Effect of quinapril or losartan alone and in combination on left ventricular systolic and diastolic functions in asymptomatic patients with diabetic autonomic neuropathy

Evaluating peripheral nerve function in asymptomatic patients with type 2 diabetes or latent autoimmune diabetes of adults (LADA): results from nerve conduction studies

“…One potential explanation could be that patients selected in relevant clinical trials were affected by established neuropathy (Dyck et al, 2007), where irreversible peripheral nerve changes may have already taken place. Unfortunately, very few, if any, have conducted interventional studies in patients with asymptomatic or subclinical neuropathy (Didangelos et al, 2006;Martyn, Reid, Young, Ewing, & Clarke, 1987). Taken together, our observation highlights the urgent need for the development of early therapeutic interventions to prevent the onset of advanced neuropathy.…”

Why Not to Use the Handgrip Test in the Assessment of Cardiovascular Autonomic Neuropathy Among Patients with Diabetes Mellitus?

“…Most patients with DM and hypertension are treated with ACE inhibitors, while these drugs might have an effect on autonomic function as well. Didangelos et al [48] assessed the effect of ACE inhibition or angiotensin receptor blockade, and their combination on CAN in patients with DM. After 12 months, improvement of CAN was observed in patients treated both with quinapril or losartan, while their combination was slightly even more effective [48].…”

“…Didangelos et al [48] assessed the effect of ACE inhibition or angiotensin receptor blockade, and their combination on CAN in patients with DM. After 12 months, improvement of CAN was observed in patients treated both with quinapril or losartan, while their combination was slightly even more effective [48]. Beneficial effect of quinapril on CAN has also been observed in another study [49], while no significant changes in CAN was detected after 12 months treatment with trandolapril [50].…”

Association of Cardiac Autonomic Neuropathy With Subclinical Myocardial Dysfunction in Type 2 Diabetes

“…In the absence of definitive evidence supporting direct treatment, the current management of diabetic CAN relies on aggressive strategies to improve glycemic control. Angiotensin-converting enzyme inhibitor and/or angiotensin receptor blocker therapy (29) have shown promising initial results, although further clinical trials are required to determine their efficacy and potential for translation of benefits to LV function. …”