β-Blockers and Glucose Control

Abstract

Literature on the effects of β-blockers on blood glucose is reviewed. Data are presented regarding the adrenergic influences on glucose regulation and the effects of β-blockade during hypo- and hyperglycemia in normal and diabetic individuals. β-adrenergic stimulation enhances insulin and glucagon secretion, as well as glycogenosis, gluconeogenesis, and lipolysis. α-adrenergic stimulation inhibits insulin secretion and may inhibit glucagon secretion and enhance liver glycogenolysis. In nondiabetics, β-blockers represent minimal risk of affecting glucose control. In insulin-dependent diabetics, β-blockers can prolong, enhance, or alter the symptoms of hypoglycemia, while hyperglycemia appears to be the major risk in noninsulin-dependent diabetics. β-blockers can potentially increase blood glucose concentrations and antagonize the action of oral hypoglycemic drugs.