Beta - Adrenergic Blockers
Beta adrenergic blockers blunt or mask the premonitory signs and symptoms of acute episodes of hypoglycemia which include these symptoms :
Tachycardia
Blood Pressure changes
Non selective beta blockers such as propranolol may even potentiate insulin induced hypoglycemia.
Although this effect is less likely with cardioselective agents,the use of either cardioselective or non-selective beta-blockers in diabetes is not recommended due to their masking effect of the normal warning signs and symptoms of hypoglycemia.
Angiotensin converting enzyme inhibitors such as captopril are treatment of choice for hypertension in Diabetics as well as Angiotensin receptor blockers such as Losartan.
Calcium channel blockers
such as Diltiazem are also considered to be safe and effective for treatment of hypertension in Diabetic patients.
Centrally acting alpha-adrenergic agonist such as Methyldopa &
Alpha 1 adrenergic antagonist such asPrazosin canbe safely used to treat hypertension in Diabetics but due to their side effects they are used only in diabetic patients who are unresponsive to ACE inhibitors and calcium channel blockers.
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