Excellent blood sugar control by liraglutide in diabetics on beta-blockers

The glucagon-like peptide-1 (GLP-1) agonist drug, liraglutide, seems to provide excellent blood sugar control in patients with type 2 diabetes who are also taking a beta-blocker, specifically propranolol, to prevent bleeding from esophageal varices due to cirrhosis, but it seems to hamper the pharmacological effects of beta-blockers.

A case report has been published in Annals of Internal Medicine.

Cirrhosis is the leading cause of portal hypertension with an increased risk of developing esophageal varices.Beta-blockers are used to lower portal pressure and decrease the risk of bleeding from esophageal varices and decrease mortality.

When using beta-blockers to prevent bleeding from esophageal varices, clinicians use the resting heart rate as a guide, as these therapies lower heart rate. GLP-1s are used to treat diabetes because they lower blood sugar levels and are especially useful when the patient is obese and has nonalcoholic fatty liver disease, but they are known to increase heart rate, although not significantly. No data are available on the concomitant treatment with GLP-1 analogues and β-blockers in patients with cirrhosis and diabetes.