Effects of Sub therapeutic Doses of ACE-I in Improving insulin sensitivity in Type II DM Patients

Abstract

Diabetes mellitus (DM) is a complex, multifactorial and heterogeneous group of disorders characterized by endogenous insulin deficiency and/or insulin resistance. Regardless of the etiology, the disease manifests itself as a state of chronic hyperglycemia with attendant small blood vessel (microvascular) and large blood vessel (macrovascular) complications, All individuals who have DM have derangement of normal blood glucose and insulin homeostasis. Insulin receptor defects (quantitative and/or qualitative) inhibit glucose uptake by cells as in type 2 diabetes mellitus (T2DM). While Beta cell failure results in inadequate circulating insulin levels as in type 1 diabetes mellitus (T1DM). 30 patients selected with uncontrolled non insulin dependent diabetes mellitus (NIDDM) .Their average age was (44.34±7.15) years and their duration of diabetes was 8.48±8.27 years,examination and selection of patients done by the consultant physician ,assistant professor ,at the national center of treatment and research for diabetes .Essential kidney disease and hypertensive patients were excluded, we tested their blood pressure, fasting blood sugar (FBS),post postprandial glucose excursion (PPGE) and albuminuria before and after daily captopril intake for 2 months.The results showed a significant decrease (p<0.01) in PPGE (postprandial glucose excursion) , after taking angiotensin converting enzyme (ACE) inhibitor captopril mean (185 ±28.75 mg/dl) when compared before captopril intake (230±45 mg/dl) , when calculating the area under the curve. In which these results indicated a positive effect of captopril on insulin sensitivity and blood glucose level.