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Nicardipine may impair glucose metabolism in hypertensive diabetic patients
1First Department of Medicine, Wakayama University of Medical Science, Japan.
Insights
Certain blood pressure medications, including beta-blockers and nicardipine, can worsen glucose control in patients with non-insulin-dependent diabetes mellitus (NIDDM). Diltiazem and enalapril did not affect hemoglobin A1c (HbA1c) levels.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Hypertension management in patients with non-insulin-dependent diabetes mellitus (NIDDM) requires careful drug selection.
- Hemoglobin A1c (HbA1c) is a key indicator of long-term glycemic control.
Purpose of the Study:
- To evaluate the impact of different antihypertensive medications on HbA1c levels in NIDDM patients.
- To identify which drug classes may adversely affect glucose metabolism.
Main Methods:
- Retrospective analysis of NIDDM patients with stable HbA1c and body weight.
- Comparison of HbA1c changes after 6 months of treatment with beta-blockers, calcium-channel blockers (nicardipine, diltiazem), and an ACE inhibitor (enalapril).
Main Results:
- Beta-blockers (atenolol, metoprolol, carteolol, arotinolol) and nicardipine significantly increased HbA1c levels.
- Diltiazem and enalapril showed no significant effect on HbA1c levels.
Conclusions:
- Beta-blockers and the dihydropyridine calcium-channel blocker nicardipine may impair glucose metabolism in NIDDM patients.
- Diltiazem and enalapril appear to be safer options regarding glycemic control in this population.
Abstract:
The respective effects of 6 month's administration of beta-blockers (atenolol, metoprolol, carteolol and arotinolol), calcium-channel blockers (nicardipine, diltiazem) and angiotensin converting enzyme inhibitor (enalapril) on hemoglobin A1c (HbA1c) levels were evaluated in hypertensive patients with non-insulin-dependent diabetes mellitus (NIDDM), using a retrospective method. NIDDM patients with stable HbA1c and body weight were selected for this study. The following results were obtained. (1) The administration of nicardipine or beta-blockers significantly elevated HbA1c levels. (2) The administration of diltiazem or enalapril did not have any influence on HbA1c levels. These findings suggest that not only beta-blocker but nicardipine (dihydropyridine type calcium-channel blocker) may cause deterioration in glucose metabolism in NIDDM patients.