Effects of Telmisartan on Glucose Levels in People at High Risk for Cardiovascular Disease but Free From Diabetes

The TRANSCEND study

  1. on behalf of the TRANSCEND Investigators
  1. 1Kaiser Permanente of Georgia & Emory University School of Medicine, Atlanta, Georgia
  2. 2Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
  3. 3Karolinska University Hospital, Stockholm, Sweden
  4. 4Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
  5. 5Department of Medicine, University of Washington School of Medicine, Seattle, Washington
  6. 6Department of Medicine, University of Cape Town Observatory, Cape Town, South Africa
  7. 7Philippine General Hospital, Manila, Philippines
  8. 8Praceta do Comércio, Amadora, Portugal
  9. 9Semmelweis University, Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary
  10. 10Estudios Clínicos Latinoamerica, Rosario, Argentina
  1. Corresponding author: Joshua I. Barzilay, joshua.barzilay{at}kp.org.

Abstract

OBJECTIVE Several large clinical trials suggest that ACE inhibitors may reduce the incidence of diabetes. Less is known about the effects of angiotensin receptor blockers (ARBs) on reducing incident diabetes or leading to regression of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) to normoglycemia.

RESEARCH DESIGN AND METHODS Participants were 3,488 adults at high risk for cardiovascular disease but free from diabetes (mean age 67 years; 61% male) in the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects With Cardiovascular Disease (TRANSCEND) study. The participants were randomized to the ARB telmisartan 80 mg (n = 1,726) or placebo (n = 1,762) in addition to usual care.

RESULTS During a median 56 months, 21.8% of participants treated with telmisartan and 22.4% of those on placebo developed diabetes (relative ratio 0.95 [95% CI 0.83–1.10]; P = 0.51). Participants originally diagnosed with IFG and/or IGT were equally likely to regress to normoglycemia (26.9 vs. 24.5%) or to progress to incident diabetes (20.1 vs. 21.1%; P = 0.59) on telmisartan or placebo.

CONCLUSIONS There was no evidence that addition of the ARB telmisartan to usual care prevents incident diabetes or leads to regression of IFG or IGT in people at high risk for cardiovascular disease but free from diabetes.

Footnotes

  • Received March 18, 2011.
  • Accepted May 24, 2011.

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  1. Diabetes Care vol. 34 no. 9 1902-1907
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