The renin-angiotensin-aldosterone system: a pivotal role in insulin sensitivity and glycemic control.

@article{citeulike:2807828, abstract = {PURPOSE OF REVIEW: Diabetes mellitus is an exploding epidemic costing billions of dollars yearly. Type 2 diabetes mellitus is characterized by insulin resistance and is closely associated with arterial hypertension. Emerging literature has demonstrated that modulation of the renin-angiotensin-aldosterone system by use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers leads to improved insulin sensitivity, glycemic control and possibly prevention of type 2 diabetes mellitus. RECENT FINDINGS: Several major studies investigating angiotensin II receptor blocker or angiotensin-converting enzyme inhibitor use in either hypertensive or heart failure patients have found lower incidence of type 2 diabetes mellitus when compared with placebo, beta-blocker, calcium-channel blocker or diuretic. None of these trials, however, studied prevention of diabetes as a primary endpoint. The Dream Trial and upcoming NAVIGATOR, ONTARGET/TRANSCEND trials specifically look at the prevention of diabetes as a primary endpoint. Several studies have evaluated possible mechanisms of how the renin-angiotensin-aldosterone system can alter insulin sensitivity and glycemic control. SUMMARY: This review will focus on the recent literature that demonstrates renin-angiotensin-aldosterone system modulation and its effects on diabetes prevention, glycemic control and insulin sensitivity, as well as possible mechanisms for achieving this goal.}, address = {Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University, Nashville, Tennesse 37232-0475, USA.}, author = {Perkins, J. M. and Davis, S. N. }, citeulike-article-id = {2807828}, doi = {10.1097/MED.0b013e3282f7026f}, issn = {1752-2978}, journal = {Current opinion in endocrinology, diabetes, and obesity}, month = {April}, number = {2}, pages = {147--152}, posted-at = {2008-05-17 15:52:45}, priority = {2}, title = {The renin-angiotensin-aldosterone system: a pivotal role in insulin sensitivity and glycemic control.}, url = {http://dx.doi.org/10.1097/MED.0b013e3282f7026f}, volume = {15}, year = {2008} }

TY - JOUR ID - citeulike:2807828 L3 - citeulike-article-id:2807828 TI - The renin-angiotensin-aldosterone system: a pivotal role in insulin sensitivity and glycemic control. JF - Current opinion in endocrinology, diabetes, and obesity VL - 15 IS - 2 SP - 147 EP - 152 AD - Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University, Nashville, Tennesse 37232-0475, USA. SN - 1752-2978 N2 - PURPOSE OF REVIEW: Diabetes mellitus is an exploding epidemic costing billions of dollars yearly. Type 2 diabetes mellitus is characterized by insulin resistance and is closely associated with arterial hypertension. Emerging literature has demonstrated that modulation of the renin-angiotensin-aldosterone system by use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers leads to improved insulin sensitivity, glycemic control and possibly prevention of type 2 diabetes mellitus. RECENT FINDINGS: Several major studies investigating angiotensin II receptor blocker or angiotensin-converting enzyme inhibitor use in either hypertensive or heart failure patients have found lower incidence of type 2 diabetes mellitus when compared with placebo, beta-blocker, calcium-channel blocker or diuretic. None of these trials, however, studied prevention of diabetes as a primary endpoint. The Dream Trial and upcoming NAVIGATOR, ONTARGET/TRANSCEND trials specifically look at the prevention of diabetes as a primary endpoint. Several studies have evaluated possible mechanisms of how the renin-angiotensin-aldosterone system can alter insulin sensitivity and glycemic control. SUMMARY: This review will focus on the recent literature that demonstrates renin-angiotensin-aldosterone system modulation and its effects on diabetes prevention, glycemic control and insulin sensitivity, as well as possible mechanisms for achieving this goal. AU - Perkins, JM AU - Davis, SN PY - 2008/04// UR - http://dx.doi.org/10.1097/MED.0b013e3282f7026f ER -