LACK OF EFFECTS OF ANGIOTENSIN-CONVERTING ENZYME (ACE-INHIBITORS ON GLUCOSE-METABOLISM IN TYPE-1 DIABETES

被引:34
作者
SEEFELDT, T
ORSKOV, L
MENGEL, A
RASMUSSEN, O
PEDERSEN, MM
MOLLER, N
CHRISTIANSEN, JS
SCHMITZ, O
机构
[1] Department of Medicine M, Randers Centralsygehus, Second University Clinic of Internal Medicine, Aarhus Kommunehospital
[2] Department of Medicine III, Aarhus Amtssygehus and Institute of Experimental Clinical Research, Aarhus University
关键词
ACE‐inhibitors; Glucose metabolism; Type 1 diabetes mellitus;
D O I
10.1111/j.1464-5491.1990.tb01473.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To evaluate the impact of ACE‐inhibitors on insulin‐mediated glucose uptake, glucoseinduced glucose uptake, and hepatic glucose production, a sequential glucose clamp was performed in eight normotensive Type 1 diabetic patients after 3 weeks of enalapril therapy 20 mg day−1 and during control conditions. The experiments were carried out in random order. Mean arterial blood pressure was significantly reduced during ACE‐inhibition (95 ± 3 (±SE) vs 84 ± 3 mmHg; p < 0.02), while blood glucose control as assessed by HbA1c was unaltered (7.9 ± 0.5 vs 7.6 ± 0.5%). The night prior to the study normoglycaemia was maintained by a Biostator. A two‐step hyperinsulinaemic euglycaemic clamp (insulin infusion rate 0.3 and 0.8 mU kg−1 min−1) was followed by a hyperinsulinaemic and hyperglycaemic clamp (insulin infusion rate 0.8 mU kg−1 min−1, plasma glucose 11 mmoll−1). Insulin concentrations were comparable with and without enalapril treatment. During the hyperinsulinaemic clamps isotopically determined glucose disposal was unchanged (low dose 2.5 ± 0.3, high dose 4.3 ± 0.7 vs 2.6 ± 0.3 and 4.3 ± 0.7 mg kg−1 min−1 enalapril vs control). Glucose‐induced glucose disposal (9.2 ± 1.2 vs 9.1 ± 1.2 mg kg−1 min1) was also similar, as were non‐protein respiratory exchange ratios (indirect calorimetry). Glucose production was not changed by enalapril. In conclusion, treatment with enalapril has no significant effect on glucose metabolism in Type 1 diabetes. 1990 Diabetes UK
引用
收藏
页码:700 / 704
页数:5
相关论文
共 25 条
[1]  
Mogensen CE., Long‐term antihypertensive treatment inhibiting progression of diabetic nephropathy, Br Med J, 285, pp. 685-689, (1982)
[2]  
Parving H-H, Andersen AR, Smidt UM, Svendsen PAA., Early and aggressive antihypertensive treatment reduces the rate of decline in kidney function in diabetic nephropathy, Lancet, 1, pp. 1175-1177, (1983)
[3]  
Feldt-Rasmussen B., Mathiesen E., Deckert T., Effect of two years of strict metabolic control on the progression of incipient nephropathy in insulin‐dependent diabetes, Lancet, 2, pp. 1300-1304, (1986)
[4]  
Christensen CK, Mogensen CE., Antihypertensive treatment: long‐term reversal of progression of albuminuria in incipient diabetic nephropathy. A longitudinal study of renal function, J Diabet Compl, 1, pp. 45-52, (1987)
[5]  
Hommel E., Parving H-H, Mathiesen E., Edsberg B., Nielsen MD, Giese J., Effect of captopril on kidney function in insulin‐dependent diabetic patients with nephropathy, Br Med J, 293, pp. 467-470, (1986)
[6]  
McMurray J., Fraser D., Captopril, enalapril and blood glucose, Lancet, 1, (1986)
[7]  
Ferriere M., Lachkar H., Richard J-L, Bringer J., Orsetti A., Mirouze J., Captopril and insul in sensitivity, Ann Intern Med, 102, pp. 134-135, (1985)
[8]  
Jauch K-W, Hartl W., Guenther B., Wicklmayr M., Rett K., Dietze G., Captopril enhances insulin responsiveness of forearm muscle tissue in non‐insulin‐dependent diabetes mellitus, Eur J Clin Invest, 17, pp. 448-459, (1987)
[9]  
Torlone E., de Feo P., Fanelli C., Botta G., Brunetti P., Bolli GB., Effects of captopril on insulin‐mediated carbohydrate and lipid metabolism in subjects with NIDDM and hypertension (Abstract), Diabetes, 38, (1989)
[10]  
Pollare T., Lithell H., Berne C., A comparison of the effects of hydrochlorothiazide and Captopril on glucose and lipid metabolism in patients with hypertension, N Engl J Med, 321, pp. 868-873, (1989)