Effect of calcium channel blockers on incidence of diabetes: a meta-analysis.
OBJECTIVE
Insulin resistance and the progressive loss of β-cell function are components of the fundamental pathophysiology of type II diabetes. A recent experimental study suggested that calcium channel blockers (CCBs) might inhibit β-cell apoptosis, enhance β-cell function, and prevent diabetes. The present meta-analysis examined the clinical effect of CCBs on the incidence of diabetes.


METHODS
MEDLINE, EMBASE, ISI Web of Science, the Cochrane Library, and ClinicalTrials. gov were each searched for relevant articles published up to March 11, 2013. Randomized controlled trials (RCTs) with a follow-up period of at least 1-year were included. Identified articles were systematically reviewed, and those with pertinent data were selected for inclusion in a meta-analysis.


RESULTS
We included ten RCTs in a meta-analysis. Of the 108,118 people with hypertension and no pre-existing diabetes, 7,073 (6.5%) cases of type II diabetes were reported. CCBs were associated with a higher incidence of diabetes than angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs; pooled risk ratios [95% confidence intervals]: 1.23 [1.01-1.51] and 1.27 [1.14-1.42], respectively) and a lower incidence compared with β blockers or diuretics (0.83 [0.73-0.94] and 0.82 [0.69-0.98], respectively). The overall risk of diabetes among subjects taking CCBs was not significant (0.99 [0.85-1.15]).


CONCLUSIONS
THE USE OF CCBS WAS NOT SIGNIFICANTLY ASSOCIATED WITH INCIDENT DIABETES COMPARED TO OTHER ANTIHYPERTENSIVE AGENTS: the association with diabetes was lowest for ACEIs and ARBs, followed by CCBs, β blockers, and diuretics. Although CCBs can be safely used in hypertensive patients, it would be premature to advocate CCBs for the prevention or treatment of diabetes.
Department of Diabetes and Metabolic Medicine, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan ; Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
Hiroshi
H
Noto
Atsushi
A
Goto
Tetsuro
T
Tsujimoto
Mitsuhiko
M
Noda
calcium channel blockers; diabetes; hypertension; meta-analysis