Do angiotensin converting enzyme inhibitors or angiotensin receptor blockers prevent diabetes mellitus? a meta-analysis

Mouaz Al-Mallah, Owais Khawaja, Mohamad Sinno, Opada Alzohaili, Abdul B.Abou Samra

Research output: Contribution to journalReview article

44 Scopus citations

Abstract

Background: The prevalence of diabetes mellitus (DM) has increased exponentially in recent years, with 100 million people expected to develop diabetes in the coming 15 years. The impact of medical therapy on the incidence of new onset DM is not clear. We performed a systematic review and meta-analysis to study the impact of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on the incidence of new onset DM. Methods: MEDLINE, EMBASE, BIOSIS, Cochrane databases from inception until February 2009 for randomized controlled trials (RCT) that reported new incident DM with ACEI or ARB therapy. A total of 18 RCT are included in this meta-analysis. A random-effect model was used and between-studies heterogeneity was estimated with I2. Results: There were 50,451 patients randomized to ACEI or ARB and 50,397 patients randomized to other therapies. ACEI/ARB use was associated with a decrease in new onset DM (RR 0.78, 95% CI 0.70-0.88, p = 0.003 for ACEI and RR 0.8, 95% CI 0.75-0.86, p < 0.0001 for ARB). Treating 100 patients with ACEI or 50 patients with ARB prevents one case of new onset DM. Conclusions: The cumulative evidence suggests that the use of ACEI/ARB prevents diabetes mellitus. This finding may be of special clinical benefit in patients with hypertension and prediabetes or metabolic syndrome.

Original languageEnglish (US)
Pages (from-to)448-456
Number of pages9
JournalCardiology Journal
Volume17
Issue number5
StatePublished - Oct 21 2010

Keywords

  • Angiotensin converting enzyme inhibitors
  • Angiotensin receptor blockers
  • Diabetes mellitus

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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