Effect of Ramipril on the Incidence of Diabetes

Bosch, Jackie; Yusuf, Salim; Gerstein, Hertzel C.; Pogue, Janice; Sheridan, Patrick; Dı́az, Rafael; Avezum, Álvaro; Lanas, Fernando; Probstfield, Jeffrey L.; Fodor, George; Holman, Rury R.

doi:10.1056/nejmoa065061

Cited by 633 publications

(116 citation statements)

References 24 publications

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“…A number of previous studies have reported beneficial metabolic effects of ACE inhibitors or angiotensin II receptor antagonists on insulin secretion, insulin action as well as on overall glucose metabolism in patients with T2D (5,6). In support of this, large-scale randomised prospective trials have reported a decreased incidence of T2D or leading to regression of impaired fasting glucose levels or impaired glucose tolerance to normoglycaemia by ACE inhibitors and angiotensin receptor blockers (ARBs), as primary or secondary outcomes (7,8). Studies on the use of bioactive peptides in diabetic patients are limited, and only a few studies have evaluated the effect of probiotics on specific elements of the metabolic syndrome (MS) in non-diabetic adolescents and adults (9,10,11).…”

Section: Introductionmentioning

confidence: 75%

Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study

Hove

Brøns

Færch

et al. 2015

European Journal of Endocrinology

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Objective: Studies have indicated a blood pressure (BP)-lowering effect of milk-derived peptides in non-diabetic individuals, but the cardiometabolic effects of such peptides in patients with type 2 diabetes (T2D) are not known. We investigated the effect of milk fermented with Lactobacillus helveticus on BP, glycaemic control and cardiovascular risk factors in T2D. Design: A randomised, double-blinded, prospective, placebo-controlled study. Methods: In one arm of a factorial study design, 41 patients with T2D were randomised to receive 300 ml milk fermented with L. helveticus (Cardi04 yogurt) (nZ23) or 300 ml artificially acidified milk (placebo yogurt) (nZ18) for 12 weeks. BPs were measured over 24-h, and blood samples were collected in the fasting state and during a meal test before and after the intervention. Results: Cardi04 yogurt did not reduce 24-h, daytime or nighttime systolic or diastolic BPs compared with placebo (PO0.05). Daytime and 24-h heart rate (HR) were significantly reduced in the group treated by Cardi04 yogurt compared with the placebo group (P!0.05 for both). There were no differences in HbA1c, plasma lipids, C-reactive protein, plasminogen activator inhibitor-1, tumour necrosis factor alpha, tissue-type plasminogen activator: Ag, and von Willebrand factor: Ag between the groups. The change in fasting blood glucose concentration differed significantly between the two groups with a larger increase in the placebo group (P!0.05). Conclusions: Ingestion of milk fermented with L. helveticus compared with placebo for 12 weeks did not significantly reduce BP in patients with T2D. Our finding of lower HRs and fasting plasma glucose levels in T2D patients during ingestion of fermented milk needs further validation.

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Section: Introductionmentioning

confidence: 75%

Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study

Hove

Brøns

Færch

et al. 2015

European Journal of Endocrinology

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“…Moreover, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are associated with a reduction in the incidence of new-onset diabetes among patients with essential hypertension [107]. A notable exception was the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) in which ramipril did not prevent the progression to diabetes in subjects with IGT or impaired fasting glucose [108]. However, in support of the hypothesis that angiotensin-converting enzyme inhibitors might protect against the development of diabetes, the rate of regression to normoglycaemia was increased by rampiril.…”

Section: Therapeutic Implicationsmentioning

confidence: 99%

Vascular Disease in the Metabolic Syndrome: Do We Need to Target the Microcirculation to Treat Large Vessel Disease?

Krentz

Clough

Byrne³

2009

J Vasc Res

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The metabolic syndrome of vascular risk is threatening large numbers of ever-younger people. To date, the syndrome has been chiefly viewed as a potential risk marker that confers a heightened probability of developing type 2 diabetes and occlusive atherothrombotic disease of large- and medium-sized arteries. Accumulating evidence suggests that the components of the metabolic syndrome may also adversely affect the microvasculature through several inter-related mechanisms. These include the following observations: classic risk factors for macrovascular disease such as high blood pressure and dyslipidaemia also accelerate microvascular complications of diabetes, lesser disturbances of glucose metabolism (i.e. impaired glucose tolerance) may be associated with some forms of microvascular dysfunction, non-glucose intermediary metabolites may promote renovascular hypertension thereby damaging the microvasculature, and insulin resistance appears to be directly associated with microvascular dysfunction. In turn, microvascular complications such as nephropathy and autonomic neuropathy may promote the development and progression of atherosclerosis. We argue that the vascular implications of the metabolic syndrome should be broadened to include the microvasculature. The hypothesis that vascular events can be prevented, or at least deferred, through earlier therapeutic intervention in pre-diabetic subjects with glucose intolerance is amenable to testing in clinical trials.

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“…In the ramipril treatment arm of the DREAM study [64], no reduction in the appearance of DM was observed, although there was a slight but statistically significant normalization of the glycemia. These data are in contrast to the above-mentioned benefits regarding blocking of the angiotension-renin system, albeit dealing with different populations at high risk, and of low risk in the case of the DREAM study.…”

Section: Prevention Of the Metabolic Syndromementioning

confidence: 99%

The Metabolic Syndrome and Cerebrovascular Disease: Suspicion and Evidence

Gil‐Núñez

2007

Cerebrovasc Dis

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The metabolic syndrome (MS) is the combination of factors which, when occurring in an individual, can result in an increased risk of diabetes mellitus (DM) and of episodes of vascular disease. We present a systematic review of the diagnostic criteria, pathology, prevalence and risk of vascular disease (including stroke) associated with the MS and, if the patients have already suffered cerebral ischemia and have the MS and/or DM, the appropriate therapies from which they could benefit.

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Effect of Ramipril on the Incidence of Diabetes

Cited by 633 publications

References 24 publications

Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study

Effects of 12 weeks of treatment with fermented milk on blood pressure, glucose metabolism and markers of cardiovascular risk in patients with type 2 diabetes: a randomised double-blind placebo-controlled study

Vascular Disease in the Metabolic Syndrome: Do We Need to Target the Microcirculation to Treat Large Vessel Disease?

The Metabolic Syndrome and Cerebrovascular Disease: Suspicion and Evidence

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