Novel treatment approaches in hypertensive type 2 diabetic patients

Table 1 Studies which observed glucose reduction carvedilol

Ref.	Study design	Participants	Main results
Ehmer et al[30]	Prospective randomized open parallel group trial	49 non-insulin-dependent diabetics with mild to moderate HTN (carvedilol n = 25, metoprolol n = 24)	Blood glucose concentrations were maintained within narrow limits. Glycated haemoglobin A1 remained unchanged. There was a reduction in blood pressure in both groups
Giugliano et al[12]	Prospective single-blind randomized trial	45 patients with non-insulin-dependent DM and HTN (carvedilol n = 23, atenolol n = 22)	Patients treated with carvedilol had improved glucose and lipid metabolism and reduced lipid perioxidation compared to atenolol. Both reduced blood pressure
Bakris et al[11]	Prospective double-blind randomized trial	GEMINI study, 1235 patients with HTN and T2DM (carvedilol n = 498, metoprolol tartrate n = 737)	The mean glycosylated hemoglobin increased with metoprolol, but not with carvedilol. An improvement of insulin sensitivity was seen with carvedilol but not with metoprolol
Phillips et al[32]	Prospective double-blind randomized trial	GEMINI study 1235 patients with HTN and T2DM (carvedilol n = 498, metoprolol tartrate n = 737)	After and adjustment for age carvedilol was superior than metoprolol reducing baseline glycosylated hemoglobin and also in female patients. In black people carvedilol showed a reduction in IR greater than metoprolol
Kveiborg et al[40]	Prospective randomized open parallel group trial	19 patients with T2DM (metoprolol succinate n = 10, carvedilol n = 9) and 10 controls	Treatment with carvedilol did not change insulin-stimulated endothelial function, whereas it deteriorated with metoprolol
Torp-Pedersen et al[46]	Prospective double-blind randomized trial	3029 patients with chronic heart failure and T2DM (carvedilol n = 1511, metoprolol tartrate n = 1518)	Fewer patients treated with carvedilol developed T2DM than with metoprolol
Wai et al[47]	Observational cohort trial	125 patients with T2DM and heart failure (carvedilol n = 80, bisoprolol n = 45)	Carvedilol significantly improved glycemic control in subjects with heart failure and T2DM
Basat et al[48]	Prospective double-blind randomized trial	59 patients with ST-elevation myocardial infarction (carvedilol n = 26, metoprolol n = 31)	After myocardial infarction, carvedilol added to background therapy improved insulin resistance and lipid profile

T2DM: Type 2 diabetes mellitus; HTN: Hypertension.