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

The effects on diabetic control of the relative cardioselective beta-blocker metoprolol and the non-selective drug propranolol were compared in 20 hypertensive diabetic patients receiving diet alone or diet and oral hypoglycaemic agents. Each drug was given for one month in a double-blind, cross-over study. Fasting, noon, and mid-afternoon blood sugar concentrations rose by 1.0-1.5 mmol/l (18-27 mg/100 ml). The rise with propranolol was not significantly greater than with metoprolol. In a few patients the rise was clinically important. The small overall change observed in diabetic control should not deter the use of beta-blockers in non-insulin-dependent diabetics, provided control is carefully monitored at the onset of treatment.