Starting β-Blockers Nearly Doubles Hypoglycemia Risk in Older Adults With Diabetes

Background: β-blockers blunt adrenergic responses to hypoglycemia and may impair counter-regulatory mechanisms in patients with diabetes. Risk may be highest during early exposure and may differ by β-blocker class. Objective: To compare the risk of serious hypoglycemia among new versus prevalent users of individual β-blockers in older adults with diabetes. Design: Population-based nested case–control study using Ontario administrative health data. Methods: Adults aged ≥66 years with diabetes and at least 1 β-blocker prescription who experienced emergency department (ED) visits or hospitalizations for hypoglycemia were identified. Patients were categorized as new users, prevalent users, recent users, or remote users of a β-blocker. Conditional logistic regression adjusted for comorbidities, insulin use, chronic kidney disease, and medication burden. Secondary analysis using 30-day exposure window. Results: New β-blocker use nearly doubled hypoglycemia risk versus prevalent use (adjust more...