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ACE Inhibitors and Angiotensin Receptor Antagonists and the Incidence of New-Onset Diabetes Mellitus

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Abstract

The prevalence of type 2 diabetes mellitus continues to rise. Given the associated co-morbidities of obesity, hypertension and cardiovascular disease, the rising incidence of diabetes has important health consequences and efforts to reduce this incidence are critical. Although lifestyle modifications, including weight loss and exercise, are instrumental in the prevention of diabetes, pharmacological therapies that reduce the incidence of diabetes have the significant potential to lower risk.

The results of several large clinical trials have demonstrated that treatment with ACE inhibitors and angiotensin receptor antagonists (angiotensin receptor blockers; ARBs) may prevent or delay the onset of diabetes. These trials have demonstrated an approximately 15–30% reduction in the new onset of diabetes in those receiving ACE inhibitors and ARBs when compared with placebo or other active therapy. Although the exact mechanism underlying the effects are not entirely clear, multiple animal and human studies have demonstrated that the renin-angiotensin system plays an important role in glucose homeostasis. Although future prospective studies to clarify the role of ACE inhibitors and ARBs in preventing diabetes are ongoing, there is substantial existing evidence from completed trials that these agents may prevent the onset of diabetes.

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Acknowledgements

No funding was received to assist in the preparation of this manuscript. Dr Solomon has received research support from Novartis and AstraZeneca, and has served as a consultant for Novartis.

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  1. Division of Cardiology, Baylor College of Medicine, 1709 Dryden Street-BCM 620, Suite 500, Box 13, Houston, Texas, 77030, USA

    David Aguilar

  2. Cardiovascular Division, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts, USA

    Scott D. Solomon

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  1. David Aguilar
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Correspondence to David Aguilar.

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Aguilar, D., Solomon, S.D. ACE Inhibitors and Angiotensin Receptor Antagonists and the Incidence of New-Onset Diabetes Mellitus. Drugs 66, 1169–1177 (2006). https://doi.org/10.2165/00003495-200666090-00001

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