Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: Results from GEMINI

Research output: Contribution to journalArticle

V. Fonseca, G. L. Bakris, D. S.H. Bell, J. B. McGill, P. Raskin, F. H. Messerli, Robert A. Phillips, R. E. Katholi, J. T. Wright, B. Waterhouse, M. A. Lukas, K. M. Anderson

Aims: To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin]. Methods: Changes in HbA1c and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed over 5 months, comparing carvedilol with metoprolol tartrate according to insulin sensitizer (TZDs and metformin) use. Results: In TZD/metformin users, carvedilol patients showed a 5.4% decrease [95% confidence interval (CI) -11.9, 1.6; P = 0.13] and metoprolol tartrate patients showed a 2.8% decrease (95% CI -8.5, 3.2; P = 0.35) in HOMA-IR. The -2.6% difference between treatments was not significant (95% CI -10.7, 6.2; P = 0.55). In contrast, those not taking TZD/metformin experienced a 13.2% increase in HOMA-IR on metoprolol tartrate (95% CI 3.2, 24.1; P < 0.01) and a 4.8% decrease in HOMA-IR on carvedilol (95% CI -14.6, 6.0; P = 0.37), with a significant treatment difference of -15.9% favouring carvedilol (95% CI -26.6, -3.6; P = 0.01). There was no significant treatment interaction for the use of TZD/metformin and HbA1c. A statistically significant treatment difference was observed for HbA1c after 5 months favouring carvedilol after adjusting for insulin sensitizer use (-0.11%, 95% CI -0.214, -0.009; P = 0.03). Conclusions: In patients with diabetes and hypertension not taking insulin sensitizers, the use of metoprolol tartrate resulted in a worsening of insulin resistance, an effect not seen with carvedilol. However, in TZD/metformin users the difference between the β-blockers was not statistically significant.

Original languageEnglish (US)
Pages (from-to)759-763
Number of pages5
JournalDiabetic Medicine
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2007

PMID: 17451422

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Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use : Results from GEMINI. / Fonseca, V.; Bakris, G. L.; Bell, D. S.H.; McGill, J. B.; Raskin, P.; Messerli, F. H.; Phillips, Robert A.; Katholi, R. E.; Wright, J. T.; Waterhouse, B.; Lukas, M. A.; Anderson, K. M.

In: Diabetic Medicine, Vol. 24, No. 7, 01.07.2007, p. 759-763.

Research output: Contribution to journalArticle

Harvard

Fonseca, V, Bakris, GL, Bell, DSH, McGill, JB, Raskin, P, Messerli, FH, Phillips, RA, Katholi, RE, Wright, JT, Waterhouse, B, Lukas, MA & Anderson, KM 2007, 'Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: Results from GEMINI' Diabetic Medicine, vol. 24, no. 7, pp. 759-763. https://doi.org/10.1111/j.1464-5491.2007.02151.x

APA

Fonseca, V., Bakris, G. L., Bell, D. S. H., McGill, J. B., Raskin, P., Messerli, F. H., ... Anderson, K. M. (2007). Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: Results from GEMINI. Diabetic Medicine, 24(7), 759-763. https://doi.org/10.1111/j.1464-5491.2007.02151.x

Vancouver

Fonseca V, Bakris GL, Bell DSH, McGill JB, Raskin P, Messerli FH et al. Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: Results from GEMINI. Diabetic Medicine. 2007 Jul 1;24(7):759-763. https://doi.org/10.1111/j.1464-5491.2007.02151.x

Author

Fonseca, V. ; Bakris, G. L. ; Bell, D. S.H. ; McGill, J. B. ; Raskin, P. ; Messerli, F. H. ; Phillips, Robert A. ; Katholi, R. E. ; Wright, J. T. ; Waterhouse, B. ; Lukas, M. A. ; Anderson, K. M. / Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use : Results from GEMINI. In: Diabetic Medicine. 2007 ; Vol. 24, No. 7. pp. 759-763.

BibTeX

@article{bcd27170cce74582a450d988a903f409,
title = "Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use: Results from GEMINI",
abstract = "Aims: To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin]. Methods: Changes in HbA1c and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed over 5 months, comparing carvedilol with metoprolol tartrate according to insulin sensitizer (TZDs and metformin) use. Results: In TZD/metformin users, carvedilol patients showed a 5.4{\%} decrease [95{\%} confidence interval (CI) -11.9, 1.6; P = 0.13] and metoprolol tartrate patients showed a 2.8{\%} decrease (95{\%} CI -8.5, 3.2; P = 0.35) in HOMA-IR. The -2.6{\%} difference between treatments was not significant (95{\%} CI -10.7, 6.2; P = 0.55). In contrast, those not taking TZD/metformin experienced a 13.2{\%} increase in HOMA-IR on metoprolol tartrate (95{\%} CI 3.2, 24.1; P < 0.01) and a 4.8{\%} decrease in HOMA-IR on carvedilol (95{\%} CI -14.6, 6.0; P = 0.37), with a significant treatment difference of -15.9{\%} favouring carvedilol (95{\%} CI -26.6, -3.6; P = 0.01). There was no significant treatment interaction for the use of TZD/metformin and HbA1c. A statistically significant treatment difference was observed for HbA1c after 5 months favouring carvedilol after adjusting for insulin sensitizer use (-0.11{\%}, 95{\%} CI -0.214, -0.009; P = 0.03). Conclusions: In patients with diabetes and hypertension not taking insulin sensitizers, the use of metoprolol tartrate resulted in a worsening of insulin resistance, an effect not seen with carvedilol. However, in TZD/metformin users the difference between the β-blockers was not statistically significant.",
keywords = "Diabetes, Hypertension, Insulin resistance, β-blockers",
author = "V. Fonseca and Bakris, {G. L.} and Bell, {D. S.H.} and McGill, {J. B.} and P. Raskin and Messerli, {F. H.} and Phillips, {Robert A.} and Katholi, {R. E.} and Wright, {J. T.} and B. Waterhouse and Lukas, {M. A.} and Anderson, {K. M.}",
year = "2007",
month = "7",
day = "1",
doi = "10.1111/j.1464-5491.2007.02151.x",
language = "English (US)",
volume = "24",
pages = "759--763",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley",
number = "7",

}

RIS

TY - JOUR

T1 - Differential effect of β-blocker therapy on insulin resistance as a function of insulin sensitizer use

T2 - Diabetic Medicine

AU - Fonseca, V.

AU - Bakris, G. L.

AU - Bell, D. S.H.

AU - McGill, J. B.

AU - Raskin, P.

AU - Messerli, F. H.

AU - Phillips, Robert A.

AU - Katholi, R. E.

AU - Wright, J. T.

AU - Waterhouse, B.

AU - Lukas, M. A.

AU - Anderson, K. M.

PY - 2007/7/1

Y1 - 2007/7/1

N2 - Aims: To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin]. Methods: Changes in HbA1c and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed over 5 months, comparing carvedilol with metoprolol tartrate according to insulin sensitizer (TZDs and metformin) use. Results: In TZD/metformin users, carvedilol patients showed a 5.4% decrease [95% confidence interval (CI) -11.9, 1.6; P = 0.13] and metoprolol tartrate patients showed a 2.8% decrease (95% CI -8.5, 3.2; P = 0.35) in HOMA-IR. The -2.6% difference between treatments was not significant (95% CI -10.7, 6.2; P = 0.55). In contrast, those not taking TZD/metformin experienced a 13.2% increase in HOMA-IR on metoprolol tartrate (95% CI 3.2, 24.1; P < 0.01) and a 4.8% decrease in HOMA-IR on carvedilol (95% CI -14.6, 6.0; P = 0.37), with a significant treatment difference of -15.9% favouring carvedilol (95% CI -26.6, -3.6; P = 0.01). There was no significant treatment interaction for the use of TZD/metformin and HbA1c. A statistically significant treatment difference was observed for HbA1c after 5 months favouring carvedilol after adjusting for insulin sensitizer use (-0.11%, 95% CI -0.214, -0.009; P = 0.03). Conclusions: In patients with diabetes and hypertension not taking insulin sensitizers, the use of metoprolol tartrate resulted in a worsening of insulin resistance, an effect not seen with carvedilol. However, in TZD/metformin users the difference between the β-blockers was not statistically significant.

AB - Aims: To determine whether the beneficial effects of carvedilol on insulin resistance (IR) are affected by the concomitant use of insulin sensitizers [thiazolidinediones (TZDs) and metformin]. Methods: Changes in HbA1c and homeostasis model assessment-insulin resistance (HOMA-IR) were assessed over 5 months, comparing carvedilol with metoprolol tartrate according to insulin sensitizer (TZDs and metformin) use. Results: In TZD/metformin users, carvedilol patients showed a 5.4% decrease [95% confidence interval (CI) -11.9, 1.6; P = 0.13] and metoprolol tartrate patients showed a 2.8% decrease (95% CI -8.5, 3.2; P = 0.35) in HOMA-IR. The -2.6% difference between treatments was not significant (95% CI -10.7, 6.2; P = 0.55). In contrast, those not taking TZD/metformin experienced a 13.2% increase in HOMA-IR on metoprolol tartrate (95% CI 3.2, 24.1; P < 0.01) and a 4.8% decrease in HOMA-IR on carvedilol (95% CI -14.6, 6.0; P = 0.37), with a significant treatment difference of -15.9% favouring carvedilol (95% CI -26.6, -3.6; P = 0.01). There was no significant treatment interaction for the use of TZD/metformin and HbA1c. A statistically significant treatment difference was observed for HbA1c after 5 months favouring carvedilol after adjusting for insulin sensitizer use (-0.11%, 95% CI -0.214, -0.009; P = 0.03). Conclusions: In patients with diabetes and hypertension not taking insulin sensitizers, the use of metoprolol tartrate resulted in a worsening of insulin resistance, an effect not seen with carvedilol. However, in TZD/metformin users the difference between the β-blockers was not statistically significant.

KW - Diabetes

KW - Hypertension

KW - Insulin resistance

KW - β-blockers

UR - http://www.scopus.com/inward/record.url?scp=34347360831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347360831&partnerID=8YFLogxK

U2 - 10.1111/j.1464-5491.2007.02151.x

DO - 10.1111/j.1464-5491.2007.02151.x

M3 - Article

VL - 24

SP - 759

EP - 763

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 7

ER -

ID: 16849322