Endocrine Abstracts

Experimental and clinical studies suggest that blocking the effects of angiotensin II increases insulin sensitivity, skeletal muscle glucose transport, and pancreatic blood flow which may contribute to the prevention of diabetes mellitus. Although large scale studies and meta-analysis reveal that the new onset of diabetes could be significantly decreased by ARBs in both hypertensive and normotensive patients, their effect on glucose regulation in patients already diagnosed with diabetes has not been investigated in a satisfactory manner. The aim of this study is to evaluate the effect of ARBs on glucose regulation in a diabetic population. All subjects were randomly selected using their electronic records. Mean follow-up duration of the whole study population was 44.3±35.4 (6–139) months with a median of 4 (2–7) HbA1c measurements per se. The mean age of the whole study population was 66.8±11.6 (31–93) years. Mean diabetes duration was 10.5±8.9 (1–49) years. Male-to-female ratio was 0.67:1. All statistical comparisons were made by adjusting both groups according to age, gender, diabetes duration, medication for diabetes (metformin, sulphonylurea, and insulin), smoking habits, β-blocker and diuretic use. Of the chosen study group 81.6% were using at least one anti-hypertensive medication. Among them 55.8% (n=67) were under ARB treatment with or without diuretics. When comparing subjects using ARB with subjects treated otherwise, we found that ARB treatment is related to significantly lower mean HbA1c levels (P=0.013). While the mean HbA1c level of ARB treated group was 6.6%, levels for non ARB treated group was found to be 7.1%. Although the population of this study group is not sufficient to make larger scale conclusions, we anticipate that patients with diabetes will benefit from ARBs in regard to glucose control.