β-Blocker use and diabetes symptom score: Results from the GEMINI study

Janet B. Mcgill, G. L. Bakris, V. Fonseca, Philip Raskin, F. H. Messerli, R. A. Phillips, R. E. Katholi, J. T. Wright, M. Iyengar, K. M. Anderson, M. A. Lukas, M. R. Dalal, S. H. Bell

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

Aim: The Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial compared the metabolic effects of two β-blockers in people with type 2 diabetes and hypertension treated with renin-angiotensin system (RAS) blockade and found differences in metabolic outcomes. In this paper, we report the results of a prespecified secondary analysis of GEMINI that sought to determine the effect of these two β-blockers on commonly reported symptoms. Methods: The Diabetes Symptom Checklist (DSC), a self-report questionnaire measuring the occurrence and perceived burden of diabetes-related symptoms, was completed by GEMINI participants at baseline and at the end of the study (maintenance month 5). The DSC assessed symptoms in eight domains: psychology (fatigue), psychology (cognitive), neuropathy (pain), neuropathy (sensory), cardiology, ophthalmology, hyperglycaemia and hypoglycaemia. Results: Comparison ofthe mean change in self-reported diabetes-related symptoms indicated a significant treatment difference favouring carvedilol over metoprolol tartrate in overall symptom score (-0.08; 95% CI -0.15, -0.01; p = 0.02) and in the domains for hypoglycaemia symptoms (-0.12; 95% CI -0.23, -0.02; p = 0.02) and hyperglycaemia symptoms (-0.16; 95% CI -0.27, -0.05; p = 0.005). Carvedilol resulted in fewer perceived diabetes-related symptoms in patients with diabetes and hypertension. Conclusion: Carvedilol resulted in a lower perceived burden of diabetes-related symptoms in patients with type 2 diabetes and hypertension. The addition of a well-tolerated β-blocker to RAS blockade may improve hypertension treatment and quality of life in patients with diabetes.

Original languageEnglish (US)
Pages (from-to)408-417
Number of pages10
JournalDiabetes, Obesity and Metabolism
Volume9
Issue number3
DOIs
StatePublished - May 2007

Keywords

  • Carvedilol
  • Diabetes
  • Diabetes Symptom Checklist
  • Metoprolol tartrate
  • Quality of life
  • Symptom score

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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    Mcgill, J. B., Bakris, G. L., Fonseca, V., Raskin, P., Messerli, F. H., Phillips, R. A., Katholi, R. E., Wright, J. T., Iyengar, M., Anderson, K. M., Lukas, M. A., Dalal, M. R., & Bell, S. H. (2007). β-Blocker use and diabetes symptom score: Results from the GEMINI study. Diabetes, Obesity and Metabolism, 9(3), 408-417. https://doi.org/10.1111/j.1463-1326.2006.00693.x