Evidence suggests that ACE inhibitors can be advantageous for prevention and halting progression of both micro- and macrovascular complications in patients with diabetes mellitus. ACE inhibitors are useful antihypertensive agents in both type 1 and type 2 diabetes; however, ACE inhibitor therapy often needs to be supplemented with calcium channel antagonists, β-blockers or diuretics to achieve good blood pressure control. ACE inhibitors are also indicated in non- hypertensive patients with type 1 and type 2 diabetes who have micro- or macroalbuminuria. The effect of ACE inhibitors in halting the development and progression of retinopathy and, potentially, neuropathy needs further proof in large-scale studies. More recently, angiotensin II receptor antagonists are emerging as drugs with the potential to be successfully included in the management of diabetic complications, especially when ACE inhibitors are not suitable because of adverse effects.
证据表明,ACE
抑制剂在预防和阻止糖尿病患者微血管和大血管并发症的进展方面是有利的。ACE
抑制剂是1型和2型糖尿病患者有效的降压药;然而,ACE
抑制剂疗法通常需要与
钙通道拮抗剂、β-阻滞剂或利尿剂联合使用,以实现良好的血压控制。在有微或大尿蛋白症的1型和2型糖尿病非高血压患者中,也适合使用ACE
抑制剂。ACE
抑制剂在阻止视网膜病变及潜在神经病变的发展和进展方面的效果,需要在大规模研究中进一步验证。最近,
血管紧张素II受体拮抗剂作为一种药物逐渐受到关注,具有成功纳入糖尿病并发症管理的潜力,尤其是在因不良反应而不适合使用ACE
抑制剂的情况下。