"War is a series of catastrophes which result in victory."Albert Pike
|
| |
Insulin
Insulin has two critical roles in the body that we cannot live without, yet it can be the root of many health problems, including diabetes. Insulin carries sugar (glucose), fat and protein into your cells where they are used for energy and the repair of ...
Raising Happy Diabetic Kids Part II Help Yor Child Develop Self-Relience
This is the second article in a series I am writing about how to raise happy diabetic children. You can find the first article titled Help Your Child Develope Self-Confidence in our article archives. Sometimes the phrase "happy diabetic kids" seems to be ...
Symptoms of Diabetes
While it's very easy to test for diabetes symptom , a simple blood glucose test is the determining factor, diabetes may not be easily recognized at first since so many of its symptoms are also common complaints for people who do not have diabetes. For ...
|
|
|
| |
Clinical Question: In patients with hypertension is it safe to combine thiazide-type diuretic and beta-blocker?
Bottom Line: Studies suggest that the routine combined use of a thiazide with a beta-blocker should be questioned in the early management of hypertension, particularly in patients who are at increased risk of developing new-onset diabetes. In such patients, the increased risk of developing diabetes may exceed the benefit of blood pressure lowering.
Reference: J Hypertens. 2005 Oct;23(10):1777-1781
Study Design: Retrieve randomized control trials and meta-analysis
Synopsis: Recently published trials addressing the pharmacological management of hypertension have reported an increase in new-onset diabetes mellitus when comparing certain older and newer treatment regimens. Thiazide-type diuretics (thiazides) and beta-blockers have been individually implicated, but these drugs are frequently combined, and the magnitude of risk associated with their combined use has not been quantified. So randomized control trials were retrieved that: (i) featured stepped treatment to manage hypertension; (ii) compared initial treatment using a thiazide or beta-blocker (older drug) with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or calcium antagonist (newer drug); (iii) assessed cardiovascular outcomes; (iv) reported new-onset diabetes; and (v) provided at least 1-year follow-up. A meta-analysis of available trials indicated that patients exposed to treatment regimens combining thiazides and beta-blockers are at greater risk of developing diabetes than regimens avoiding this combination of drugs (risk ratio for alternative therapy 0.81, 95% confidence interval 0.77-0.86). Current data cannot inform reliably about the risks associated with individual older drugs because of similar overall exposures in patients starting on newer and older drugs.
About the Author
A Certified Family Physician of the Philippine Academy of Family Physician and continue to complete the requirements for Continuing Medical Education in Family Practice. Also a member of the Philippine Medical Informatics Society, Philippine Occupational Health and Safety Inc., and Pangasinan Medical Society. Faculty Department of Physiology (Medicine) Lyseum- Northwestern University, Dagupan, Pangasinan, Faculty Medical Informatics Lyseu
|
|
|
|
|
|
|
