The role of renin blockers in the prevention of diabetes

OBJECTIVE: To evaluate the role of renin blockers angiotensin converting enzymes inhibitors (ACEI) or angiotensin receptor blockers (ARB) in the prevention of diabetes.

METHODS: We did a meta-analysis using the Cochrane group methodology of all available randomized controlled trials (RCTs) that evaluated the role of renin blockers in which outcomes of new-onset diabetes was reported. This meta-analysis was conducted between April 2005-April 2006 at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.

RESULTS: Thirteen trials including 91,388 individuals met the inclusion criteria. There was a statistically significant reduction in the incidence of new-onset diabetes in patients receiving renin blockers compared to other antihypertensive agents [relative risks=0.79; 95% confidence interval=0.75-0.84). There was a statistically significant reduction in the incidence of new-onset diabetes in patients receiving renin-blockers compared to diuretics, conventional antihypertensive therapy (diuretics or beta-blockers), and calcium channel blockers.

CONCLUSION: Renin blockers reduce the incidence of new-onset diabetes and should be considered as first line therapy, when indicated, in patients at high risk for diabetes.