Effects of calcium antagonists on glucose homeostasis and serum lipids in non-diabetic and diabetic subjects: a review.

Results from early in vitro experiments have led to the assumption that a deterioration in carbohydrate metabolism must be expected if diabetic patients are treated with calcium antagonists. In order to determine the truth of this assumption, we reviewed 74 publications reporting effects on glucose homeostasis from acute, short-term and long-term therapy with calcium antagonists in non-diabetic patients, and 35 papers and abstracts dealing with the same problem in diabetic patients. The analogous question concerning the influence of calcium antagonists on the serum lipid profile was pursued in 43 recent communications. Long-term studies in particular suggest that although minor transitory changes under special circumstances cannot be excluded, in all likelihood neither glucose nor lipid homeostases are unfavourably altered by current clinical dosages of calcium antagonists in non-diabetic subjects or in patients with diabetes mellitus. Therefore, the benefit of antihypertensive or anti-anginal treatment with these medications is not compromised by untoward metabolic cardiovascular risks.