title: The role of angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists in the management of diabetic complications.
abstract: Evidence suggests that ACE inhibitors can be advantageous for prevention and halting progression of both micro- and macrovascular complications in patients with diabetes mellitus. ACE inhibitors are useful antihypertensive agents in both type 1 and type 2 diabetes; however, ACE inhibitor therapy often needs to be supplemented with calcium channel antagonists, beta-blockers or diuretics to achieve good blood pressure control. ACE inhibitors are also indicated in non-hypertensive patients with type 1 and type 2 diabetes who have micro- or macroalbuminuria. The effect of ACE inhibitors in halting the development and progression of retinopathy and, potentially, neuropathy needs further proof in large-scale studies. More recently, angiotensin II receptor antagonists are emerging as drugs with the potential to be successfully included in the management of diabetic complications, especially when ACE inhibitors are not suitable because of adverse effects.
authors.affiliation: Department of Endocrinology, Tartu University Clinics, Tartu, Estonia.
authors.forename: Toomas
authors.initials: T
authors.lastname: Podar
authors.forename: Jaakko
authors.initials: J
authors.lastname: Tuomilehto
mesh_terms: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000818:Animals; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D006801:Humans
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors