THURSDAY, Oct. 18, 2001 (HealthDayNews) -- A drug used to control high blood pressure appears to help prevent diabetes in high-risk people, a study indicates.
The drug is ramipril, marketed as Altace. It is an ACE inhibitor, a member of a class of drugs most often prescribed to prevent heart disease. Its diabetes connection emerged from a study intended to measure its effect on the incidence of heart disease.
Ramipril reduced the risk of diabetes by about 40 percent in that trial, which included persons at high risk of heart attack and stroke, says a report in the latest issue of The Journal of the American Medical Association. Only 3.4 percent of the people in that trial who took ramipril developed diabetes, compared with 5.6 percent of those who got a placebo.
That result requires confirmation, says study leader Salim Yusuf, professor of medicine at McMaster University in Hamilton, Ontario. That study was not intended to measure the effect of the drug on diabetes, he says. A multicenter trial will be undertaken "because of the enormous clinical and public health implications of these findings," Yusuf says.
Ramipril is the second drug shown to have promise in preventing diabetes, says Dr. Eugene Barrett, director of the diabetes center at the University of Virginia. The other is metformin, marketed as Glucophage, which is used to reduce blood levels of glucose in diabetics.
Yusuf say his study showed that ramipril also reduces blood sugar levels.
Barrett says, "It was a surprise that ramipril has an effect on blood glucose. Now this finding has to be confirmed."
Barrett says besides the two drugs, the good news is that simple lifestyle changes can prevent diabetes in high-risk individuals. "Modest exercise and fairly modest dietary restrictions can prevent diabetes in that population," he says.
The recommendations for exercise and diet to prevent diabetes are generally the same as those to prevent heart disease, including a diet low in fat and high in fruits and vegetables, and at least 30 minutes of physical activity, such as a brisk walk, every day.
People at high risk for diabetes include those who are overweight and who have a family history of the disease. African-Americans, Hispanics and women who have diabetes during pregnancy also are at high risk, Barrett says.
The incidence of diabetes has been rising in recent years, largely because Americans are gaining more weight and getting less physical activity. The Centers for Disease Control and Prevention (CDC) reported earlier this year that the incidence of diabetes increased by a third from 1990 to 1998, from 4.9 percent to 6.5 percent of the adult American population. The CDC say 800,000 new cases of diabetes are reported each year.
Now there is hope of reversing that trend, Barrett says. "People can watch their diet and exercise, and now at least two pharmacological agents look promising," he says.
What To Do
"At this point, all that high-risk persons should do about ramipril is talk to their doctor about it," Barrett says. "The effect of changes in diet and exercise are very clear."
For information about diabetes, go to the American Diabetes Association or the CDC.
