It was traditionally believed that some drugs used to treat high blood pressure might cause diabetes. Previous research has suggested that beta-blockers and other drugs called thiazide diuretics may lead to diabetes. However the results of a new study show that beta-blockers are the only blood pressure drugs linked to the disease.
Potential mechanisms by which beta-blockers may contribute to the development of diabetes include weight gain, attenuation of the beta-receptor-mediated release of insulin from pancreatic beta cells, and decreased blood flow through the microcirculation in skeletal-muscle tissue, leading to decreased insulin sensitivity.
The results are based on a study of more than 12,000 people aged 45 to 64 who did not have diabetes. At the start of the study, participants underwent a physical examination, which included blood pressure measurements and an interview about the medications they were taking.
The study also found that just having high blood pressure more than doubles a person's risk of developing type 2 diabetes, which usually begins in adulthood. Interestingly, the data from both short-term and long-term studies indicate that ACE inhibitors may actually improve insulin sensitivity and decrease the risk of type 2 diabetes.
The New England Journal of Medicine 2000;342:905-912, 969-970