Does metoprolol affect blood sugar

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

The Impact of Metoprolol on Blood Sugar Levels

Introduction to Metoprolol and Blood Sugar

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

Metoprolol and Hyperglycemia

Several studies have indicated that metoprolol can lead to an increase in blood glucose levels. For instance, a study on patients with diastolic hypertension found that while metoprolol effectively reduced blood pressure, it also caused hyperglycemia, necessitating careful monitoring of blood glucose levels . Similarly, another study comparing metoprolol with propranolol in hypertensive diabetic patients observed a rise in blood sugar concentrations by 1.0-1.5 mmol/l, suggesting that metoprolol can affect diabetic control .

Insulin Sensitivity and Glucose Tolerance

Research has shown that metoprolol can impair insulin sensitivity. A randomized, double-blind study comparing metoprolol and atenolol found that both drugs decreased glucose uptake mediated by insulin, indicating reduced insulin sensitivity . Additionally, metoprolol was found to increase fasting plasma insulin and blood glucose concentrations, further supporting its role in metabolic disturbances .

However, not all studies agree on the extent of these effects. Some research has shown that metoprolol does not significantly alter glucose tolerance or insulin response in certain populations. For example, a study on maturity-onset diabetics found no significant effect of metoprolol on fasting plasma glucose, glucose tolerance, or insulin response . Another study on hypertensive diabetic subjects reported no significant changes in glucose homeostasis after eight weeks of metoprolol therapy .

Comparative Studies with Other Beta-Blockers

Comparative studies have highlighted differences between metoprolol and other beta-blockers. For instance, a study comparing nebivolol and metoprolol found that nebivolol was more effective in reducing blood glucose levels and had fewer adverse metabolic effects . Another study noted that while both metoprolol and propranolol potentiated insulin-induced hypoglycemia, metoprolol delayed the return to normoglycemia, indicating a potential risk for prolonged hypoglycemia .

Conclusion

In summary, metoprolol can affect blood sugar levels by increasing blood glucose concentrations and impairing insulin sensitivity. These effects necessitate careful monitoring, especially in diabetic patients or those at risk of developing diabetes. While some studies suggest minimal impact on glucose tolerance, the overall evidence points to a need for caution when prescribing metoprolol to patients with metabolic concerns. Further research and comparative studies with other beta-blockers can provide deeper insights into optimizing treatment for hypertensive patients with diabetes.

Sources and full results

Most relevant research papers on this topic

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

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·

125citations

·A. Wright et al.

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·

383citations

·T. Pollare et al.

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·

68citations

·R. Newman

Lack of effect of propranolol and metoprolol on glucose tolerance in maturity-onset diabetics.

Propranolol and metoprolol do not significantly affect glucose tolerance or insulin response in maturity-onset diabetics, with no consistent difference between the two drugs.

RCT

1980·

11citations

·K. L. Woods 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.

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.

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.

To Study the Comparative Effect of Nebivolol and Metoprolol on Fasting and Post meal Blood Glucose Level in Patients of Type II Diabetes Mellitus with Essential Hypertension

Nebivolol is more effective than metoprolol in reducing blood glucose, HbA1c, and blood pressure with lesser side effects in type II diabetic and hypertension patients.

2021·

0citations

·Bhagat Ah et al.

Differential Effects of Nebivolol and Metoprolol on Insulin Sensitivity and Plasminogen Activator Inhibitor in the Metabolic Syndrome

Metoprolol decreases insulin sensitivity and increases oxidative stress in patients with metabolic syndrome, while nebivolol does not have these negative effects.

RCTRigorous JournalHighly Cited

2012·

76citations

·Kati A. Ayers et al.

Try another search

space exploration rockets

omeprazole 20 mg cpdr

1.5 degrees celsius climate change

prilosec otc vs prescription prilosec

how long do gabapentin take to work

is omeprazole over the counter