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December 7, 2002


Question from San Antonio, Texas, USA:

My mom, who has type 2 diabetes treated with pills, was just diagnosed with probable complications and was taking captopril for high blood pressure which I read is good for her kidneys. However, the captopril caused her to always cough (same thing happened to me with captopril), so the doctor prescribed a different medication (I don't have the name at the moment). Which other medications, besides captopril, would help my mom? Of course, she is trying to follow a more strict diet, etc.


Approximately a year ago, several reports were presented at the Annual Scientific Sessions of the American Diabetes Association hat are appropriate here. Investigators from Europe, the United States, and Canada studied individuals with type 2 diabetes, and instead of giving them a drug from the same class IACE inhibitor) as Captopril a group called, they tested a drug that blocks the angiotensin II receptor. The idea here is that they work in the same pathway but at different targets. What they found was that these drugs protect the kidneys over time. These results support the use of this class of drugs in the treatment of patients with type 2 diabetes, especially those who cannot tolerate ACE inhibitors (an example of which would be Captopril).

However, there are some issues that are still not settled about the angiotensin II receptor blockers. First, in addition to protecting the kidneys, are there other target organs affected by diabetes that will see beneficial effects? Second, what will be the long-term heart protection provided by this class of drugs? For now, it should be noted there is information to support the use of another class of drugs if patients have side effects with ACE inhibitors.