Background and objectives: Hypertension is an extremely common co-morbid condition in diabetes. Peripheral insulin resistance (IR) plus compensatory hyperinsulinaemia is a common mechanism underlying both hypertension and diabetes. The aim of this study was to compare the effects of telmisartan and captopril on IR in type2 diabetes mellitus with hypertension. . Sixty-eight patients on oral hypoglycemic agents were assigned to receive two month treatment of either telmisartan (n = 34) or captopril (n = 34). Forty diabetic normotensive patients, with age and BMI, matched to the diabetic hypertensive patients, served as a control group. The oral hypoglycemic agents remained unchanged during the two-months study period. Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results: This study showed that the two groups of diabetic hypertensive patients who were assigned to receive captopril or telmisartan have a non-significant difference in fasting serum glucose (FSG), fasting serum insulin (FSI), QUICKI and HOMA-IR before starting therapy. Telmisartan and captopril groups showed insignificant change in body mass index (BMI). HOMA-IR, QUICKI, FSI and FSG were changed non-significantly in telmisartan group; while FSI, FSG and HOMA-IR decreased significantly (from 18.1± 9.69 to 15.14 ± 7.49, p=0.022; and from 187.32± 65.34 to 162.95 ± 56.87, p=0.048; and from 8.27 ± 6.28 to 6.02 ± 3.73, p-value= 0.027, respectively) and QUICKI increased significantly (from 0.293 ± 0.024 to 0.306 ± 0.031, p-value = 0.022) in the captopril group versus baseline. Conclusion: Captopril, but not telmisartan, significantly improves insulin sensitivity in diabetic hypertensive patients.
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