The influence of beta-adrenoceptor blocking drugs with and without intrinsic sympathomimetic activity on the hormonal responses to hypo- and hyperglycaemia.

  title={The influence of beta-adrenoceptor blocking drugs with and without intrinsic sympathomimetic activity on the hormonal responses to hypo- and hyperglycaemia.},
  author={K. J. Schl{\"u}ter and Walter H. Aellig and K. G. Petersen and H C Rieband and Adolf Wehrli and Lothar Kerp},
  journal={British journal of clinical pharmacology},
  volume={13 Suppl 2},
1 The effects of oral doses of pindolol (15 mg), metoprolol (200 mg) and propranolol (160 mg) on the response to insulin-induced hypoglycaemia and an oral glucose load were investigated. 2 Serum insulin and serum C-peptide secretion in response to a glucose load were inhibited (2P less than 0.01) by metoprolol and propranolol but not by pindolol. 3 During hypoglycaemia metoprolol and propranolol inhibited the clearance of insulin (2P less than 0.01) and caused a delay of glucose nadirs. 4… 
Beta-adrenoceptor blockade and hypoglycaemia. A randomised, double-blind, placebo controlled comparison of metoprolol CR, atenolol and propranolol LA in normal subjects.
It is concluded that beta-adrenoceptor antagonists modify the physiological and hormonal responses to, but do not adversely affect awareness of, moderate hypoglycaemia in healthy volunteers.
During a corticotropin-releasing hormone test in healthy subjects, administration of a beta-adrenergic antagonist induced secretion of cortisol and dehydroepiandrosterone sulfate and inhibited secretion of ACTH.
Sympathetic hyperactivity may be a common denominator for low levels of DHEAS in inflammatory and non-inflammatory diseases and a beta-adrenergic influence seems to inhibit adrenal steroids under unstimulated and stimulated conditions.
β-Blockers and Glucose Control
In insulin-dependent diabetics, β-blockers can prolong, enhance, or alter the symptoms of hypoglycemia, while hyperglycemia appears to be the major risk in noninsulin-dependentdiabetics.
The possible role of the ancillary properties of beta adrenoceptor antagonists in the management of angina pectoris.
  • J. Fitzgerald
  • Biology, Medicine
    Acta medica Scandinavica. Supplementum
  • 1985
It is concluded that selective beta adrenoceptor antagonism confers limited, but tangible advantages over non-selective antagonists in regard to patients with reversible airways obstruction, and also in the metabolic and haemodynamic response to acute hypoglycaemia.
Haemodynamic effects of atenolol, pindolol and propranolol during adrenaline infusion in man
It is concluded that a beta1- selective blocker interferes very little with the haemodynamic response to adrenaline, whereas it is changed to a pure pressor response during coadministration of a non-selective betablockers.
β-Adrenoceptor Blocking Agents
The first report of s adrenoceptor blocking activity came in 1958 when the properties of dichloroisoprenaline were discovered in animal experiments and while its importance as a pharmacological tool was recognized, the therapeutic potential of this new approach was not.
The effect of metoprolol treatment on insulin sensitivity and diurnal plasma hormone levels in hypertensive subjects
The insulin sensitivity index may not accurately reflect the insulin effect as the plasma level of insulin was significantly increased during insulin infusion but not at 24’h, possibly because of alteration of distribution and/or degradation rate of exogenous insulin.
Intrinsic Sympathomimetic Activity: Physiological Reality or Marketing Phenomenon
  • C. Black, H. Mann
  • Medicine, Biology
    Drug intelligence & clinical pharmacy
  • 1984
ISA does have a physiological basis and increased experience in larger patient populations will help to place it in proper clinical perspective.


The metabolic consequences of adrenergic blockade: a reveiw.
  • J. L. Day
  • Medicine, Biology
    Metabolism: clinical and experimental
  • 1975
Blockade of isoprenaline-induced changes in plasma free fatty acids, immunoreactive insulin levels and plasma renin activity in healthy human subjects, by propranolol, pindolol, practolol, atenolol, metoprolol and acebutolol.
The results are compatible with the hypothesis that both β1- and β2-adrenoceptors are involved in the regulation of lipolysis, insulin release and renin release and the cardioselectivity for propranolol, pindolol and the higher dose of acebutolol.
The effect of beta-blockade on glucose tolerance and insulin release in adult diabetes.
The data show that treatment with a non-selective beta-blocker can in some patients cause a considerable deterioration of the glucose tolerance, presumably due to inhibition of insulin release.
Effect of adrenergic blocking agents on insulin response to glucose infusion in man.
It isested that the signal induced by the action of glucose on its receptor is transmitted to the insulin secretory mechanisms of the cell by adenyl cyclase, and it is reasoned that glucose in this respect might act directly on specific receptors in the /Ocell membrane.
Acebutolol, atenolol, and propranolol and metabolic responses to acute hypoglycaemia in diabetics.
The hypothesis that beta-adrenoreceptor blocking drugs that are highly beta1 specific and without membrane-stabilising activity should be safer than the non-selective drugs when used in diabetic patients at risk from hypoglycaemia is supported.
Beta-adrenoceptor-blocking drugs and blood sugar control in diabetes mellitus.
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.
Can insulin-treated diabetics be given beta-adrenergic blocking drugs?
It is concluded that beta-blocking drugs are generally safe in insulin-treated diabetics and that hypoglycaemic unconsciousness resulting from their use is rare.
Comparison of atenolol and propranolol during insulin-induced hypoglycaemia.
The effects of atenolol, a new beta1-blocking drug, on pulse rate, sweating, and blood glucose levels during insulin-induced hypoglycaemia were studied in a double-blind crossover trial in eight
Effect of metabolic control on urinary excretion and plasma levels of catecholamines in diabetics.
  • G. Bolli, M. Cartechini, P. Brunetti
  • Medicine, Biology
    Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme
  • 1979
It is confirmed that there is an increased rate of catecholamine release in poorly controlled diabeties and a close correlation between sympathetic activity and metabolic derangement in diabetes is suggested.