Response to Hypoglycemia Masked by Propranolol

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Abstract
To the Editor: In a patient with coronary vascular disease who is under treatment with beta-adrenergic blockade, hypoglycemia is a pernicious disorder that is difficult to recognize. We saw a 57-year-old man who was taking propranolol (15 mg four times a day) for angina and who reported only intermittent emotional irritability and hunger, without sweating or palpitations. He was euthyroid while taking propylthiouracil two months after receiving iodine-131 for very mild toxic nodular goiter; he was of normal weight, nutritional status, and liver function; he was not diabetic and was without evidence of excessive insulin-like factors; and he did not . . .

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