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What is the role of ACE inhibitors in diabetes?

Angiotensin-converting enzyme (ACE) inhibitors are a class of drugs commonly prescribed for high blood pressure and heart failure. They reduce blood pressure and ease the workload on the heart.

These drugs can help people with diabetes reduce their risk of heart attack, stroke, and premature death. They may also delay the onset and progression of kidney disease. In addition, ACE inhibitors can help reduce other complications of diabetes, such as foot ulcers and eye damage (retinopathy). Retinopathy is the leading cause of blindness for people with diabetes. They can help prevent diabetic complications in people who do not have high blood pressure.

ACE inhibitors include the drugs benazepril (brand name Lotensin), captopril (>Capoten), enalapril (>Vasotec), fosinopril (>Monopril), lisinopril (>Prinivil or >Zestril), moexipril (>Univasc), quinapril (>Accupril), ramipril (>Altace), perindopril (>Aceon), and trandolapril (>Mavik).

People who take ACE inhibitors run a slightly increased risk of low blood sugar. Therefore, if you have diabetes, you should have your blood sugar levels closely monitored for the first few weeks after you start taking an ACE inhibitor, or after increasing the dosage.

Sources:
Cecil Textbook of Medicine, 21st Edition. W. B. Saunders Company, 2000.
Conn's Current Therapy 2000, 52nd Edition. W. B. Saunders Company, 2000.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
Mancia, G. "Antihypertensive Efficacy of Manidipine and Enalapril in Hypertensive Diabetic Patients." Journal of Cardiovascular Pharmacology 35(2000).
Micromedex® Healthcare Series. Thomson Micromedex, 2006.
Nicola W. “Plasma Angiotensin II, Renin Activity and Serum Angiotensin Converting Enzyme Activity in NonInsulin Dependent Diabetes Mellitus Patients with Diabetic Nephropathy.” Endocrinology Journal. 48 (2001).
Parving, Hans-Henrik. “Evolving Strategies for Renoprotection: Diabetic nephropathy.” Current Opinion in Nephrology & Hypertension. 10 (2001).
Ustundag B. “Angiotensin Converting Enzyme (ACE) Activity Levels in Insulin-Independent Diabetes Mellitus and Effect of ACE Levels on Diabetic Patients with Nephropathy.” Cell Biochemical Function. 18 (2000).

This answer prepared 6/19/2001.
This information updated 1/30/2007.

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