Question

B. A 54 year old male is in for a follow-up visit to monitor treatment for type 2 diabetes. The provider added regular insulin to his treatment regimeg last month. He tells you that he has not had any symptoms of hypoglycemia with the new plan and that his glucose levels have been between 50 and 80. Additionaly, after a visit to his cardiologist he was prescribed a new medication, atenolol. 1. Provide an indepth discussion on the possible complications/effects are possible when patients with diabetes are treated with a beta blocker. Are certain beta blockers more likely to create problems more than are others? 2. What action of beta blockers is a concen if taken by patients with a diagnosis of diabetes? What educational easures must be disoussed with this patient if a beta blockers is medically indicated? 3. Describe any changes to the treatment plan that are important to address considering her gluoose reading. 4. Discuss the use of beta blockers in patients over 60, those respiratory conditions, and patients with AV blocks

Answer 1

1.Beta blockers are not the first choice of drug in managing hypertension in diabetic patients.The possible complications in a diabetic patients are an increase in the rate of mortality if patient has cardiac problem like CAD, CHF, hypoglycemia or hyperglycemia,nausea, vomiting, diarrhoea, blurred vision,fatigue.

Certain Beta blocker in diabetic patients may mask the sign of low blood sugar by increased heart rate (atenalol) and drugs link metaprololo and propanalol may increase the blood sugar level

2.The concerns of taking a Beta blocker in diabetic patients are

• Decreased blood sugar
• Increased blood sugar
• Chest pain

The following education is necessary

• Regular monitoring of blood glucose level
• Monitoring the BO and pulse
• Serum sodium and calcium level to be monitored
• Follow a salt restricted diet

3.A blood sugar of 50 to 80 is severe hypoglycemia where patient can land up in coma if not treated at tight time.The patient can be changed for th drug and a regular monitoring of blood glucose is essential

4.Beta blockers are not generally indicated for elderly population, respiratory conditions like asthma,COPD ,AV block because they can increase the mortality due to cardiovascular problems, breathing difficulties and sudden heart attack