title: Effects of telmisartan on glucose levels in people at high risk for cardiovascular disease but free from diabetes: the TRANSCEND study.
abstract: OBJECTIVE
  Several large clinical trials suggest that ACE inhibitors may reduce the incidence of diabetes. Less is known about the effects of angiotensin receptor blockers (ARBs) on reducing incident diabetes or leading to regression of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) to normoglycemia.
  
  
  METHODS
  Participants were 3,488 adults at high risk for cardiovascular disease but free from diabetes (mean age 67 years; 61% male) in the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease (TRANSCEND) study. The participants were randomized to the ARB telmisartan 80 mg (n = 1,726) or placebo (n = 1,762) in addition to usual care.
  
  
  RESULTS
  During a median 56 months, 21.8% of participants treated with telmisartan and 22.4% of those on placebo developed diabetes (relative ratio 0.95 [95% CI 0.83-1.10]; P = 0.51). Participants originally diagnosed with IFG and/or IGT were equally likely to regress to normoglycemia (26.9 vs. 24.5%) or to progress to incident diabetes (20.1 vs. 21.1%; P = 0.59) on telmisartan or placebo.
  
  
  CONCLUSIONS
  There was no evidence that addition of the ARB telmisartan to usual care prevents incident diabetes or leads to regression of IFG or IGT in people at high risk for cardiovascular disease but free from diabetes.
authors.affiliation: Kaiser Permanente of Georgia, Atlanta, GA, USA. joshua.barzilay@kp.org
authors.forename: Joshua I
authors.initials: JI
authors.lastname: Barzilay
authors.forename: Peggy
authors.initials: P
authors.lastname: Gao
authors.forename: Lars
authors.initials: L
authors.lastname: Rydén
authors.forename: Helmut
authors.initials: H
authors.lastname: Schumacher
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Probstfield
authors.forename: Patrick
authors.initials: P
authors.lastname: Commerford
authors.forename: Antonio
authors.initials: A
authors.lastname: Dans
authors.forename: Rafael
authors.initials: R
authors.lastname: Ferreira
authors.forename: Mátyás
authors.initials: M
authors.lastname: Keltai
authors.forename: Ernesto
authors.initials: E
authors.lastname: Paolasso
authors.forename: Salim
authors.initials: S
authors.lastname: Yusuf
authors.forename: Koon
authors.initials: K
authors.lastname: Teo
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood* / Q000517:prevention & control; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077333:Telmisartan
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D001786:Blood Glucose; D000077333:Telmisartan