Can Metoprolol be a cause of low blood sugar level?
QUESTION: I take metoprolol, and my random blood glucose readings are sometimes below 90 mg/dL. Can metoprolol cause low blood sugar?
Quick Answer
A random glucose below 90 mg/dL is usually not hypoglycemia. For most people with diabetes, low glucose means below 70 mg/dL. Metoprolol does not automatically lower glucose, but it can increase the risk of severe or prolonged hypoglycemia in susceptible people and can hide warning signs—especially a fast heartbeat. This matters most if you use insulin or medicines such as sulfonylureas, are fasting, have poor food intake, are vomiting, or have kidney or liver problems.
Answer by Dr. Albana Greca, MD, MMedSc
Hi,
The earlier claim that beta-blockers only raise glucose and cannot contribute to hypoglycemia is incorrect. The first step is to decide whether your readings are actually low.
Is a Random Reading Below 90 Low?
A reading between 70 and 89 mg/dL is generally within a healthy range, particularly before a meal or several hours after eating. It does not need sugar treatment unless your healthcare team has given you a different threshold. Review our high and low blood sugar guide and blood sugar level chart.
For people with diabetes, a reading below 70 mg/dL is clinically important. Below 54 mg/dL is more serious. Symptoms can occur at higher readings when glucose is falling rapidly or has been chronically high, but symptoms alone do not prove true hypoglycemia.
How Can Metoprolol Affect Hypoglycemia?
Metoprolol is a beta-blocker used for high blood pressure, angina, heart rhythm conditions, heart failure, and protection after some heart attacks. It may affect hypoglycemia in two important ways:
- It can mask warning symptoms. A rapid heartbeat or palpitations may be reduced, so a person may not recognize the low as early.
- It may increase the risk of severe or prolonged hypoglycemia in susceptible people, particularly during fasting, vomiting, poor intake, or treatment with glucose-lowering medicine.
Sweating, hunger, dizziness, weakness, confusion, or visual changes may still occur. Because the pulse response may be muted, glucose should be checked whenever these symptoms appear.
Which Medicines Usually Cause Low Glucose?
Insulin is the most common medication-related cause. Sulfonylureas such as gliclazide, glimepiride, glipizide, or glyburide and meglitinides such as repaglinide can also cause lows. Metformin, DPP-4 inhibitors, GLP-1 medicines, and SGLT2 inhibitors generally have a low hypoglycemia risk when used alone, although combinations change that risk.
Review every tablet and injection with the prescriber or pharmacist. Our diabetes medicine safety guide and guide to causes of low glucose can help you prepare.
Other Reasons Glucose May Fall
- A missed or delayed meal, prolonged fasting, vomiting, or diarrhea
- More exercise than usual without adjusting food or diabetes treatment
- Alcohol, especially without food
- Reduced kidney or liver function that slows medicine clearance
- Recent weight loss without a corresponding medicine review
- Less commonly, severe illness, adrenal or pituitary disease, accidental medicine exposure, or an insulin-producing tumor
An insulinoma is rare and should not be assumed from readings in the 70s or 80s. In a person not using a glucose-lowering medicine, evaluation is usually based on recurring symptoms, a reliably confirmed low plasma glucose, and improvement when glucose is corrected.
Check Whether the Meter Reading Is Accurate
Wash and dry your hands, use an unexpired strip, and repeat an unexpected result. Compare the meter with a laboratory glucose if readings are repeatedly inconsistent with symptoms. Keep the time, meal, exercise, medicines, symptoms, and result in a blood sugar log.
What Should You Do With a True Low?
If glucose is below 70 mg/dL and you are awake and able to swallow, take about 15 grams of fast-acting carbohydrate, such as glucose tablets or a small amount of regular juice. Recheck after 15 minutes and repeat if it remains below 70. Once improving, follow your treatment plan for the next meal or snack.
Do not repeatedly eat sugar for readings between 70 and 89 mg/dL unless instructed. Unnecessary treatment can cause rebound high glucose and weight gain. See our hypoglycemia and insulin safety guide.
Should Metoprolol Be Stopped?
No—do not stop metoprolol suddenly. Abrupt withdrawal may worsen angina or trigger serious heart problems in susceptible people. Ask the prescriber to review the reason for metoprolol, dose, heart rate, blood pressure, glucose-lowering medicines, kidney and liver function, meals, alcohol, and any confirmed readings below 70 mg/dL.
Important Safety Note
Call emergency services for unconsciousness, seizure, inability to swallow, severe confusion, collapse, chest pain, or breathing difficulty. Someone who cannot swallow must not be given food or drink. Seek prompt medical review for repeated readings below 70 mg/dL, any reading below 54 mg/dL, nighttime lows, or symptoms occurring while driving or operating machinery.
Doctor’s Note
A random glucose below 90 mg/dL is usually normal. The clinically important issue is whether you have confirmed readings below 70 mg/dL or symptoms that correlate with a low. Metoprolol may conceal a fast heartbeat and can make hypoglycemia more dangerous in high-risk situations, so the complete medicine list and glucose pattern should be reviewed.
Educational safety note: This answer is for general diabetes education only. It does not replace personal medical advice. Do not stop or change metoprolol, insulin, diabetes tablets, food intake, alcohol use, or exercise without guidance from your healthcare professional.
Related Questions
- What can cause recurring low blood glucose?
- When does an abnormal glucose reading require hospital care?
- Why do home glucose readings sometimes appear inconsistent?
Related Resources
- Dangerous blood sugar levels and warning signs
- Diabetes medicines: benefits and side effects
- Normal blood sugar level chart
Last reviewed: July 2026.
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