Novel treatment approaches in hypertensive type 2 diabetic patients

Table 3 Comparison between carvedilol and renal denervation as therapeutic choices to reduce blood pressure and glucose levels in hypertensive type 2 diabetes mellitus patients

Therapeutic method	Mechanism of action	Medical indication	Mechanisms which explain glucose reduction	Contraindications	Side effects
Carvedilol	α1, non-selective β-blocker, antioxidant and calcium antagonist properties[17-20]	Treatment of hypertension[21] heart failure[25] and coronary artery disease[27]	An improvement in insulin sensitivity by a reduction in sympathetic nerve activity[74,75] and free radicals[68,69]	Bronchial asthma, second-third degree atrioventricular block, sick sinus syndrome, severe bradycardia, patients with severe cardiogenic shock and heart failure who use inotropic drugs and hepatic impairement[17-20]	Frequent: edema, dizziness, bradycardia, hypotension, nausea, diarrhea and blurred vision Rare: deterioration of renal and hepatic function[17-20]
RDN	Ablation of afferent and efferent renal nerves[51-55]	Treatment of resistant hypertension[56,57]	An improvement in insulin sensitivity by reduction in sympathetic nerve activity[56,57]	Polar or accessory arteries, renal artery stenosis, prior renal revascularization and glomerular filtration rate < 45 mL/min per 1.73 m2[56,57,62]	Renal artery dissection, postprocedural hypotension, femoral artery pseudoaneuryn, intraprocedural bradycardia[56,57]