INFLUENCE OF BETA-BLOCKERS ON INSULIN RESISTANCE IN PATIENTS WITH DIABETES MELLITUS TYPE 2

The insulin resistance is present when the concentration of insulin is normal and biological response is decreased. The most frequent metabolic change that was detected during anti-hypertension therapy is a change in the insulin resistance. Beta-blockers are generally accompanied by the deterioration of metabolic control in patients with diabetes. It is considered that using certain beta-blockers in hypertension therapy in patients with diabetes mellitus type 2 (DM type 2) can significantly influence the insulin resistance. Taking into consideration the latest knowledge on pharmaco-dynamics of insulin analogues and beta -blockers, by observing the parameters of glycoregulation, it would be of great interest and practical significance to determine the following influence of beta blockers and their selectivity on the insulin resistance in patients with DM type 2 and hypertension. The research was conducted at the Endocrinology Clinic of the Clinical Centre Nis, and it included 60 patients with diagnosed diabetes mellitus type 2. After collecting anamnesis data, clinical and laboratory research performance, all patients were divided into two therapy groups: first group, 30 patients that were administered the therapy based on insulin glargine and second group, 30 patients that were administered the therapy based on insulin glargine and blocker divided into two therapy subgroups: 15 patients that were administered the therapy based on insulin glargine and carvedilol and 15 patients that were administered the therapy based on insulin glargine and metoprolol. Higher values of glycaemia and glycolised haemoglobin were found in patients receiving therapy based on beta–blocker (p<0.05). Therapy group treated with metoprolol had higher average values of glycaemia and HbA1C, compared to the group treated with carvedilol. The obtained difference was not statistically significant. Is confirmed that the group of patients to which beta–blockers had been administered had statistically higher values of glycaemia and glycolised haemoglobin. This indicates that the application of beta – blockers deteriorates glycoregulation, thus increasing the possibility of early manifestation of complications caused by diabetes. Acta Medica Medianae 2011;50(4):23-28.