Comparison of the Overtime Fasting Plasma Glucose Between Patients Receiving Angiotensin Receptor Blocker (ARB) and Non-ARB Drugs

Abstract

Background: Previous studies have shown a relationship between renin angiotensin aldosterone system (RAAS) and insulin resistance. This in turn can delay the onset of diabetes mellitus (DM). The impact of angiotensin receptor blocker (ARB) on the fasting plasma glucose (FPG) level is not clear.
 Objective: To compare the overtime FPG between ARB and non-ARB using.
 Methods: A retrospective-longitudinal cohort study, data were collected from medical records of hypertensive patients who were not diagnosed DM in 2007 and 2008, each patient was followed up 10 years. The association between antihypertensive drugs and FPG by multilevel mixed-effects linear regression was evaluated. Multistate Markov chain model was used to evaluate the probability to become pre-DM or DM stage.
 Results: Of 822 patients, 571 patients were excluded and 251 patients met criteria for analysis. From multilevel mixed-effects linear regression, ARB usage was associated with a nonsignificant decreased FPG when adjusted with visit (mean FPG change, -0.98; 95% CI, -2.65 to 0.69; P = .25) and with visit plus glomerular filtration rate (mean FPG change, -1.89, 95% CI, -4.88 to 1.19; P = .24). The probability of change in 10 years from normal to pre-DM stage was 0.41 and 0.38, normal to DM stage was 0.03 and 0.01, pre-DM to DM stage was 0.08 and 0.04, in non-ARB and ARB group, respectively.
 Conclusions: ARB tended to decrease probability to become DM. Thus, physicians should prescribe ARB in hypertensive patients to prevent new-onset DM.