Podar Toomas, Tuomilehto Jaakko
Department of Endocrinology, Tartu University Clinics, Tartu, Estonia.
Drugs. 2002;62(14):2007-12. doi: 10.2165/00003495-200262140-00001.
Evidence suggests that ACE inhibitors can be advantageous for prevention and halting progression of both micro- and macrovascular complications in patients with diabetes mellitus. ACE inhibitors are useful antihypertensive agents in both type 1 and type 2 diabetes; however, ACE inhibitor therapy often needs to be supplemented with calcium channel antagonists, beta-blockers or diuretics to achieve good blood pressure control. ACE inhibitors are also indicated in non-hypertensive patients with type 1 and type 2 diabetes who have micro- or macroalbuminuria. The effect of ACE inhibitors in halting the development and progression of retinopathy and, potentially, neuropathy needs further proof in large-scale studies. More recently, angiotensin II receptor antagonists are emerging as drugs with the potential to be successfully included in the management of diabetic complications, especially when ACE inhibitors are not suitable because of adverse effects.
有证据表明，血管紧张素转换酶（ACE）抑制剂对于预防和阻止糖尿病患者微血管和大血管并发症的进展可能有益。ACE抑制剂在1型和2型糖尿病中都是有用的抗高血压药物；然而，ACE抑制剂治疗通常需要补充钙通道拮抗剂、β受体阻滞剂或利尿剂，以实现良好的血压控制。ACE抑制剂也适用于患有微量或大量蛋白尿的1型和2型非高血压糖尿病患者。ACE抑制剂在阻止视网膜病变以及可能的神经病变的发生和进展方面的作用，需要大规模研究提供进一步的证据。最近，血管紧张素II受体拮抗剂正逐渐成为有可能成功用于糖尿病并发症管理的药物，尤其是当ACE抑制剂因不良反应而不适用时。
