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Chronic Propranolol Administration Impairs Glucagon Release during Insulin-Induced Hypoglycemia in Normal Man^*

A. M. LAWRENCE, K. AJLOUNI and T. C. HAGEN

Departments of Medicine, Loyola University Stritch School of Medicine Maywood, Illinois 60153 Hines Veterans Administration Hospital Hines, Illinois 60141 Wood Veterans Administration Medical Center, The Medical College of Wisconsin Milwaukee, Wisconsin 53193

Address requests for reprints to: A. M. Lawrence, M.D., Ph.D., Veterans Administration Hospital, Building 1, Room C-344, Hines, Illinois 60141.

Failure of a plasma glucagon rise in response to insulin-induced hypoglycemia was demonstrated in normal subjects taking therapeutic doses of the nonselective β-adrenergic blocker, propranolol, for 7 days before testing. This is the first study to examine glucose homeostasis in normal subjects exposed to chronic propranolol therapy and helps to explain the development of spontaneous hypoglycemia in patients, either diabetic or nondiabetic, during β-adrenergic receptor blockade. Previous studies of the acute parenteral effects of propranolol administration failed to show any significant effect on glucagon secretory dynamics in response to insulin-induced hypoglycemia. In the present study, however, chronic oral administration of propranolol resulted in severe impairment of the expected glucagon rise in response to hypoglycemia and was associated with severe hypoglycemia in one normal subject.

^* This work was supported by The Veterans Administration.

Current address: Department of Medicine, Faculty of Medicine, University of Jordan, Amman, Jordan.

Received September 28, 1983.