Long-Standing Problem of β-Blocker–Elicited Hypoglycemia in Diabetes Mellitus
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- Published on May 31, 2017RE: If use of BB is mandatory: use antidiabetic agents without potential for hypoglycemia
- Rajeev Gupta, Consultant Cardiologist, Mediclinic Al Jowhara hospital, Al Ain, UAE
I read with interest the article and the accompanying editorial. In patients with heart failure with reduced ejection fraction (HFrEF), beta blockers (BB) have shown to reduce sudden cardiac deaths and cardiovascular outcomes. However in patients with HFrEFwith AF, BB failed to improve outcomes. Likewise, in diabetics one has to use BB juditiously. With BB, as far as possible avoid using oral sulfonylureas and insulins, as now we have plenty of drugs to control glycemia, particularly with documented favorable CVD outcomes like SGLT2 inhibitors and GLP1 agonists.
In the era of reperfusion, and revascularization therapies: use of BB following acute coronary syndromes (ACS) with normal LV function and without angina pectoris is redundant, may be harmful.
It is high time to conduct a prospective study addressing use of BB amongst patients with HFrEF in diabetics.Competing Interests: None declared.