7. Beta-blockers (atenolol, metoprolol, propranolol)
Beta-blockers are used for treatment of hypertension (high blood pressure), heart failure, or angina (chest pain). Beta-blockers may increase blood glucose by reducing insulin sensitivity. More commonly they mask symptoms of low blood glucose (hypoglycemia) such as tremors, hunger, sweating, and increased heart rate. These symptoms are controlled the adrenergic nervous system which is blocked by beta-blockers. Diabetic patients treated with beta-blockers should monitor their blood glucose more frequently.
8. Vasopressors (epinephrine, norepinephrine)
These medications are used for increasing blood pressure when blood pressure is too low (hypotension). Vasopressors increase blood glucose by increasing the breakdown of glycogen into glucose, increasing production of glucose in the liver, stimulation of glucagon and cortisol, and decreasing insulin release. These medications are used during emergencies and for critical care. Their benefits outweigh the risk of increased blood glucose.
9. Oral contraceptives
Oral contraceptives may increase blood glucose by altering glucose metabolism in the liver and increasing insulin resistance. Women with diabetes who are taking oral contraceptives should check their blood glucose more often. If increased blood glucose is a concern there are other options for contraception. Lower doses of oral contraceptives have a smaller effect on glucose than higher doses.
Blood glucose should be monitored more frequently when receiving a medication that may increase blood glucose. Some drugs will increase blood glucose more than others and will affect each patient differently. Healthcare providers should weigh the benefits and risks of each medication before deciding to discontinue or initiate medications that may increase blood glucose. Diabetic patients should be counseled about the symptoms of hyperglycemia and to monitor their glucose levels more frequently if they are diabetic.
Sarafidis PA, Bakris GL. Antihypertensive treatment with beta-blockers and the spectrum of glycaemic control. Q J Med 2006; 99:431.
Luna B, Feinglos MN. Drug-induced hyperglycemia. JAMA 2001; 286:1945.
Thomas Z, Bandali F, McCowen K, et al. Drug induced endocrine disorders in the intensive care unit. Crit Care Med 2010; 38:S219.
Dipiro, Joseph T. Chapter 76 Schizophrenia. Pharmacotherapy. a Pathophysiologic Approach. New York: McGraw-Hill Education, 2012. Print.