Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study
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Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study. / Kveiborg, Britt; Hermann, Thomas S; Major-Pedersen, Atheline; Christiansen, Buris; Rask-Madsen, Christian; Raunsø, Jakob; Køber, Lars; Torp-Pedersen, Christian; Dominguez, Helena.
In: Cardiovascular Diabetology, Vol. 9, 2010, p. 21.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study
AU - Kveiborg, Britt
AU - Hermann, Thomas S
AU - Major-Pedersen, Atheline
AU - Christiansen, Buris
AU - Rask-Madsen, Christian
AU - Raunsø, Jakob
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Dominguez, Helena
PY - 2010
Y1 - 2010
N2 - AIM: Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol on endothelial function and insulin-stimulated endothelial function in patients with type 2 diabetes.METHOD: 24 patients with type 2 diabetes were randomized to receive either 200 mg metoprolol succinate or 50 mg carvedilol daily. Endothelium-dependent vasodilation was assessed by using venous occlusion plethysmography with increasing doses of intra-arterial infusions of the agonist serotonin. Insulin-stimulated endothelial function was assessed after co-infusion of insulin for sixty minutes. Vaso-reactivity studies were done before and after the two-month treatment period.RESULTS: Insulin-stimulated endothelial function was deteriorated after treatment with metoprolol, the percentage change in forearm blood-flow was 60.19% +/- 17.89 (at the highest serotonin dosages) before treatment and -33.80% +/- 23.38 after treatment (p = 0.007). Treatment with carvedilol did not change insulin-stimulated endothelial function. Endothelium-dependent vasodilation without insulin was not changed in either of the two treatment groups.CONCLUSION: This study shows that vascular insulin sensitivity was preserved during treatment with carvedilol while blunted during treatment with metoprolol in patients with type 2 diabetes.TRIAL REGISTRATION: Current Controlled Trials NCT00497003.
AB - AIM: Studies of beta blockade in patients with type 2 diabetes have shown inferiority of metoprolol treatment compared to carvedilol on indices of insulin resistance. The aim of this study was to examine the effect of metoprolol versus carvedilol on endothelial function and insulin-stimulated endothelial function in patients with type 2 diabetes.METHOD: 24 patients with type 2 diabetes were randomized to receive either 200 mg metoprolol succinate or 50 mg carvedilol daily. Endothelium-dependent vasodilation was assessed by using venous occlusion plethysmography with increasing doses of intra-arterial infusions of the agonist serotonin. Insulin-stimulated endothelial function was assessed after co-infusion of insulin for sixty minutes. Vaso-reactivity studies were done before and after the two-month treatment period.RESULTS: Insulin-stimulated endothelial function was deteriorated after treatment with metoprolol, the percentage change in forearm blood-flow was 60.19% +/- 17.89 (at the highest serotonin dosages) before treatment and -33.80% +/- 23.38 after treatment (p = 0.007). Treatment with carvedilol did not change insulin-stimulated endothelial function. Endothelium-dependent vasodilation without insulin was not changed in either of the two treatment groups.CONCLUSION: This study shows that vascular insulin sensitivity was preserved during treatment with carvedilol while blunted during treatment with metoprolol in patients with type 2 diabetes.TRIAL REGISTRATION: Current Controlled Trials NCT00497003.
KW - Adrenergic beta-Antagonists
KW - Carbazoles
KW - Denmark
KW - Diabetes Mellitus, Type 2
KW - Dose-Response Relationship, Drug
KW - Endothelium, Vascular
KW - Female
KW - Forearm
KW - Humans
KW - Hypoglycemic Agents
KW - Infusions, Intra-Arterial
KW - Insulin
KW - Insulin Resistance
KW - Male
KW - Metoprolol
KW - Middle Aged
KW - Nitroprusside
KW - Photoplethysmography
KW - Propanolamines
KW - Regional Blood Flow
KW - Serotonin
KW - Time Factors
KW - Treatment Outcome
KW - Vasodilation
KW - Vasodilator Agents
U2 - 10.1186/1475-2840-9-21
DO - 10.1186/1475-2840-9-21
M3 - Journal article
C2 - 20500877
VL - 9
SP - 21
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
SN - 1475-2840
ER -
ID: 157441223