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DrVirgo
Forum Junior  Topics: 731 Posts: 3487 |
What is the mechanism by which Beta blockers mask the symptoms of hypoglycemia? (this is for both selective and non-selective beta blockers)...
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mjl1717
| Forum Junior  Topics: 964 Posts: 5442
it may have to do with beta blockers inhibiting gluconeogenesis
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DrVirgo
| Forum Junior Topics: 731 Posts: 3487
Also: Beta 2 effects on Sk. Muscle and Liver cause increased glycogenolysis... and increase glucose. So, beta blockers would decrease glycogenolysis... and decrease glucose. (maybe this is the reason) Beta 2 also works on the pancreas and causes increase insulin secretion which would decrease glucose... Blocking this would do the opposite... decrease insulin, increase glucose... So final effect of beta blockade would be.......?
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syed312
| Forum Newbie  Topics: 1 Posts: 13
All Right Guys, i got the ANSWER to the question, It is not that B-Blockers masking ... Question is like this, When a Patient is taking Both B-Blockers and Insulin at same time, B-Blockers will not let the hypoglycemic symptoms show, and thus a patient will never know if he took more or less Insulin, and if now the body is at Hypoglycemia or Hyperglycemia, that is why it is Contraindicated.. it is Fatal
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arpita1586
| Forum Newbie Topics: 5 Posts: 90
the sx of hypoglycemia (tremors, sweating, palpitations) are all sympathetic system mediated. now if you give b-blockers, you block catecholamine actions, and therefore you prevent these sx from occuring... so b-blockers mask hypoglycemia. isn't this the right mechanism?
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zwmack
| Forum Senior  Topics: 16 Posts: 103
yea arpita1586 sounds the most correct. Whats also interesting yet confusing is the fact that i read an article that reported hyperglycemia in diabetic patients taking beta blockers. Beta blockers are also contraindicated with thiazide diuretics for the same reason. Can anyone explain this? 
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zwmack
| Forum Senior Topics: 16 Posts: 103
This is the article i was talking about. www.diabetes.org/diabetes-r...s/bakris-bloodpressure.jsp
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fauzia
| Forum Newbie Topics: 1 Posts: 64
the reason for B-blocker masking the hypoglycemia is exactly wat, arpita1586 said. b/c B-blockers inhibit flight, fright n fight response by blocking symp. activity. which is very crucial in DM. if pat wouldnt have any clue he would be unable to take any action n might die. without knowing wat went wrong. the reason why Bblockers causes hyperglycemia is......B2 (Via Epi) stimulatiom causes increase gycogenolysis ,gluconeogenesis & increase Insulin secretion, which helps decreasing bld glucose......and if we block B2 recepters. the insulin secretion will decrease-------------->which will cause Hyperglycemia.
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doctprashant
| Forum Junior  Topics: 2 Posts: 58
hi friends..  i want to correct the concept which is all in the air here... particularly beta 2 cause release of glucose from the liver by glycogenolysis so beta blocker which is non specific or b2 specific blocker they reduces the this glycogenolysis and beta blocker also inhibit the adrenergic symptoms except sweating..so in diabetes beta blocker may mask the hypoglycemic symptoms and also cause prolonged hypoglycemia............friends..to spare this effect one can use beta1 blocker as bisoprolol in diabetes
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mylkoa
| Forum Newbie Topics: 1 Posts: 2
arpita1586 is correct. "Diabetes. Propranolol can be detrimental to diabetic patients in two ways. First, by blocking beta2 receptors in muscle and liver, propranolol can suppress glycogenolysis, thereby eliminating an important mechanism for correcting hypoglycemia (which can occur when insulin dosage is excessive). Second, by blocking beta1 receptors, propranolol can suppress tachycardia, which normally serves as an early warning signal that blood glucose levels are falling too low. (When glucose drops below a safe level, the sympathetic nervous system is activated, causing an increase in heart rate.) By “masking” tachycardia, propranolol can delay awareness of hypoglycemia, thereby compromising the patient's ability to correct the problem in a timely fashion. Diabetic patients who are taking propranolol should be warned that tachycardia may no longer be a reliable indicator of hypoglycemia. In addition, they should be taught to recognize alternative signs (sweating, hunger, fatigue, poor concentration) that blood glucose is falling perilously low. Because of its ability to suppress glycogenolysis and mask tachycardia, propranolol must be used with caution by diabetic patients." (Lehne, Richard A.. Pharmacology for Nursing Care, 7th Edition. W.B. Saunders Company, 082009. 19.4.1.5.2). pg 169
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