Internal Medicine News - Ramipril cuts diabetes risk
The ACE inhibitor ramipril appears to reduce the risk of developing diabetes among high-risk patients who take it to prevent myocardial infarction, stroke, and diabetic nephropathy, reported Salim Yusuf, D.Phil., and associates in the Heart Outcomes Prevention Evaluation trial.
The HOPE trial involved more than 10,000 subjects treated at 267 hospitals around the world between 1994 and 1999. A subgroup of 5,887 patients who were at risk for diabetes but did not yet have the disease was randomly assigned to receive ramipril or a placebo, said Dr. Yusuf of Hamilton (Ont.) General Hospital.
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Over a mean follow-up of 4.5 years, 102 subjects in the ramipril group (3.6%) developed diabetes, compared with 155 (5.4%) in the placebo group. The proportion of patients who required an oral glucose-lowering agent or insulin and the proportion who had a glycated hemoglobin of 110% or more above normal were significantly lower in the ramipril group, they said (JAMA 286[15]:1882-85, 2001).
These findings require confirmation because of their “enormous clinical and public health potential,” so the researchers are now conducting a large prospective trial with patients who have impaired glucose tolerance.
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