Benefits and Risks of Beta-Blockers for Diabetes

Beta-blockers are used to manage several medical issues, including some complications related to diabetes. They can produce side effects like headaches and tiredness.

People with diabetes often develop cardiovascular disease or experience stroke earlier than those without diabetes. One contributing factor is that elevated blood sugar increases the likelihood of developing high blood pressure (hypertension).

According to the American Diabetes Association (ADA), nearly 1 in 3 Americans have high blood pressure and don’t know it. Among people with diabetes, about 2 out of 3 have hypertension.

High blood pressure often has no noticeable symptoms. You might feel well while your heart is under extra strain. This is particularly dangerous for individuals with diabetes.

Elevated blood pressure places substantial stress on your body. Over time it can lead to hardening of the arteries and can damage the brain, kidneys, eyes, and other organs.

What are beta-blockers?

Beta-blockers (beta-adrenergic blocking agents) are a group of prescription medicines. They treat a range of problems such as glaucoma, migraines, and anxiety, as well as heart failure and hypertension. High blood pressure raises the chance of heart disease and stroke.

Beta-blockers block the actions of the hormone norepinephrine (adrenaline). This reduces nerve signals to the heart, causing the heart to beat more slowly.

Your heart then exerts less effort and pumps with less force. Beta-blockers can also help dilate blood vessels, improving circulation.

Different beta-blockers

Beta-blockers are sold under many brand and generic names. Examples include:

• acebutolol (Sectral)
• atenolol (Tenormin)
• betaxolol (Kerlone)
• bisoprolol (Zebeta)
• metoprolol (Lopressor, Toprol-XL)
• nadolol (Corgard)
• penbutolol sulfate (Levatol)
• pindolol (Visken)
• propranolol (Inderal LA, InnoPran XL)
• timolol maleate (Blocadren)

Your physician will choose the best option for you. Follow their directions and read the medication label carefully. If you experience adverse effects, inform your doctor promptly. Modifying the dose or switching drugs may change the side effect profile.

Managing high blood pressure

If you have hypertension, your clinician might try other treatments first. If other first-line drugs don’t control your blood pressure, beta-blockers may be considered.

The choice to use medications, including beta-blockers, depends on your individual medical background. A 2015 systematic review suggests drug therapy to reduce systolic blood pressure (the top number) when it’s above 130 mm Hg.

For people with diabetes, controlling high blood pressure lowers the risk of cardiovascular events, kidney disease, and nerve damage.

Effects of beta-blockers on blood sugar

If you have diabetes, you know how crucial it is to recognize signs of low blood sugar so you can respond quickly. Taking beta-blockers can make spotting those warning signs harder.

One sign of hypoglycemia is a rapid heartbeat. Because beta-blockers slow the heart rate, that reaction may be muted.

You might not be able to rely on symptoms to detect low blood sugar, which can be dangerous. You’ll need to monitor your glucose levels frequently and maintain consistent eating habits, especially if you’re prone to hypoglycemia.

Common side effects of beta-blockers

Beta-blockers can cause a range of side effects. Some of the more common ones include:

• fatigue
• cold hands and feet
• headache
• dizziness
• upset stomach
• constipation or diarrhea

Because beta-blockers can affect nutrient absorption, your doctor might advise reducing sodium and/or calcium intake. Also note that orange juice can interfere with how these medications work.

Some patients report shortness of breath, trouble sleeping, and decreased libido. In men, beta-blockers can reduce blood flow to the penis and contribute to erectile dysfunction.

Beta-blockers may also increase triglyceride and cholesterol levels. This can be temporary, but your provider may want to monitor these values.

Working closely with your healthcare team

For people with diabetes, regular medical follow-up is essential. Along with tracking blood glucose, you should monitor your blood pressure.

Because hypertension usually produces no symptoms, have your blood pressure checked regularly. Ask your clinician about using a home blood pressure monitor.

Detecting elevated blood pressure early might help you postpone or avoid the need for medications to control it.

Limit alcohol intake. If you smoke, think about quitting. Collaborate with your doctor and dietitian to maintain a balanced diet and regular physical activity.

Bottom line

Beta-blockers are medications prescribed for several conditions, including high blood pressure, anxiety, and migraine. They can cause side effects such as headaches, fatigue, and lightheadedness.

Discuss with your doctor whether beta-blockers are a suitable choice for your situation.