Are beta blockers beneficial in the management of dyslipidemia in type 2 diabetes mellitus (DM)?

Updated: Oct 23, 2019
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Small studies have led to a suggestion that a lower LDL cholesterol goal, of less than 70 mg/dL, be considered in patients at very high risk, including patients with diabetes. However, the National Cholesterol Education Program (NCEP) lists this as a therapeutic option rather than a formal recommendation as of this writing.

Vasoconstricting beta blockers are known to reduce HDL cholesterol levels and increase triglyceride, LDL cholesterol, and total cholesterol levels. The vasodilating beta blocker carvedilol (mixed alpha1, beta1, and beta2 blocker) has not been associated with the aforementioned effects.

In a randomized, double-blind trial in patients with type 2 diabetes mellitus receiving renin-angiotensin blockers, the addition of carvedilol for blood pressure control resulted in a significant decrease in triglyceride, total cholesterol, and non ̶ HDL cholesterol levels. Patients given metoprolol (a vasoconstricting beta blocker) were significantly more likely to be started on statin therapy or, if already on statin therapy, to require an increase in the dose, than were patients taking carvedilol. [292]


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