Has your diabetes team discussed the benefits of ACE inhibitors with you?
No, but I know what they are
No, and I don't know what they are
Yes, for the future
Yes, but I don't want to take one
Yes, but I don't understand the benefits
Yes, and I am already taking an ACE Inhibitor
Total votes: 442
Has your diabetes team discussed the benefits of ACE inhibitors with you?Poll dates: March 21 - 28, 2004
Total Votes: 442
It is somewhat disconcerting to learn that 70% of the respondents to this poll are unaware of the benefits of ACE-inhibitors to people with diabetes. It's interesting that there has been essentially no change in responses since we first ran this poll in March 2002.
ACE-inhibitors (Angiotensin Converting Enzyme inhibitors) are a group of medications originally designed for the treatment of hypertension (high blood pressure). Examples include captopril, enalapril, quinapril, lisinopril, and others.
These medications are the first drug therapy for diabetic nephropathy, a common and often fatal complication of diabetes. Until these drugs were available, the only treatments were waiting for disaster, then treating with hemodialysis or a kidney transplant.
The use of one of these ACE inhibitors, captopril, was associated with a 50 percent reduction in the combined risk of death or of kidney failure requiring dialysis or a transplant. Several other studies have also shown that captopril can slow progression of diabetic kidney disease. Indeed, it almost seems reasonable to add ACE inhibitors to the program for everybody with diabetes, but it must be pointed out that:
- The benefit, if any, of their use for prevention of kidney disease is unproven (although it sounds reasonable).
- They cost money.
- They have common side effects (including chronic cough) and rare side effects (they are not recommended in pregnancy as they can cause injury and even death to the developing fetus).
This table shows how people responded to this poll the last time we ran it, compared with results from this poll:
Answer Mar 2004 Mar 2003 Mar 2002 No, but know about them 19% 21% 19% No, and don't know about them 69% 70% 72% Yes, for the future 2% 1% 2% Yes, don't want to take 1% 1% 1% Yes, don't understand 1% 1% 1% Yes, already taking 7% 5% 5%
The interested reader is encouraged to look at the following resources:
- Captopril approved for treating diabetic kidney disease from the FDA.
- Preventing and Slowing Kidney Disease from the NIDDK.
- Diabetic Nephropathy from the ADA.
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Last Updated: Wednesday March 16, 2005 16:37:46
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