Beta-Blockers Mask Hypoglycaemia — MFDS Part 1 MCQ

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ModeratePharmacologyBeta-Blockers Mask HypoglycaemiaMFDS Part 1

A patient with insulin-treated diabetes develops hypoglycaemia during a dental appointment, but the expected tachycardia is absent. Which medication taken chronically is most likely to have masked this warning sign?

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Correct answer: E — Beta-adrenoceptor blocker

A beta-adrenoceptor blocker is the best answer. Beta-blockade can blunt sympathetic warning manifestations of hypoglycaemia, particularly tachycardia and palpitations, so a patient may not develop the expected cardiovascular warning signs. Non-selective agents such as propranolol may additionally prolong the hypoglycaemic response to insulin. Sweating is not reliably abolished and may still occur, so it should not be described categorically as masked. ACE inhibitors and calcium-channel blockers do not characteristically suppress the adrenergic warning response to hypoglycaemia. Statins and proton pump inhibitors likewise have no clinically relevant masking effect on hypoglycaemic warning signs.

Reference: Electronic Medicines Compendium, Atenolol 50 mg Tablets, Summary of Product Characteristics, sections 4.4 and 4.5, updated 3 February 2026. https://www.medicines.org.uk/emc/product/100827/smpc