Clinical Summary

Combining Sulphonylureas and Beta-Blockers Increases Severe Hypoglycaemia Risk

Vinrod Rane, BS Pharm | Disclosures

Takeaway

In patients with type 2 diabetes (T2D), the concomitant use of sulphonylureas and beta-blockers was associated with an increased risk of severe hypoglycaemia compared with the use of sulphonylureas alone.
Cardioselectivity of beta-blockers did not modify this association.

Patients with T2D and hypertension or heart failure should exercise caution when using sulphonylureas and beta-blockers concurrently and consider the use of alternative antidiabetic or cardiovascular drugs, especially if the baseline risk of hypoglycaemia is elevated.

This retrospective cohort study included 252,869 patients with T2D who initiated a second-generation sulphonylurea between 1998 and 2020, identified using data from the UK Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases.
Funding: A Project Grant from the Canadian Institutes of Health Research.

During a median follow-up of 7.9 years, 16,857 severe hypoglycaemic events were reported, with a corresponding crude incidence rate of 7.8 per 1000 person-years.
The concomitant use of sulphonylureas and beta-blockers vs the use of sulphonylureas alone was associated with a higher risk of severe hypoglycaemia (adjusted HR [aHR] 1.53; 95% CI 1.42 to 1.65).
The risk of severe hypoglycaemia did not differ by beta-blockers cardioselectivity (aHR 0.95; 95% CI 0.74 to 1.24).