title: The role of renin-angiotensin agents in altering the natural history of type 2 diabetes mellitus.
abstract: Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD) morbidity and mortality worldwide. Renin-angiotensin system (RAS) blockers have been indispensable in diminishing the macrovascular and microvascular complications of diabetes. In addition, cumulative evidence from retrospective studies pointed toward a beneficial effect of RAS agents in preventing the development and progression of T2DM. This disease-modifying potential of RAS blockers has been substantiated by recent prospective trials. Contemporary concepts regarding the natural history of T2DM and the pathophysiologic processes involved have increased our understanding of the mechanisms underlying the therapeutic potential of these agents in diabetes management. In addition to their established roles in the primary prevention of CVD in patients with diabetes, RAS blockers might be considered a suitable therapeutic choice for preventing the development of frank diabetes in high-risk patients.
authors.affiliation: Department of Medicine, University of California in San Francisco (Fresno-MEP), 155 North Fresno Street, Fresno, CA 93701, USA. dr_jolar@yahoo.com
authors.forename: Joel A
authors.initials: JA
authors.lastname: Lardizabal
authors.forename: Prakash C
authors.initials: PC
authors.lastname: Deedwania
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D018450:Disease Progression; D006801:Humans; D007333:Insulin Resistance; D055806:Microvessels; D012084:Renin-Angiotensin System / Q000187:drug effects*; D012307:Risk Factors; D015398:Signal Transduction
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001786:Blood Glucose
references.citation: Lancet. 2007 Jan 20;369(9557):201-7
references.pmid: 17240286
references.citation: Arch Intern Med. 2006 Nov 13;166(20):2191-201
references.pmid: 17101936
references.citation: Am J Med. 2007 Sep;120(9 Suppl 2):S12-7
references.pmid: 17826041
references.citation: Cell. 2005 Dec 29;123(7):1307-21
references.pmid: 16377570
references.citation: N Engl J Med. 1989 Aug 10;321(6):337-43
references.pmid: 2664520
references.citation: Am J Cardiol. 2006 Oct 1;98(7):890-4
references.pmid: 16996868
references.citation: Biochem Biophys Res Commun. 2006 Jun 16;344(4):1224-33
references.pmid: 16650382
references.citation: Diabetologia. 2010 Aug;53(8):1727-31
references.pmid: 20390403
references.citation: Diabetes Care. 2004 Nov;27(11):2597-602
references.pmid: 15504992
references.citation: N Engl J Med. 2008 Apr 10;358(15):1547-59
references.pmid: 18378520
references.citation: Am J Physiol. 1997 Jul;273(1 Pt 1):E220-5
references.pmid: 9252500
references.citation: Diabetes Metab. 2009 Nov;35(5):392-7
references.pmid: 19713141
references.citation: J Hypertens. 2002 Sep;20(9):1879-86
references.pmid: 12195132
references.citation: Circulation. 2005 Jul 5;112(1):48-53
references.pmid: 15983242
references.citation: Arch Intern Med. 2004 Jul 12;164(13):1422-6
references.pmid: 15249351
references.citation: N Engl J Med. 1991 Jul 18;325(3):147-52
references.pmid: 2052059
references.citation: N Engl J Med. 2006 Oct 12;355(15):1551-62
references.pmid: 16980380
references.citation: Diabetes Care. 2010 Jul;33(7):1549-54
references.pmid: 20357373
references.citation: Diabetes Care. 2007 Jan;30(1):162-72
references.pmid: 17192355
references.citation: Diabetes Care. 2004 Oct;27(10):2540-53
references.pmid: 15451934
references.citation: JAMA. 2003 Jan 1;289(1):76-9
references.pmid: 12503980
references.citation: Diabetes Care. 2006 Jul;29(7):1585-90
references.pmid: 16801583
references.citation: Diabetes Care. 2009 Mar;32(3):439-44
references.pmid: 19056613
references.citation: Diabetes. 1994 Aug;43(8):1066-84
references.pmid: 8039601
references.citation: Diabetes Care. 2000 May;23(5):589-94
references.pmid: 10834414
references.citation: Diabetes Care. 2005 Jan;28(1):164-76
references.pmid: 15616252
references.citation: J Hypertens. 2009 Dec;27(12):2409-20
references.pmid: 19901849
references.citation: Arterioscler Thromb Vasc Biol. 2002 Nov 1;22(11):1845-51
references.pmid: 12426214
references.citation: Diabetes Metab. 2004 Dec;30(6):487-96
references.pmid: 15671918
references.citation: Circulation. 2010 Feb 23;121(7):e46-e215
references.pmid: 20019324
references.citation: Med J Aust. 2007 May 7;186(9):461-5
references.pmid: 17484708
references.citation: Diabetes. 1996 Jan;45 Suppl 1:S66-9
references.pmid: 8529803
references.citation: Lancet. 2002 Mar 23;359(9311):1004-10
references.pmid: 11937179
references.citation: Diabetes Care. 2008 Jan;31 Suppl 1:S12-54
references.pmid: 18165335
references.citation: JAMA. 1988 Dec 16;260(23):3456-60
references.pmid: 2974889
references.citation: Diabetes. 1996 Jan;45 Suppl 1:S24-8
references.pmid: 8529796
references.citation: Nat Med. 2007 Mar;13(3):340-7
references.pmid: 17322896
references.citation: N Engl J Med. 2010 Apr 22;362(16):1477-90
references.pmid: 20228403
references.citation: Diabetes. 1996 Jan;45 Suppl 1:S34-7
references.pmid: 8529798
references.citation: Lancet. 2009 Jun 27;373(9682):2215-21
references.pmid: 19515410
references.citation: Diabetes Care. 2007 Mar;30(3):753-9
references.pmid: 17327355
references.citation: JAMA. 2001 Oct 17;286(15):1882-5
references.pmid: 11597291
references.citation: Lancet. 2000 Jan 22;355(9200):253-9
references.pmid: 10675071
references.citation: Diabetes Care. 2005 Oct;28(10):2501-7
references.pmid: 16186287
references.citation: Exp Clin Endocrinol Diabetes. 1999;107(2):133-9
references.pmid: 10320054
references.citation: Diabetes Metab. 2004 Dec;30(6):498-505
references.pmid: 15671919
references.citation: J Clin Invest. 1999 Sep;104(6):787-94
references.pmid: 10491414
references.citation: J Hypertens. 2003 May;21(5):875-86
references.pmid: 12714861
references.citation: Diabetes. 2007 Dec;56(12):2927-37
references.pmid: 17717282
references.citation: Diabetes. 2003 Jun;52(6):1475-84
references.pmid: 12765960
references.citation: Eur J Endocrinol. 1998 Mar;138(3):344-52
references.pmid: 9539311
references.citation: Hypertension. 2010 Mar;55(3):715-21
references.pmid: 20100990