مجلة الموصل للتمريض (Dec 2014)

Effect of Telmisartan Versus Captopril on Insulin Resistance in Hypertensive Type 2 Diabetic Patients

  • Adnan Ali Zainal,
  • Fadhel Abbas Al-Hamamy

DOI
https://doi.org/10.33899/mjn.2014.162935
Journal volume & issue
Vol. 2, no. 2
pp. 99 – 106

Abstract

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Background and objectives: Hypertension is an extremely common co-morbid condition in diabetes. Peripheral insulin resistance (IR) plus compensatory hyperinsulinaemia is a common mechanism underlying both hypertension and diabetes. The aim of this study was to compare the effects of telmisartan and captopril on IR in type2 diabetes mellitus with hypertension. Materials and Methods: This study was conducted in the Department of Pharmacology, Mosul College of Medicine, University of Mosul and Al-Wafaa center for diabetes management, Mosul, Iraq, from 1 March, 2012 to 30 March, 2013. Sixty-eight patients on oral hypoglycemic agents were assigned to receive two month treatment of either telmisartan (n = 34) or captopril (n = 34). Forty diabetic normotensive patients, with age and BMI, matched to the diabetic hypertensive patients, served as a control group. The oral hypoglycemic agents remained unchanged during the two- months study period. Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). Results: This study showed that the two groups of diabetic hypertensive patients who were assigned to receive captopril or telmisartan have a non-significant difference in fasting serum glucose (FSG), fasting serum insulin (FSI), QUICKI and HOMA- IR before starting therapy. Telmisartan and captopril groups showed insignificant change in body mass index (BMI). HOMA-IR, QUICKI, FSI and FSG were changed non-significantly in telmisartan group; while FSI, FSG and HOMA-IR decreased significantly (from 18.1± 9.69 to 15.14 ± 7.49, p=0.022; and from 187.32± 65.34 to 162.95 ± 56.87, p=0.048; and from 8.27 ± 6.28 to 6.02 ± 3.73, p-value= 0.027, respectively) and QUICKI increased significantly (from 0.293 ± 0.024 to 0.306 ± 0.031, p-value = 0.022) in the captopril group versus baseline. Conclusion: Captopril, but not telmisartan, significantly improves insulin sensitivity in diabetic hypertensive patients. Keywords: Captopril, HOMA-IR, telmisartan, type 2 diabetes.

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