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The effects of increasing doses of enalapril on insulin sensitivity in normotensive non‐insulin dependent diabetic subjects
Author(s) -
Walker R. J.,
LewisBarned N. J.,
Edwards E. A.,
Robertson M. C.
Publication year - 1995
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1995.tb02856.x
Subject(s) - enalapril , medicine , insulin , endocrinology , diabetes mellitus , blood pressure , insulin sensitivity , angiotensin converting enzyme , ace inhibitor , insulin resistance
Background: There are conflicting reports about the effects of ACE inhibitors (ACEI) on insulin sensitivity and glycaemic control. Most studies have used a standard high dose of an ACEI but there have been no studies reported to establish whether any changes in glycaemic control or insulin sensitivity associated with ACEI are dose‐related. Aim: To examine the effect of increasing doses of enalapril on insulin sensitivity in normotensive non‐insulin dependent diabetic subjects. Methods: The effects of increasing doses of enalapril on insulin sensitivity in ten normotensive non‐insulin dependent diabetic subjects were measured, using the hyperinsulinaemic isoglycaemic clamp technique. Following a baseline study, enalapril was commenced at 5 mg daily and increased to 10 mg daily then 20 mg daily at 14 day intervals. Repeat studies were undertaken after 14 days at each dosage. Results: There was a significant dose‐related reduction of systolic blood pressure with enalapril. In contrast enalapril at 5‐20 mg daily produced no significant changes in insulin mediated glucose uptake (M‐value) or insulin sensitivity index (ISI). Conclusions: These findings indicate that in this insulin resistant population of normotensive non‐insulin dependent diabetics, angiotensin converting enzyme inhibition with enalapril has no significant effect on insulin mediated glucose uptake.