Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Morris, A. D.
Right arrow Articles by MacDonald, T. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Morris, A. D.
Right arrow Articles by MacDonald, T. M.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

Diabetes Care, Vol 20, Issue 9 1363-1367, Copyright © 1997 by American Diabetes Association

ARTICLES

ACE inhibitor use is associated with hospitalization for severe hypoglycemia in patients with diabetes. DARTS/MEMO Collaboration. Diabetes Audit and Research in Tayside, Scotland. Medicines Monitoring Unit

AD Morris, DI Boyle, AD McMahon, H Pearce, JM Evans, RW Newton, RT Jung and TM MacDonald
Department of Medicine, Ninewells Hospital and Medical School, University of Dundee, Scotland, U.K. amorris@clinpharm.dundee.ac.uk

OBJECTIVE: To evaluate the association between the use of ACE inhibitors and hospital admission for severe hypoglycemia and to explore the effects of potential confounding variables on this relationship. RESEARCH DESIGN AND METHODS: The association between the use of ACE inhibitors and the incidence of hypoglycemia is controversial. A recent study reported that 14% of all hospital admissions for hypoglycemia might be attributable to ACE inhibitors. We performed a nested case-control study, using a cohort of 6,649 diabetic patients taking insulin or oral antidiabetic drugs, on the Diabetes Audit and Research in Tayside, Scotland (DARTS) database. From 1 January 1993 to 30 April 1994, we identified 64 patients who had been admitted to Tayside hospitals with hypoglycemia and selected 440 control patients from the same cohort. RESULTS: Hypoglycemia was associated with the use of ACE inhibitors (odds ratio [OR] 3.2, 95% CI 1.2-8.3, P = 0.023), whereas use of beta-blockers and calcium antagonists was not associated with an increased risk of hospitalization for hypoglycemia with ORs of 0.9 (95% CI 0.3-3.3) and 1.7 (95% CI 0.2-2.1), respectively. There were significant differences between case and control patients in type of diabetes treatment, diabetes duration, place of routine diabetes care, and congestive cardiac failure. These differences did not confound the relationship between ACE inhibitors and hypoglycemia (adjusted OR 4.3, 95% CI 1.2-16.0). CONCLUSIONS: The results show that the association between ACE inhibitor therapy and hospital admission for severe hypoglycemia is not explained by these confounding factors. Although ACE inhibitors have distinct advantages over other antihypertensive drugs in diabetes, the risk of hypoglycemia should be considered.
Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 The Diabetes EducatorHome page
A. A. Ginde, D. J. Pallin, and C. A. Camargo Jr
Hospitalization and Discharge Education of Emergency Department Patients With Hypoglycemia
The Diabetes Educator, July 1, 2008; 34(4): 683 - 691.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
M. R. MacDonald, M. C. Petrie, N. M. Hawkins, J. R. Petrie, M. Fisher, R. McKelvie, D. Aguilar, H. Krum, and J. J.V. McMurray
Diabetes, left ventricular systolic dysfunction, and chronic heart failure
Eur. Heart J., May 2, 2008; 29(10): 1224 - 1240.
[Abstract] [Full Text] [PDF]

Home page
 Journal of Renin-Angiotensin-Aldosterone SystemHome page
U. Pedersen-Bjergaard, C. E Thomsen, H. Hogenhaven, A. Smed, T. W Kjaer, J. J Holst, F. Dela, L. Hilsted, E. Frandsen, S. Pramming, et al.
Angiotensin-converting enzyme activity and cognitive impairment during hypoglycaemia in healthy humans
Journal of Renin-Angiotensin-Aldosterone System, March 1, 2008; 9(1): 37 - 48.
[Abstract] [PDF]

Home page
 Eur Heart J SupplHome page
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. V. d. Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al.
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Eur. Heart J. Suppl., June 1, 2007; 9(suppl_C): C3 - C74.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
Authors/Task Force Members, L. Ryden, E. Standl, M. Bartnik, G. Van den Berghe, J. Betteridge, M.-J. de Boer, F. Cosentino, B. Jonsson, M. Laakso, et al.
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Eur. Heart J., January 1, 2007; 28(1): 88 - 136.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
W. C. Winkelmayer, Z. Zhang, S. Shahinfar, M. E. Cooper, J. Avorn, and B. M. Brenner
Efficacy and Safety of Angiotensin II Receptor Blockade in Elderly Patients With Diabetes
Diabetes Care, October 1, 2006; 29(10): 2210 - 2217.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
D. S. Lee, J. V. Tu, D. N. Juurlink, D. A. Alter, D. T. Ko, P. C. Austin, A. Chong, T. A. Stukel, D. Levy, and A. Laupacis
Risk-Treatment Mismatch in the Pharmacotherapy of Heart Failure
JAMA, September 14, 2005; 294(10): 1240 - 1247.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
G. B. Appel, J. Radhakrishnan, M. M. Avram, R. A. DeFronzo, F. Escobar-Jimenez, M.M. Campos, E. Burgess, D. A. Hille, T. Z. Dickson, S. Shahinfar, et al.
Analysis of Metabolic Parameters as Predictors of Risk in the RENAAL Study
Diabetes Care, May 1, 2003; 26(5): 1402 - 1407.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
S. Nordfeldt and U. Samuelsson
Serum ACE Predicts Severe Hypoglycemia in Children and Adolescents With Type 1 Diabetes
Diabetes Care, February 1, 2003; 26(2): 274 - 278.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
M. Bartnik, K. Malmberg, and L. Ryden
Diabetes and the heart: compromised myocardial function -- a common challenge
Eur. Heart J. Suppl., January 1, 2003; 5(suppl_B): B33 - B41.
[Abstract] [PDF]

Home page
 Diabetes CareHome page
J. L. Gross, T. Zelmanovitz, C. C. Moulin, V. De Mello, M. Perassolo, C. Leitao, A. Hoefel, A. Paggi, and M. J. Azevedo
Effect of a Chicken-Based Diet on Renal Function and Lipid Profile in Patients With Type 2 Diabetes: A randomized crossover trial
Diabetes Care, April 1, 2002; 25(4): 645 - 651.
[Abstract] [Full Text] [PDF]

Home page
 J. Clin. Endocrinol. Metab.Home page
J. R. Petrie, A. D. Morris, S. Ueda, M. Small, R. Donnelly, J. M. C. Connell, and H. L. Elliott
Trandolapril Does Not Improve Insulin Sensitivity in Patients with Hypertension and Type 2 Diabetes: A Double-Blind, Placebo-Controlled Crossover Trial
J. Clin. Endocrinol. Metab., May 1, 2000; 85(5): 1882 - 1889.
[Abstract] [Full Text]

Home page
 BMJHome page
J. M M Evans, R. W Newton, D. A Ruta, T. M MacDonald, R. J Stevenson, and A. D Morris
Frequency of blood glucose monitoring in relation to glycaemic control: observational study with diabetes database
BMJ, July 10, 1999; 319(7202): 83 - 86.
[Abstract] [Full Text]

Home page
 Arch Intern MedHome page
A. L. Peters and W. Hsueh
Antihypertensive Agents in Diabetic Patients: Great Benefits, Special Risks
Arch Intern Med, March 22, 1999; 159(6): 541 - 542.
[Full Text] [PDF]

Home page
 JWatch GeneralHome page
DO ACE INHIBITORS PROMOTE HYPOGLYCEMIA IN DIABETIC PATIENTS?
Journal Watch (General), September 16, 1997; 1997(916): 1 - 1.
[Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 1997 by the American Diabetes Association.