October 16, 2001 CHICAGO (AP) - A widely used blood pressure drug may prevent diabetes in people at high risk for the disease, a study suggests.
The preliminary research found that patients taking an ACE inhibitor called ramipril and sold as Altace reduced their risk of diabetes by more than 30 percent.
The tantalizing result was first observed by the same researchers in a previously published study showing that ramipril could reduce deaths, heart attacks and other complications in diabetics and people at high risk for the disease.
The new study, published in Wednesday's Journal of the American Medical Association, expands on the finding.
The researchers and other doctors expressed caution because the results came in a study that was not designed to determine if the drug could prevent diabetes.
The results "require confirmation because of the enormous clinical and public health potential of these findings," said the researchers, led by Dr. Salim Yusuf of McMaster University in Canada.
Dr. Christopher Saudek, president of the American Diabetes Association, agreed that more study is needed but said it is a potentially important and scientifically plausible theory.
ACE - angiotensin converting enzyme - inhibitors block formation of angiotensin, an enzyme involved in regulating blood pressure. The enzyme can cause blood vessels and arteries to constrict, but the drug relaxes them, keeping blood pressure down.
The researchers said the drug's effects on blood vessels may improve functioning of the pancreas and reduce insulin resistance. Diabetes occurs when the body cannot produce or properly use insulin, a hormone produced in the pancreas that regulates blood sugar.
The study involved 5,720 patients 55 and older with vascular disease or other diabetes risk factors. They randomly received either a placebo or ramipril for an average of about 4 1/2 years.
Diabetes developed during the study in 102 people in the ramipril group, 3.6 percent, compared with 155, or 5.4 percent, of patients on placebos.
The patients reported that they had been diagnosed with diabetes; the study did not attempt to confirm that they had the disease.
Funding for the study came in part from the Medical Research Council of Canada, the Stroke Foundation of Ontario and several drug companies, including Altace manufacturer Aventis Pharmaceuticals.
Dr. John Buse, director of the diabetes care center at the University of North Carolina in Chapel Hill, said ramipril might indeed protect against diabetes, "but without the exact right study, it's hard to take this to the bank."
He said one possibility - which he considers unlikely - is that ramipril simply made patients feel better, so they exercised more. Exercise is known to help prevent diabetes.
Copyright 2001 The Associated Press. All rights reserved.
