Diabetes by Anti-hypertensive Drugs

[Guest guest]

Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis.Elliott WJ, Meyer PM.SourceDepartment of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...Erratum inLancet. 2007 May 5;369(9572):1518. AbstractBACKGROUND: The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident diabetes.METHODS: We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes.FINDINGS: Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB (1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses.INTERPRETATION: The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order.http://www.ncbi.nlm.nih.gov/pubmed/17240286 +++++++++++++++++++++Results: Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): 1. A2RB = 0.57 (bad)2. ACEI = 0.673. CCB = 0.754. Placebo = 0.775. Beta-blockers = 0.906. Diuretics = 1.00 (worse) i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. Max.

[Guest guest]

Diabetes occurs in those who have a BMI OF MORE than 25 as they age mostly. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 14, 2012, at 14:29, StudyCircle <studycircle@...> wrote:

Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis.Elliott WJ, Meyer PM.SourceDepartment of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...Erratum

inLancet. 2007 May 5;369(9572):1518. AbstractBACKGROUND: The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident

diabetes.METHODS: We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes.FINDINGS: Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB

(1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses.INTERPRETATION: The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order.http://www.ncbi.nlm.nih.gov/pubmed/17240286 +++++++++++++++++++++Results: Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): 1. A2RB = 0.57 (bad)2. ACEI = 0.673. CCB = 0.754. Placebo = 0.775. Beta-blockers = 0.906. Diuretics = 1.00 (worse) i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. Max.

[Guest guest]

Diabetes occurs in those who have a BMI OF MORE than 25 as they age mostly. May your pressure be low!CE Grim MS, MDSpecializing in DifficultHypertensionOn Jan 14, 2012, at 14:29, StudyCircle <studycircle@...> wrote:

Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis.Elliott WJ, Meyer PM.SourceDepartment of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...Erratum

inLancet. 2007 May 5;369(9572):1518. AbstractBACKGROUND: The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident

diabetes.METHODS: We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes.FINDINGS: Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB

(1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses.INTERPRETATION: The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order.http://www.ncbi.nlm.nih.gov/pubmed/17240286 +++++++++++++++++++++Results: Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): 1. A2RB = 0.57 (bad)2. ACEI = 0.673. CCB = 0.754. Placebo = 0.775. Beta-blockers = 0.906. Diuretics = 1.00 (worse) i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. Max.

[Guest guest]

Is this just one of the causes? I understood you to say T2DM would likely

resolve when I got PA under control. (Do you think that tumor is big enough to

cut my BMI in half when I have it removed?!!?)

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

>

> > Incident diabetes in clinical trials of antihypertensive drugs: a network

meta-analysis.

> >

> > Elliott WJ, Meyer PM.

> >

> > Source

> >

> > Department of Preventive Medicine, Rush Medical College of Rush University

at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...

> >

> > Erratum in

> >

> > Lancet. 2007 May 5;369(9572):1518.

> > Abstract

> >

> > BACKGROUND:

> >

> > The effect of different classes of antihypertensive drugs on incident

diabetes mellitus is controversial because traditional meta-analyses are

hindered by heterogeneity across trials and the absence of trials comparing

angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor

blockers (ARB). We therefore undertook a network meta-analysis, which accounts

for both direct and indirect comparisons to assess the effects of

antihypertensive agents on incident diabetes.

> >

> > METHODS:

> >

> > We undertook a systematic review up to Sept 15, 2006, and identified 48

randomised groups of 22 clinical trials with 143,153 participants who did not

have diabetes at randomisation and so were eligible for inclusion in our

analysis. 17 trials enrolled patients with hypertension, three enrolled

high-risk patients, and one enrolled those with heart failure. The main outcome

was the proportion of patients who developed diabetes.

> >

> > FINDINGS:

> >

> > Initial drug therapy used in the trials (and the number of patients with

diabetes of the total number at risk) included: an ARB (1189 of 14,185, or

8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB,

2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker

(2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an

initial diuretic as the standard of comparison (eight groups), the degree of

incoherence (a measure of how closely the entire network fits together) was

small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB

(five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups)

0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002);

placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups)

0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity

analyses.

> >

> > INTERPRETATION:

> >

> > The association of antihypertensive drugs with incident diabetes is

therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta

blockers and diuretics in rank order.

> >

> > http://www.ncbi.nlm.nih.gov/pubmed/17240286

> >

> >

> >

> > +++++++++++++++++++++

> >

> > Results:

> >

> >

> >

> > Drugs increasing blood glucose and glucose intolerance in the order from bad

(1) to worse (6) (Odd ratios are relative to Diuretics):

> >

> >

> >

> > 1. A2RB = 0.57 (bad)

> >

> > 2. ACEI = 0.67

> >

> > 3. CCB = 0.75

> >

> > 4. Placebo = 0.77

> >

> > 5. Beta-blockers = 0.90

> >

> > 6. Diuretics = 1.00 (worse)

> >

> >

> >

> > i.e., diuretics cause maximum increase in glucose and glucose intolerance

while A2RB drugs cause least.

> >

> >

> >

> > Max.

> >

> >

>

[Guest guest]

Is this just one of the causes? I understood you to say T2DM would likely

resolve when I got PA under control. (Do you think that tumor is big enough to

cut my BMI in half when I have it removed?!!?)

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

>

> > Incident diabetes in clinical trials of antihypertensive drugs: a network

meta-analysis.

> >

> > Elliott WJ, Meyer PM.

> >

> > Source

> >

> > Department of Preventive Medicine, Rush Medical College of Rush University

at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...

> >

> > Erratum in

> >

> > Lancet. 2007 May 5;369(9572):1518.

> > Abstract

> >

> > BACKGROUND:

> >

> > The effect of different classes of antihypertensive drugs on incident

diabetes mellitus is controversial because traditional meta-analyses are

hindered by heterogeneity across trials and the absence of trials comparing

angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor

blockers (ARB). We therefore undertook a network meta-analysis, which accounts

for both direct and indirect comparisons to assess the effects of

antihypertensive agents on incident diabetes.

> >

> > METHODS:

> >

> > We undertook a systematic review up to Sept 15, 2006, and identified 48

randomised groups of 22 clinical trials with 143,153 participants who did not

have diabetes at randomisation and so were eligible for inclusion in our

analysis. 17 trials enrolled patients with hypertension, three enrolled

high-risk patients, and one enrolled those with heart failure. The main outcome

was the proportion of patients who developed diabetes.

> >

> > FINDINGS:

> >

> > Initial drug therapy used in the trials (and the number of patients with

diabetes of the total number at risk) included: an ARB (1189 of 14,185, or

8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB,

2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker

(2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an

initial diuretic as the standard of comparison (eight groups), the degree of

incoherence (a measure of how closely the entire network fits together) was

small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB

(five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups)

0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002);

placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups)

0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity

analyses.

> >

> > INTERPRETATION:

> >

> > The association of antihypertensive drugs with incident diabetes is

therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta

blockers and diuretics in rank order.

> >

> > http://www.ncbi.nlm.nih.gov/pubmed/17240286

> >

> >

> >

> > +++++++++++++++++++++

> >

> > Results:

> >

> >

> >

> > Drugs increasing blood glucose and glucose intolerance in the order from bad

(1) to worse (6) (Odd ratios are relative to Diuretics):

> >

> >

> >

> > 1. A2RB = 0.57 (bad)

> >

> > 2. ACEI = 0.67

> >

> > 3. CCB = 0.75

> >

> > 4. Placebo = 0.77

> >

> > 5. Beta-blockers = 0.90

> >

> > 6. Diuretics = 1.00 (worse)

> >

> >

> >

> > i.e., diuretics cause maximum increase in glucose and glucose intolerance

while A2RB drugs cause least.

> >

> >

> >

> > Max.

> >

> >

>

[Guest guest]

not unless it is gold or maybe lead or mercury. The major cause is feeding the genome wrong.Goes away when folks starve as does HTN. You might want to read the Biology of Starvation by Ancel Keys et al.Old but excellent. On Jan 15, 2012, at 7:27 PM, wrote: Is this just one of the causes? I understood you to say T2DM would likely resolve when I got PA under control. (Do you think that tumor is big enough to cut my BMI in half when I have it removed?!!?) - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. > > > > Elliott WJ, Meyer PM. > > > > Source > > > > Department of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@... > > > > Erratum in > > > > Lancet. 2007 May 5;369(9572):1518. > > Abstract > > > > BACKGROUND: > > > > The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident diabetes. > > > > METHODS: > > > > We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes. > > > > FINDINGS: > > > > Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB (1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses. > > > > INTERPRETATION: > > > > The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order. > > > > http://www.ncbi.nlm.nih.gov/pubmed/17240286 > > > > > > > > +++++++++++++++++++++ > > > > Results: > > > > > > > > Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): > > > > > > > > 1. A2RB = 0.57 (bad) > > > > 2. ACEI = 0.67 > > > > 3. CCB = 0.75 > > > > 4. Placebo = 0.77 > > > > 5. Beta-blockers = 0.90 > > > > 6. Diuretics = 1.00 (worse) > > > > > > > > i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. > > > > > > > > Max. > > > > >

[Guest guest]

not unless it is gold or maybe lead or mercury. The major cause is feeding the genome wrong.Goes away when folks starve as does HTN. You might want to read the Biology of Starvation by Ancel Keys et al.Old but excellent. On Jan 15, 2012, at 7:27 PM, wrote: Is this just one of the causes? I understood you to say T2DM would likely resolve when I got PA under control. (Do you think that tumor is big enough to cut my BMI in half when I have it removed?!!?) - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS. > > > Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. > > > > Elliott WJ, Meyer PM. > > > > Source > > > > Department of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@... > > > > Erratum in > > > > Lancet. 2007 May 5;369(9572):1518. > > Abstract > > > > BACKGROUND: > > > > The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident diabetes. > > > > METHODS: > > > > We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes. > > > > FINDINGS: > > > > Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB (1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses. > > > > INTERPRETATION: > > > > The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order. > > > > http://www.ncbi.nlm.nih.gov/pubmed/17240286 > > > > > > > > +++++++++++++++++++++ > > > > Results: > > > > > > > > Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): > > > > > > > > 1. A2RB = 0.57 (bad) > > > > 2. ACEI = 0.67 > > > > 3. CCB = 0.75 > > > > 4. Placebo = 0.77 > > > > 5. Beta-blockers = 0.90 > > > > 6. Diuretics = 1.00 (worse) > > > > > > > > i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. > > > > > > > > Max. > > > > >

[Guest guest]

What we need to know is how using the DASH, which would minimize K loss, protects against these problems.Also the dose of thiazides would be important. We are using much lower doses than in the old days.I used to go up to 100 mg a day HCTZ for example. CE Grim MDOn Jan 14, 2012, at 12:29 PM, StudyCircle wrote: Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis.Elliott WJ, Meyer PM.SourceDepartment of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...Erratum inLancet. 2007 May 5;369(9572):1518. AbstractBACKGROUND: The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident diabetes.METHODS: We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes.FINDINGS: Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB (1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses.INTERPRETATION: The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order.http://www.ncbi.nlm.nih.gov/pubmed/17240286 +++++++++++++++++++++Results: Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): 1. A2RB = 0.57 (bad)2. ACEI = 0.673. CCB = 0.754. Placebo = 0.775. Beta-blockers = 0.906. Diuretics = 1.00 (worse) i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. Max.

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What we need to know is how using the DASH, which would minimize K loss, protects against these problems.Also the dose of thiazides would be important. We are using much lower doses than in the old days.I used to go up to 100 mg a day HCTZ for example. CE Grim MDOn Jan 14, 2012, at 12:29 PM, StudyCircle wrote: Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis.Elliott WJ, Meyer PM.SourceDepartment of Preventive Medicine, Rush Medical College of Rush University at Rush University Medical Center, Chicago, IL 60612, USA. welliott@...Erratum inLancet. 2007 May 5;369(9572):1518. AbstractBACKGROUND: The effect of different classes of antihypertensive drugs on incident diabetes mellitus is controversial because traditional meta-analyses are hindered by heterogeneity across trials and the absence of trials comparing angiotensin-converting-enzyme (ACE) inhibitors with angiotensin-receptor blockers (ARB). We therefore undertook a network meta-analysis, which accounts for both direct and indirect comparisons to assess the effects of antihypertensive agents on incident diabetes.METHODS: We undertook a systematic review up to Sept 15, 2006, and identified 48 randomised groups of 22 clinical trials with 143,153 participants who did not have diabetes at randomisation and so were eligible for inclusion in our analysis. 17 trials enrolled patients with hypertension, three enrolled high-risk patients, and one enrolled those with heart failure. The main outcome was the proportion of patients who developed diabetes.FINDINGS: Initial drug therapy used in the trials (and the number of patients with diabetes of the total number at risk) included: an ARB (1189 of 14,185, or 8.38%), ACE inhibitor (1618 of 22,941, or 7.05%), calcium-channel blocker (CCB, 2791 of 38,607, or 7.23%), placebo (1686 of 24,767, or 6.81%), beta blocker (2705 of 35,745, or 7.57%), or diuretic (998 of 18,699, or 5.34%). With an initial diuretic as the standard of comparison (eight groups), the degree of incoherence (a measure of how closely the entire network fits together) was small (omega=0.000017, eight degrees of freedom). The odds ratios were: ARB (five groups) 0.57 (95% CI 0.46-0.72, p<0.0001); ACE inhibitor (eight groups) 0.67 (0.56-0.80, p<0.0001); CCB (nine groups): 0.75 (0.62-0.90, p=0.002); placebo (nine groups) 0.77 (0.63-0.94, p = 0.009); beta blocker (nine groups) 0.90 (0.75-1.09, p=0.30). These estimates changed little in many sensitivity analyses.INTERPRETATION: The association of antihypertensive drugs with incident diabetes is therefore lowest for ARB and ACE inhibitors followed by CCB and placebo, beta blockers and diuretics in rank order.http://www.ncbi.nlm.nih.gov/pubmed/17240286 +++++++++++++++++++++Results: Drugs increasing blood glucose and glucose intolerance in the order from bad (1) to worse (6) (Odd ratios are relative to Diuretics): 1. A2RB = 0.57 (bad)2. ACEI = 0.673. CCB = 0.754. Placebo = 0.775. Beta-blockers = 0.906. Diuretics = 1.00 (worse) i.e., diuretics cause maximum increase in glucose and glucose intolerance while A2RB drugs cause least. Max.