Use of beta-blockers for heart failure in patients with diabetes mellitus.

Although strong evidence supports the use of beta-blockers for reducing morbidity and improving survival rates in patients with heart failure, this treatment is often underused. The presence of comorbidities, such as diabetes mellitus, is considered a precaution to the use of beta-blockers and may contribute to this underutilization. Recently completed retrospective analyses of subgroups of patients from several large, landmark heart failure trials, such as Metoprolol CR/XL Randomized Intervention Trial in Congestive Heart Failure (MERIT-HF), Cardiac Insufficiency Bisoprolol Study II (CIBIS-II), and the Carvedilol Prospective Randomized Cumulative Survival (COPERNICUS) trial, have established the beneficial effects of beta-blockers in diabetic patients with heart failure. beta-blockers are as beneficial and well tolerated in patients with heart failure and diabetes as they are in those without diabetes. These observations strongly support a role for the use of beta-blockers in patients with both heart failure and diabetes.