type 2 and atenolol

[twokatss]

I am taking 25 mg of atenolol in the morning. I have been reading if you are type 2 that perhaps you should be taking another tpe of BP med. If so, what would it be.

[CobaltBlue]

Originally Posted by twokatss

I am taking 25 mg of atenolol in the morning. I have been reading if you are type 2 that perhaps you should be taking another tpe of BP med. If so, what would it be.

Twokatss,

I am not sure where you read that? When I was diagnosed, I was switched from Ziac to Atenolol because of the diabetes. Later on, I was switched to Toprol. I have not seen anything to indicate that there would be a reason to avoid Atenolol if you are diabetic.

[davitude]

Beta blockers like atenolol have been shown to increase insulin resistance.

Diuretics don't seem to have an effect (concerning diabetes) at all.

ACE inhibitors have a positive effect in glucose control and have been shown to help prevent eye nerve damage.

At first it would seem silly to use BB's on diabetics, but it's not that simple. Sometimes beta blockers are still necessary and different doctors will have differing opinions. You should definitely ask your doctor about switching, though.

[JacquelineL]

When I was diagnosed with diabetes, my doctor switched me from 25mg of atenolol to 5mg of Altace, an ACE inhibitor. He said it would be better for my kidneys. Glad to hear it is better for my eyes too.

[zuzu8]

Originally Posted by twokatss

I am taking 25 mg of atenolol in the morning. I have been reading if you are type 2 that perhaps you should be taking another tpe of BP med. If so, what would it be.

Twokatss- As you can see from the above posts, everyone is different, and has different treatment options.

I can only tell you what I've read (latest JNC-7 Report and other studies recently published in JAMA and LANCET).
The recommendations for treatment of hypertension in adults with Type 2 diabetes in general seem to be ever-changing. However, last May in the JNC Report, treatment targets were lowered (doctors now aim for blood pressure less than 130/80 mmHg for diabetics, although many physicians feel that a systolic # of 135 is a more realistic goal and reasonable).
With or without associated diabetic nephropathy, physicians are tending more and more to therapy with ACE inhibitors or ARBs as first-line therapy for hypertension in diabetics in general. Other drugs should be used as circumstances and side effects dictate, obviously.
Studies that compare drug classes do not suggest that there are obvious superior agents. However, most conclude that thiazide diuretics, angiotensin-II receptor blockers (ARBS like Diovan, Atacand, Benicar), and angiotensin-converting enzyme (ACE) inhibitors may be the preferred first-line agents for treatment of hypertension in Type 2 diabetes. Beta-Blockers (like Atenolol) and calcium-channel blockers are more effective than placebo, but they may not be as effective as diuretics, angiotensin-II receptor blockers, or ACE inhibitors.
However, study results are inconsistent and there's still a lot of on-going discussion in the medical community.
Sometimes other agents are necessary to achieve optimum BP goals.

You are on a beta blocker only. Is it keeping your BP at 130/80 or lower? If not, you should discuss going after really aggressive BP control with your doctor, since it may be the most important factor in preventing adverse outcomes in patients with type 2 diabetes. Atenolol is not usually thought of as a first-line agent for Type 2's.

zuzu xx