Effect of chronic ACE inhibition on glucose tolerance and insulin sensitivity in hypertensive type 2 diabetic patients.
We studied 14 moderately overweight Type 2 diabetic patients with essential hypertension in stable metabolic control after a run-in period, and again after 3 months of antihypertensive treatment with the angiotensin-converting enzyme (ACE) inhibitor captopril. Glucose tolerance was tested with a 75g oral glucose load (OGTT) and insulin sensitivity was measured by the insulin suppression test (IST) while dietary and drug treatment of the hyperglycemia was maintained constant. In the whole group, mean blood pressure (MBP) fell progressively over 3 months from a baseline value of 123 +/- 3 mmHg (1 mmHg = 0.133 kpa) to a final value of 115 +/- 2 mmHg (P < 0.005). After treatment, fasting plasma glucose, insulin, free fatty acid (FFA), potassium, and glycosylated hemoglobin concentrations were unchanged from baseline. There were no significant differences in glucose tolerance and insulin sensitivity between pre- and post-treatment values. Neither endogenous (oral glucose) nor exogenous (IST) insulin caused any change in plasma potassium concentration. This resistance to the hypokalemic action of insulin was not affected by captopril.
Yin
W
W
Metabolism Unit, C.N.R. Institute of Clinical Physiology, University of Pisa, Italy.
Seghieri
G
G
Boni
C
C
Sanna
G
G
Anichini
R
R
Bartolomei
G
G
Ferrannini
E
E
D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D002216:Captopril; D011188:Potassium