Question

A type I diabetic on insulin reports that he takes propranolol (Inderal) for his hypertension. This raises a concern and the nurse will teach the patient to check glucose levels more frequently because:

1. The beta blocker can produce insulin resistance.
2. The two agents used together will increase the risk of ketoacidosis. 3. Propranolol will increase insulin requirements by antagonizing the effects at the receptors.
4. The beta blocker can mask symptoms of hypoglycemia.

Answer 1

The concern with a type I diabetic patient taking propranolol is that it can mask the symptoms of hypoglycemia. Patients are advised to monitor their glucose levels more frequently to avoid unnoticed low blood sugar incidents which could be dangerous.

Step-by-step explanation:

A type I diabetic patient who is on insulin therapy and also takes propranolol (Inderal) for hypertension should be aware that this beta blocker can mask symptoms of hypoglycemia. This is concerning because the ability to perceive warning signs of low blood sugar, such as tremors, palpitations, and anxiety (which are mediated by adrenergic symptoms), can be diminished due to the beta-blocking effects of propranolol. As a result, the patient may not be able to timely recognize and treat hypoglycemia, which could lead to severe consequences.

Propranolol does not produce insulin resistance, increase the risk of ketoacidosis, or increase insulin requirements by antagonizing effects at receptors significantly; the primary concern is the masking of hypoglycemic symptoms. Therefore, the patient should check glucose levels more frequently to avoid missing any episodes of hypoglycemia.