Beta-blockers are common medications used to control high blood pressure, but can block dangerous signs of low blood sugar in people with diabetes. Read this lesson to learn more about how diabetes is affected by this class of medication.

Diabetes: a Magnet for Comorbidities

Diabetes occurs when the body creates little to no usable insulin. The hormone insulin helps regulate blood sugar levels, and it’s stored and released by beta cells in the pancreas. Dave knows this, since he’s been diagnosed as a diabetic for over twenty years. This means that when Dave intakes sugar, his body cannot effectively break down the food into sugars his body’s cells can actually use.

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Dave’s issue is problematic because it leaves a large amount of unprocessed sugars in his bloodstream, which can lead to a myriad of concerning health issues. Not only does hyperglycemia (a dangerously high amount of sugar in the bloodstream) lead to excessive thirst, urination, and altered mental status, it also has potential long-term side effects if left unmanaged.

Diabetes places people like Dave at risk for other diseases, or comorbidities. A comorbidity is a disease or condition that occurs alongside and is often made worse by a primary disease. Some of these chronic conditions include the following:

  • Multi-system organ damage
  • Cardiovascular disease
  • Permanent blindness
  • Nerve damage

Because Dave’s diabetes was left unmanaged for many years before it was diagnosed, he developed cardiovascular disease and experiences frequent high blood pressure.

Cardiovascular Disease and Diabetes

Cardiovascular disease is a common comorbidity found in individuals with diabetes. The term cardiovascular means anything in the body that is related to the heart, veins, and arteries that are responsible for pumping blood throughout our system. Sometimes, people with cardiovascular disease have issues with hardening of the veins and arteries, atypical heart rhythms, or insufficient pumping action of the heart.

When Dave was diagnosed with high blood pressure, his physician also found his heartbeat to be irregular. To help prevent Dave from having a heart attack, he was prescribed a beta-blocker. A beta-blocker is an oral medication that remains the typical course of treatment for high blood pressure and irregular heart rhythms.

How Beta-Blockers Work

Since Dave takes a beta-blocker, his physician thought it was a good idea for Dave to have a basic understanding of how beta-blockers work. In the body, there are two types of beta receptors, or special nerve receptors that respond to hormones and other agents to cause physiological responses, like raising a person’s heart rate. Beta-blockers work by doing just what they say they are going to do: they block messages to receptor cells.

Beta-1 receptors, the first type of beta receptor, help to regulate messages sent to the heart, while beta-2 receptors receive messages to other organs in the body, including pancreatic beta cells. This information is important to consider while trying new beta-blocker medications. Since pancreatic beta cells store and release insulin, they may or may not be affected by the class of beta-blocker.

Beta-Blocker Risks for Diabetics

While beta-blockers may be a great solution to high blood pressure, Dave’s physician was aware that the medication may cause additional issues with Dave’s diabetes. The physician made sure to educate Dave on the following information to help prevent future complications.

  1. Symptoms of low blood sugar – Dave’s physician explained that signs of hypoglycemia, or low blood sugar, may be masked when taking beta-blockers. This occurs because the drug targets beta receptors (including ones that control and regulate organs other than just the heart) that play a part in hypoglycemic symptoms. Dave did some research and learned that a few common symptoms of low blood sugar included chills, confusion, sweating, and a rapid heartbeat. Dave learned that, while beta-blockers maintained his blood pressure within the safe range, the medication would still manage his heart beat and rhythm despite experiencing low blood sugar.
  2. Monitoring blood sugar levels – Because Dave would not be able to sense low blood sugar as well as he could if he was not taking beta-blocker medication, he must be extra-vigilant. He was advised to check his blood sugar levels regularly, so he agreed to check blood sugar levels before every meal and prior to bedtime.

Dave’s doctor also explained that, even if Dave was not a diabetic, beta-blockers could increase his risk of developing diabetes. He learned that this medication may block the release of insulin from pancreatic beta cells, which would interfere with the body’s ability to break down common sugars found in foods – in other words, diabetes. This fact really caught Dave’s attention as to how this important medication reacts with his body and his ability to metabolize sugars and create energy.

Lesson Summary

Diabetes is a disease where the body creates little to no usable insulin for regulating blood sugar levels. Due to systemic effects of diabetes, it is common to have comorbidities like cardiovascular, nerve, and other organ diseases. Cardiovascular conditions, like high blood pressure and atypical heart rhythms, are especially common in individuals with diabetes, making it critical to control and monitor these damaging effects on the body.

As a form of treatment, medications like beta-blockers are often prescribed to control blood pressure and prevent dangerous, irregular heart rhythms. This medication works by blocking beta receptors, special nerve receptors that respond to hormones and other agents to cause physiological responses.

Unfortunately, while beta-blockers are effective in managing these cardiac conditions, they require vigilance and close monitoring of diabetic condition, as they frequently mask the signs and symptoms of low blood sugar, or hypoglycemia. Lack of attention to other more subtle signs of hypoglycemia puts the diabetic even more at risk for poorly controlled diabetes, and the inability to sense critically low blood sugars. Also, for those who aren’t diabetic, beta-blockers could increase the risk of developing diabetes, since some classes of the drug may block the release of insulin from pancreatic beta cells.