Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

Britt Kveiborg; Thomas S Hermann; Atheline Major-Pedersen; Buris Christiansen; Christian Rask-Madsen; Jakob Raunsø; Lars Køber; Christian Torp-Pedersen; Helena Dominguez

doi:10.1186/1475-2840-9-21

Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

Britt Kveiborg, Thomas S Hermann, Atheline Major-Pedersen, Buris Christiansen, Christian Rask-Madsen, Jakob Raunsø, Lars Køber, Christian Torp-Pedersen, Helena Dominguez

24 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Cardiovascular Diabetology
Volume	9
Pages (from-to)	21
ISSN	1475-2840
DOIs	https://doi.org/10.1186/1475-2840-9-21
Publication status	Published - 25 May 2010

Keywords

Adrenergic beta-Antagonists
Carbazoles
Denmark
Diabetes Mellitus, Type 2
Dose-Response Relationship, Drug
Endothelium, Vascular
Female
Forearm
Humans
Hypoglycemic Agents
Infusions, Intra-Arterial
Insulin
Insulin Resistance
Male
Metoprolol
Middle Aged
Nitroprusside
Photoplethysmography
Propanolamines
Regional Blood Flow
Serotonin
Time Factors
Treatment Outcome
Vasodilation
Vasodilator Agents

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/1475-2840-9-21Licence: CC BY

pmc2893119?pdf=renderFinal published version, 446 KBLicence: CC BY

Cite this

@article{df146d8b74804b219f5444944fbc3c6a,

title = "Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study",

abstract = "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.",

keywords = "Adrenergic beta-Antagonists, Carbazoles, Denmark, Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Endothelium, Vascular, Female, Forearm, Humans, Hypoglycemic Agents, Infusions, Intra-Arterial, Insulin, Insulin Resistance, Male, Metoprolol, Middle Aged, Nitroprusside, Photoplethysmography, Propanolamines, Regional Blood Flow, Serotonin, Time Factors, Treatment Outcome, Vasodilation, Vasodilator Agents",

author = "Britt Kveiborg and Hermann, {Thomas S} and Atheline Major-Pedersen and Buris Christiansen and Christian Rask-Madsen and Jakob Rauns{\o} and Lars K{\o}ber and Christian Torp-Pedersen and Helena Dominguez",

year = "2010",

month = may,

day = "25",

doi = "10.1186/1475-2840-9-21",

language = "English",

volume = "9",

pages = "21",

journal = "Cardiovascular Diabetology",

issn = "1475-2840",

publisher = "BioMed Central Ltd.",

}

TY - JOUR

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 - 2010/5/25

Y1 - 2010/5/25

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

SN - 1475-2840

VL - 9

SP - 21

JO - Cardiovascular Diabetology

JF - Cardiovascular Diabetology

ER -

Metoprolol compared to carvedilol deteriorates insulin-stimulated endothelial function in patients with type 2 diabetes - a randomized study

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this