Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study

Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study

The study aimed to identify predictors of severe acute hypertension (≥180/110 mmHg) during severe hypoglycemia and to assess the efficacy of prior use of catecholamine-blocking agents for preventing adverse influences in diabetic patients with severe hypoglycemia. We performed a retrospective study...

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Main Authors: Tsujimoto, Tetsuro, Yamamoto-Honda, Ritsuko, Kajio, Hiroshi, Kishimoto, Miyako, Noto, Hiroshi, Hachiya, Remi, Kimura, Akio, Kakei, Masafumi, Noda, Mitsuhiko
Format: Online
Language:English
Published: Wolters Kluwer Health 2015
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616818/
id pubmed-4616818
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spelling pubmed-46168182015-10-27 Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study Tsujimoto, Tetsuro Yamamoto-Honda, Ritsuko Kajio, Hiroshi Kishimoto, Miyako Noto, Hiroshi Hachiya, Remi Kimura, Akio Kakei, Masafumi Noda, Mitsuhiko 4300 The study aimed to identify predictors of severe acute hypertension (≥180/110 mmHg) during severe hypoglycemia and to assess the efficacy of prior use of catecholamine-blocking agents for preventing adverse influences in diabetic patients with severe hypoglycemia. We performed a retrospective study between January 2006 and March 2012 to assess diabetic patients with severe hypoglycemia at a single center in Japan. Severe hypoglycemia was defined as the presence of any hypoglycemic symptoms that required the medical assistance of another person after visiting the emergency room by ambulance. Multivariate logistic regression analysis was performed to identify possible predictors of severe hypertension due to severe hypoglycemia and to assess whether prior use of alpha- or beta-blockers is beneficial for the prevention of severe hypertension in diabetic patients with severe hypoglycemia. Multivariate adjustments were made for age, sex, preexisting hypertension, history of ischemic heart disease, blood glucose level upon arrival, estimated GFR, and prior use of alpha- or beta-blockers. A total of 59,602 patients who visited the emergency room were screened and 352 diabetic patients with severe hypoglycemia were enrolled. Incidences of severe hypertension before and at 3 and 6 hours after the initiation of antihypoglycemic treatment were 21.3%, 6.7%, and 0% in patients with type 1 diabetes (n = 61) and 38.8%, 18.2%, and 8.2% in patients with type 2 diabetes (n = 291), respectively. Aging was positively (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00−1.03; P = 0.02) and female sex was negatively (OR, 0.50; 95% CI, 0.29−0.86; P = 0.01) associated with occurrence of severe hypertension during severe hypoglycemia. In addition, prior use of beta-blockers was negatively associated with occurrence of severe hypertension during severe hypoglycemia using multivariate logistic regression analysis (OR, 0.31; 95% CI, 0.11−0.83; P = 0.02). None of the patients with prior use of beta-blockers had hypokalemia (<3.0 mEq/L). Prior use of beta-blockers may prevent adverse influences such as severe hypertension and hypokalemia during severe hypoglycemia in diabetic patients. Wolters Kluwer Health 2015-10-02 /pmc/articles/PMC4616818/ /pubmed/26426649 http://dx.doi.org/10.1097/MD.0000000000001629 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Tsujimoto, Tetsuro
Yamamoto-Honda, Ritsuko
Kajio, Hiroshi
Kishimoto, Miyako
Noto, Hiroshi
Hachiya, Remi
Kimura, Akio
Kakei, Masafumi
Noda, Mitsuhiko
spellingShingle Tsujimoto, Tetsuro
Yamamoto-Honda, Ritsuko
Kajio, Hiroshi
Kishimoto, Miyako
Noto, Hiroshi
Hachiya, Remi
Kimura, Akio
Kakei, Masafumi
Noda, Mitsuhiko
Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
author_facet Tsujimoto, Tetsuro
Yamamoto-Honda, Ritsuko
Kajio, Hiroshi
Kishimoto, Miyako
Noto, Hiroshi
Hachiya, Remi
Kimura, Akio
Kakei, Masafumi
Noda, Mitsuhiko
author_sort Tsujimoto, Tetsuro
title Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
title_short Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
title_full Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
title_fullStr Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
title_full_unstemmed Effectiveness of Prior Use of Beta-Blockers for Preventing Adverse Influences of Severe Hypoglycemia in Patients With Diabetes: An Observational Study
title_sort effectiveness of prior use of beta-blockers for preventing adverse influences of severe hypoglycemia in patients with diabetes: an observational study
description The study aimed to identify predictors of severe acute hypertension (≥180/110 mmHg) during severe hypoglycemia and to assess the efficacy of prior use of catecholamine-blocking agents for preventing adverse influences in diabetic patients with severe hypoglycemia. We performed a retrospective study between January 2006 and March 2012 to assess diabetic patients with severe hypoglycemia at a single center in Japan. Severe hypoglycemia was defined as the presence of any hypoglycemic symptoms that required the medical assistance of another person after visiting the emergency room by ambulance. Multivariate logistic regression analysis was performed to identify possible predictors of severe hypertension due to severe hypoglycemia and to assess whether prior use of alpha- or beta-blockers is beneficial for the prevention of severe hypertension in diabetic patients with severe hypoglycemia. Multivariate adjustments were made for age, sex, preexisting hypertension, history of ischemic heart disease, blood glucose level upon arrival, estimated GFR, and prior use of alpha- or beta-blockers. A total of 59,602 patients who visited the emergency room were screened and 352 diabetic patients with severe hypoglycemia were enrolled. Incidences of severe hypertension before and at 3 and 6 hours after the initiation of antihypoglycemic treatment were 21.3%, 6.7%, and 0% in patients with type 1 diabetes (n = 61) and 38.8%, 18.2%, and 8.2% in patients with type 2 diabetes (n = 291), respectively. Aging was positively (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00−1.03; P = 0.02) and female sex was negatively (OR, 0.50; 95% CI, 0.29−0.86; P = 0.01) associated with occurrence of severe hypertension during severe hypoglycemia. In addition, prior use of beta-blockers was negatively associated with occurrence of severe hypertension during severe hypoglycemia using multivariate logistic regression analysis (OR, 0.31; 95% CI, 0.11−0.83; P = 0.02). None of the patients with prior use of beta-blockers had hypokalemia (<3.0 mEq/L). Prior use of beta-blockers may prevent adverse influences such as severe hypertension and hypokalemia during severe hypoglycemia in diabetic patients.
publisher Wolters Kluwer Health
publishDate 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616818/
_version_ 1613491666059001856

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