Southside Endocrinology, Birmingham, Alabama, USA.
Grandview Endocrinology, Birmingham, Alabama, USA.
Diabetes Obes Metab. 2021 Apr;23(4):877-885. doi: 10.1111/dom.14295. Epub 2021 Jan 5.
Drugs that protect against cardiovascular events in the patient with diabetes may also positively or negatively affect glycaemic control in the patient with established diabetes and may induce the development of diabetes in the predisposed patient. Mainly through increasing insulin resistance, beta-blockers, statins and high-dose diuretics have the potential to worsen glycaemic control. Dihydropyridine calcium channel blockers, low-dose diuretics, vasodilating beta-blockers, alpha-blockers and pitavastatin have little or no effect on glycaemic control. Blockers of the renin-angiotensin-aldosterone system, colesevelam, ranolazine and verapamil, through slowing breakdown of bradykinin, vasodilation, increasing cholecystokinin levels, blocking sodium channels and decreasing beta cell apoptosis, may improve glycaemic control and avoid the development of diabetes.
预防糖尿病患者心血管事件的药物也可能对已确诊糖尿病患者的血糖控制产生积极或消极的影响，并可能导致易患患者发生糖尿病。β受体阻滞剂、他汀类药物和大剂量利尿剂主要通过增加胰岛素抵抗，有可能使血糖控制恶化。二氢吡啶类钙通道阻滞剂、小剂量利尿剂、血管扩张β受体阻滞剂、α受体阻滞剂和匹伐他汀对血糖控制几乎没有影响或没有影响。肾素-血管紧张素-醛固酮系统阻滞剂、考来烯胺、雷诺嗪和维拉帕米通过减缓缓激肽的分解、血管扩张、增加胆囊收缩素水平、阻断钠通道和减少β细胞凋亡，可能改善血糖控制并避免糖尿病的发生。
