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Prazosin, Diuretics, and Glucose Intolerance
- Ivan Berlin, MD
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TO THE EDITOR:
In their recent review of drug-induced disorders of glucose tolerance, Pandit and colleagues [1] state that prazosin, an -1-adrenoceptor antagonist, may improve glucose tolerance through increased glucose-dependent insulin secretion. They suggest that this effect results from decreased -2-adrenoceptor stimulation [2].
However, Broadstone and colleagues [2] tested phentolamine, an -1-adrenoceptor and -2-adrenoceptor antagonist, and found that this agent improved glucose-potentiated insulin secretion in patients with non–insulin-dependent diabetes mellitus. Because -adrenoceptors on pancreatic -cells are of the -2 subtype [3], this effect of phentolamine can only be attributed to an -2-adrenoceptor and not -1-adrenoceptor blockade. To our knowledge, there is no clinical evidence that prazosin improves glucose tolerance. However, if prazosin and other -1-adrenoceptor antagonists do improve glucose tolerance, it is possibly by increasing peripheral glucose uptake through raised muscle blood flow [4].
Ivan Berlin
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
