Author Topic: Bisoprolol  (Read 476 times)

0 Members and 1 Guest are viewing this topic.

Offline Dr DeEath

  • Member
  • Posts: 526
Bisoprolol
« on: 22 July 2018, 11:43:18 AM »
Not sure if this is the right section. If not could a moderator please move it.

On discharge after my bypass meds had been tweaked. The default seems to be to add Bisoprolol if you are not already on it and to double or treble any statins. Bisoprolol is a beta blocker and when my GP decided I should be on BP medication he also commented that beta blockers were a no-no for diabetics treated with insulin. I queried this and was told it was fine and that I just needed to monitor my BGs more closely initially. Since discharge I have only had one hypo buy very good BGs as the diet/exercise regime is tighter than ever. However, I did not recognise the symptoms until was under 3.0. This morning I woke about 5:00 soaked in perspiration and with badly blurred vision. BG was 2.1 (keep kit on bedside table). HypoCat appeared when my feet hit the floor and stayed with me until I was near 5.0
 I think what fooled us was that the beta blocker keeps the heart rate down and an elevated pulse was one of my early warning signs of a hypo!

Has anyone else experienced this and how did you tackle the problem. I do not want to get in the position where I need assistance for hypos and all the knock on effects this can kick off. I have searched the internet but not found an alternative drug to suggest to my medics. A drug that suppresses symptoms of a hypo  cannot be ideal. It reminds me of the disastrous attempts to get me off porcine insulin.
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Online Pattidevans

  • Administrator
  • Posts: 24,781
  • It's ONLY Diabetes. It could be something worse!
Re: Bisoprolol
« Reply #1 on: 22 July 2018, 02:29:57 PM »
If you do need to continue with the Bisoprolol could you not take less insulin to avoid hypos?  On the other hand, I should think that the necessity to take it, combined with how it wipes out your hypo awareness would be a good argument for getting a CGM funded.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans

Offline nytquill17

  • Global Moderator
  • Posts: 6,769
  • It's all in the balance.
Re: Bisoprolol
« Reply #2 on: 22 July 2018, 03:02:09 PM »
I think the person who told you it was fine and to just monitor more was going on the assumption that probably you wouldn't get this particular problem and hence the benefits would outweigh the risk. Since you HAVE gotten the problem, though, I think that's reason to go back and query the prescription again.
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Lucy

  • Member
  • Posts: 2,219
Re: Bisoprolol
« Reply #3 on: 22 July 2018, 08:45:57 PM »
I take propanalol and previously took bisoprolol. It sounds like you need to adjust the insulin to avoid the hypos. I treat my bg at 5 rather than 4 to keep my hypo awareness and try to look for other symptoms of hypos, hands shaking, sweating face, tingling lips etc. If you look out for the signs you might be able to spot different warning signs of hypos, and/or running bg a bit higher to keep the awareness.

Probably also worth going back and checking if they are necessary if you’re finding it harder to notice hypos.
Type: Lucy.
Lantus and Apidra. Metformin XR, Propanolol

Offline GrammaBear

  • Member
  • Posts: 1,856
Re: Bisoprolol
« Reply #4 on: 23 July 2018, 04:42:32 AM »
I take metoprolol and it has the side effect of "masking" the symptoms of a hypo.  I am blessed to have a cgm because without it I have very little awareness of a hypo until I am really feeling poorly.  What I do is to keep a small plastic bottle of apple juice on my nightstand.  If I wake up feeling shaky or weak, then I take some juice straight away.  I hope you are able to get this med sorted for yourself. 
Type 1
Tandem Tslim pump Oct 2015
Dexcom G5 CGM Sep 2007
A1C 6.3% ~ Sep 2018

Offline Dr DeEath

  • Member
  • Posts: 526
Re: Bisoprolol
« Reply #5 on: 26 July 2018, 11:37:31 AM »
I am seeing my GP next week to discuss and will also discuss with my cardiologist the week after. Having struggled to get my HbA1c down pre-op and been advised good control with good cholesterol (despite it never having been high) are key to prevent future problems I am loathe to run my BGs higher. I will report back after.
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline nytquill17

  • Global Moderator
  • Posts: 6,769
  • It's all in the balance.
Re: Bisoprolol
« Reply #6 on: 26 July 2018, 12:55:18 PM »
Although on the one hand, if you want to stick between 4-8 it's inevitable that you will sometimes see 3s and lower due to the usual diabetes randomness, on the other hand, arguably hypos that you don't feel are just as much "poor control" as lots of highs. Both are bad for you, but a hypo can kill you here and now and as such a hypo "problem" like this is actually the more urgent of the two to resolve, in spite of run of the mill hypos being also a somewhat usual occurrence for most insulin-dependent folk.
T1 DX 1995
Omnipod since 06/04/18 (Novorapid)
 
  ~-~-~-~
"If you can't ride, can you fall?"
"I suppose anyone can fall," said Shasta.
"I mean can you fall and get up again without crying, and mount again and fall again and yet not be afraid of falling?"
"I - I'll try," said Shasta.
  ~C.S. Lewis, The Horse and His Boy
  ~-~-~-~
"There is no answer; seek it lovingly."

Offline Avocado

  • Member
  • Posts: 1,605
    • My French website
Re: Bisoprolol
« Reply #7 on: 29 July 2018, 08:56:58 AM »
I am seeing my GP next week to discuss and will also discuss with my cardiologist the week after.
A beta blocker is given post open heart surgery for a period of six to eight weeks - this is standard for anyone post OHS whether they have high blood pressure or not. I suppose the rationale is to help the heart during its recovery from the trauma of surgery to it. Most people complain about these beta blockers and their side effects - you might be able to get the dose reduced before the cut off time, on the other hand if you are near six weeks post op they might take you off if you ask when you see your cardiologist.
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Dr DeEath

  • Member
  • Posts: 526
Re: Bisoprolol
« Reply #8 on: 08 August 2018, 12:44:16 PM »
I am now starting to recognise hypos earlier so at least something is looking promising!
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline sedge

  • Global Moderator
  • Posts: 14,369
Re: Bisoprolol
« Reply #9 on: 08 August 2018, 02:40:49 PM »
That's a good sign Dr D.  Nobody except other T1s could feel as delighted.  A small thing to say but a ruddy great milestone for any of us!
Jenny

T1 DX 1972, pumping Novorapid 24/05/11

HbA1c - 7/07 8.7, 1/08 7.8, 9/08 8.4, 3/09 7.3, 7/09 7.2, 12/09 7.3, 11/10 8.1, 2/11 8.6, 9/11 6.5 2/12 6.4  5/12 50/6.7  11/12 52/6.9  01/13 46/6.4  06/16 46/6.4  12/16 45/6.4

Online Pattidevans

  • Administrator
  • Posts: 24,781
  • It's ONLY Diabetes. It could be something worse!
Re: Bisoprolol
« Reply #10 on: 08 August 2018, 03:00:50 PM »
Pleased to hear that!
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 Sept 2017.  45 (6.3) April 2018.


© 2015 Patti Evans