diabetes and beta blokcers

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2cr8tive

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im a bit confused about the relationship between beta blockers and diabetes...

so do beta blockers decrease the insulin release? increase glucagon release? neither? both?

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im a bit confused about the relationship between beta blockers and diabetes...

so do beta blockers decrease the insulin release? increase glucagon release? neither? both?

I believe beta blockers inhibit Both glucagon release (and glycogenolysis), as well as insulin release....seems a bit counterintuitive, but this is what I've learned...FA says that beta 2 causes increased glucagon release, and i read elsewhere that it also increases insulin release....beta blockers would exert the opposite effects then and decrease both
 
As far as I know the effects of beta blockade on the release of insulin are not the main reason for their contraindication in DM. The problem with giving beta blockers to a diabetic is that it will prevent the heart palpitations which warn the patient of an impending hypoglycemic crisis when he/she has administered too much insulin or skipped a meal. Those palpitations are sort of like the early warning system and without them the patient may not have enough time to correct the situation before they become severely hypoglycemic.
 
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activation of B2 receptors causes icrease insulin release from the pancreas (beta blockers do the opposite), and activation of alpha2 decreases it.
 
im a bit confused about the relationship between beta blockers and diabetes...

so do beta blockers decrease the insulin release? increase glucagon release? neither? both?

My understanding:

Data show decreased glucose utilization and development of insulin resistance. Decreased glucose utilization is pretty easy to explain, but speculations abound about insulin resistance.
Decrease insulin release, decrease perfusion--> decrease glucose utilization.

Don't block beta3 receptors, depending on agent may not block beta2 as strongly as beta1, doesn't block alpha--> leads to increased activity of B3 and B2 and A--> increased intracellular lipolysis, increased glycogenolysis, increased gluconeogenesis--> wave my hands -->insulin resistance.
Carvedilol doesn't seem to be as much of a problem in developing insulin resistance, so unopposed activity of B2 has some support there.

In the clinic, don't knee jerk avoid beta blockers for DM2 patients (who's big problem is really heart disease, not glycemic control).

I think I'll check with my friendly neighborhood cardiologist.
 
im a bit confused about the relationship between beta blockers and diabetes...

so do beta blockers decrease the insulin release? increase glucagon release? neither? both?

From my understanding, beta2 agonists send K+ into the cell by way of the Na-K pump by increasing cAMP. Insulin also sends K+ into the cell. So both would decrease serum K+

So in a diabetic Pt with low insulin levels, if you give them a beta-blocker you can make them hyperkalemic. The beta blocker also may lower insulin, thus worsening the hyperkalemia.

From FA (pharm section):
*beta2 R-> increase glucagon release.
*alpha2 R-> decrease insulin release.

From BRS Phys (p 256):
*Glucagon stimulates insulin release
*Epi/NE/Ach stimulate glucagon release

So my interpretation is: if you give a beta blocker-> decrease in glucagon-> no stimulus for insulin release-> would lower insulin levels (I'm not taking into account other factors that would affect insulin/glucagon here)

Please somebody correct me if I'm wrong.

Hope this helps!
 
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