indeed raise blood sugar levels in diabetic individuals.

Long-Term Effects on Blood Glucose

Long-term use of metoprolol has also been associated with metabolic abnormalities. A study on patients with diastolic hypertension reported that metoprolol treatment led to an increase in fasting blood glucose and 2-hour postprandial blood glucose levels after 24 months . This suggests that prolonged use of metoprolol can contribute to sustained hyperglycemia.

Experimental Studies on Metoprolol

Experimental studies on animals have further supported these findings. Research on male Wistar rats demonstrated that metoprolol administration resulted in elevated blood glucose levels and decreased glycogen content, which may be related to higher glucose output . These results highlight the potential for metoprolol to induce hyperglycemia as an unwanted side effect.

Conclusion

In summary, metoprolol has been shown to raise blood sugar levels by decreasing insulin sensitivity and causing metabolic abnormalities. This effect is observed in both diabetic and non-diabetic patients, as well as in experimental animal studies. Therefore, careful monitoring of blood glucose levels is recommended for patients undergoing metoprolol treatment, particularly those with diabetes or at risk of developing diabetes.

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Most relevant research papers on this topic

Sensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients.

Long-term use of metoprolol and atenolol causes metabolic abnormalities, potentially contributing to the increased incidence of diabetes in patients with hypertension treated pharmacologically.

RCTHighly Cited

1989·

382citations

·T. Pollare et al.

Beta-adrenoceptor-blocking drugs and blood sugar control in diabetes mellitus.

Beta-blockers can improve blood sugar control in non-insulin-dependent diabetics, with propranolol showing a slightly greater rise in blood sugar than metoprolol.

Highly Cited

1979·

124citations

·A. Wright et al.

The effect of Metoprolol on blood glucose in patients with diastolic hypertension

Metoprolol effectively lowers diastolic blood pressure but may cause hyperglycemia, so monitoring blood glucose is crucial.

RCT

2013·

0citations

·Deng Wen-ji

Comparison of propranolol, metoprolol, and acebutolol on insulin-induced hypoglycaemia.

Propranolol and metoprolol both potentiate insulin-induced hypoglycemia and delay return to normal blood glucose levels, while acebutolol also potentiates but does not delay return to normal blood glucose levels.

Non-RCT

1976·

67citations

·R. Newman

The effect of metoprolol treatment on insulin sensitivity and diurnal plasma hormone levels in hypertensive subjects

Metoprolol treatment may not induce insulin resistance in hypertensive subjects, as its effect on insulin sensitivity may be less significant than previously thought.

RCT

1997·

18citations

·S. Gudbjörnsdottir et al.

[Experimental study of metoprolol-induced side effects].

Metoprolol, a beta1-selective adrenoceptor antagonist, can cause high blood glucose and secondary hypertriglyceridaemia in male Wistar rats, potentially causing unwanted effects.

Non-RCTAnimal Study

1998·

1citation

·J. Gergely

Metoprolol in diabetes mellitus: effect on glucose homeostasis.

Metoprolol therapy combined with hydrochlorothiazide effectively lowers blood pressure in hypertensive diabetic patients without significantly affecting glucose homeostasis.

Non-RCT

1980·

10citations

·B. Garrett et al.

Glucose tolerance and insulin release in hypertensive patients treated with the cardioselective beta-receptor blocking agent metoprolol.

Metoprolol treatment does not affect blood glucose or insulin levels in hypertensive patients, and does not affect insulin response to i.v. or oral glucose loads.

2009·

46citations

·Göran Ekberg et al.

Effects of metoprolol on the counter-regulation and recognition of prolonged hypoglycemia in insulin-dependent diabetics.

Metoprolol does not aggravate prolonged hypoglycemia in insulin-dependent diabetics with blunted glucagon response, and may compensate for its inhibitory effect on insulin clearance through increased responses of counter-regulatory hormones.

Non-RCT

2009·

41citations

·N. Clausen-Sjöbom et al.

Beta-blockers used in cardiac failure and blood glucose level impairment - a literature review

Metoprolol should not be used in patients with impaired glucose metabolism, while bisoprolol, nebivolol, or carvedilol may be recommended for cardiac failure and impaired carbohydrate metabolism.

Systematic Review

2023·

2citations

·Kamila Fularska et al.

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