To investigate liver function changes, blood glucose fluctuation, insulin secretion and gender differences in hyperthyroidism patients before and after propranolol with methimazole. Clinical data 110 hyperthyroidism patients admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from February 2023 to February 2024 were retrospectively analyzed. They were categorized into the methimazole group (methimazole, n = 55) and the coalition medication group (Methimazole with propranolol, n = 55). The therapeutic effects of both groups were observed. Pre- and post-treatment liver function dynamic blood glucose parameters and insulin secretion characteristics were analyzed between the two groups. Gender differences prior to treatment were also examined. Overall efficacy was significantly higher in the oalition group (96.35%) than in the methimazole group (83.64%) (P<0.05); Post-treatment, the TBiL, AST, ALT, FT, FT, FBG, P1BG, HOMA-IR, HOMA-β, postprandial blood glucose peak value, LAGE, MAGE, MODD and SDBG levels in the coalition group were lower compared to the methimazole group, while TSH was higher (P<0.05). Female patients exhibited significantly lower LAGE, MAGE, MODD and SDBG levels compared to the male group (P<0.05). The combination of methimazole and propranolol enhances thyroid and liver functions for hyperthyroid patients while improving insulin resistance along with reducing postprandial blood glucose variability.

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