Effects of telmisartan on glucose levels in people at high risk for cardiovascular disease but free from diabetes: the TRANSCEND study.

Abstract

OBJECTIVE:

Several large clinical trials suggest that ACE inhibitors may reduce the incidence of diabetes. Less is known about the effects of angiotensin receptor blockers (ARBs) on reducing incident diabetes or leading to regression of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) to normoglycemia.

RESEARCH DESIGN AND METHODS:

Participants were 3,488 adults at high risk for cardiovascular disease but free from diabetes (mean age 67 years; 61% male) in the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease (TRANSCEND) study. The participants were randomized to the ARB telmisartan 80 mg (n = 1,726) or placebo (n = 1,762) in addition to usual care.

RESULTS:

During a median 56 months, 21.8% of participants treated with telmisartan and 22.4% of those on placebo developed diabetes (relative ratio 0.95 [95% CI 0.83-1.10]; P = 0.51). Participants originally diagnosed with IFG and/or IGT were equally likely to regress to normoglycemia (26.9 vs. 24.5%) or to progress to incident diabetes (20.1 vs. 21.1%; P = 0.59) on telmisartan or placebo.

CONCLUSIONS:

There was no evidence that addition of the ARB telmisartan to usual care prevents incident diabetes or leads to regression of IFG or IGT in people at high risk for cardiovascular disease but free from diabetes.

• Authors: Joshua I Barzilay, Peggy Gao, Lars Rydén, Helmut Schumacher, Jeffrey Probstfield, Patrick Commerford, Antonio Dans, Rafael Ferreira, Mátyás Keltai, Ernesto Paolasso, Salim Yusuf, Koon Teo, TRANSCEND Investigators
• Journal: Diabetes care (Diabetes Care) Vol. 34 Issue 9 Pg. 1902-7 (Sep 2011) ISSN: 1935-5548 [Electronic] United States
• PMID: 21788624 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Benzimidazoles
• Benzoates
• Blood Glucose
• Telmisartan

Topics

• Aged
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Benzimidazoles (therapeutic use)
• Benzoates (therapeutic use)
• Blood Glucose (drug effects)
• Cardiovascular Diseases (blood)
• Diabetes Mellitus (blood, prevention & control)
• Fasting (blood)
• Female
• Glucose Intolerance
• Humans
• Male
• Middle Aged
• Telmisartan