A trial of metoprolol in hypertensive insulin-dependent diabetic patients

Twenty-four insulin-dependent, hypertensive diabetic patients were treated with a beta 1-selective blocking agent (metoprolol) to evaluate its influence on diabetic state and arterial blood pressure (BP). Two groups were delineated after exclusion of one patient. Twelve patients (group A) obtained normotension with metoprolol alone, whilst 11 (group B) required concomitant treatment with thiazides, 7 of them both with thiazides and hydralazine. BP fell significantly in group B, by 15% (p less than 0.01), compared with pretreatment levels. Postprandial blood glucose levels, glucose excretion and insulin requirements were unchanged during treatment in all patients. Neither quantitative nor qualitative changes in the recognition of the effects of insulin were observed by 15 diabetics familiar with this sensation. Side-effects were few. One episode of severe hypoglycaemia, probably unrelated to the beta-blockade, was encountered. We suggest that antihypertensive treatment with metoprolol is a reasonable alternative in the treatment of hypertensive insulin-dependent diabetic patients.