ACE Inhibitors and NSAIDS: More Pieces to the Diabetes Puzzle?

Type 2 diabetes, commonly referred to as adult onset, is becoming a larger and larger public health issue. It is especially important because people are beginning to experiencing the disease at younger ages. Left untreated, type 2 diabetes can lead to stroke and cause damage to the kidneys and retina of the eye. Identifying early signs of insulin resistance, may help identify potential type 2 diabetics. As cited in “Inflammation and the etiology of type 2 diabetes,” almost 90% of type 2 diabetes patients show signs of reduced insulin sensitivity before type 2 diabetes symptoms became apparent (Sjöholm 2005)

As discussed in the previous blogs, studies have indicated that a low level chronic inflammation (inflammation lasting for long periods of time) may be a factor in type 2 diabetes. In a review article cited above, Sjöholm and Nyström indicate that when compared to a placebo group, ACE inhibitors and angiotensin receptor antagonists which affect the renin-angiogensin system showed lower proportions of newly diagnosed diabetes patients. Another interesting drug they note is the possibility of NSAIDs (i.e. aspirin) to improve glucose tolerance and the affect of insulin. When compared, ACE inhibitors, angiotensin receptor antagonists and the NSAIDs are vasoactive substances. They work to improve blood flow. Interestingly enough, increased blood flow and delivery of nutrients to active tissue reduces stress and reduces inflammation. This data provides us with a potential direction to further explore the relationship between chronic inflammation and type 2 diabetes. The scientists of the review hope to identify potential drug targets and a more complete biological profile can help treat and identify pre-diabetic individuals.

Although pharmacological advances will play a decent role in reducing the rate of diabetes, it is imperative that physicians stress the importance of physical activity and nutritious diet as a natural preventative measure. It is especially important at this time since treatment/management of type 2 is hardly straightforward due to the difference among patients. Moving people away from the “quick fix” attitude, where they can make bad decisions and “start over,” will hopefully cause individuals to realize the importance of exhibiting and maintaining a health life style. Learning this knowledge and passing it down generations by example to children and the community is where I believe we can make the greatest leap in battling type 2 diabetes.

Sjöholm, Åke and Thomas Nyström. Inflammation and the etiology of type 2 diabetes. Eiabetes/Metabolism Research and Reviews 2005; 22: 4-10.