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ADA: Enalapril Shows Renoprotective Effect in Diabetics with Microalbuminuria By Jill Stein NEW ORLEANS, LA -- June 18, 2003 -- The angiotensin-converting (ACE) enzyme inhibitor enalapril decreases albuminuria in normotensive type 2 diabetics, researchers noted here June 16th at the 63rd Scientific Sessions of the American Diabetes Association. The findings suggest that all type 2 diabetics should be started on an ACE inhibitor upon diagnosis, said Jamal Ahmad, MD, PhD, from Aligarh Muslim University, in Aligarh, India, who presented the results. Dr. Ahmad and colleagues enrolled 103 type 2 diabetics who had normal blood pressure levels and a persistent albumin excretion rate (AER) of 20 to 200 mcg/min with normal renal function. Subjects were randomized to 5 years of treatment with enalapril or placebo, after which placebo-treated patients were switched to enalapril for another 5 years. In enalapril-treated patients, AER decreased from 55 to 20 mcg/min after 5 years; in the placebo group, AER increased from 53 to 85 mcg/min. Overall, 7.7% of enalapril-treated patients and 23.5% of placebo-treated patients progressed to clinical albuminuria, which translated into a 66.7% risk reduction (P<0.001). The results also show that AER increased at an annual rate of 12.3% in the placebo group, and declined by 16.7% in the enalapril group (P<0.001). Results in patients who were initially assigned to placebo and then switched to enalapril confirmed the ACE inhibitor's renoprotective effect. "Based on the results, we recommend all type 2 diabetics should be started on an ACE inhibitor immediately upon diagnosis," Dr. Ahmad said. [Study title: Long-Term Renoprotective Effects of Enalapril in Normotensive Type 2 Diabetic Patients with Microalbuminuria. Abstract 209] E-mail this page to a friend or colleague! To print, use this version