PREVENTION OF DIABETES

Ramipril for prevention of Type 2 DM in pts with vascular disease:

• "HOPE" Study--5720 pts > 55yo with h/o CAD, CVA, or PVD randomized to Ramipril 10mg QD vs. placebo. Over mean 4.5y f/u, RR for new dx of DM was 0.66 with Ramipril (sig.) (JAMA 286:1882, 2001--abst)
• In a study in 5,269 pts > 30yo with impaired fasting glucose or impaired glucose tolerance but no h/o cardiovascular disease or DM randomized to ramipril 15mg/d vs. placebo, after median 3y f/u, incidence of progression to DM was not significantly different in Ramipril recipients ("Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication" ("DREAM") Trial; NEJM 355:1551,2006--JW).

Click on link re: use of Acarbose in pts with impaired glucose tolerance to prevent type 2 DM

In a prospective cohort study of 41,934 men and 84,276 women (in the Health Professionals' Follow-up Study and Nurses' Health Study, respectively), caffeinated coffee consumption was inversely ass'd, in multivariate analysis adjusting for potential confounders, with risk for type 2 DM (for men, RR 0.7 for 4-5 cups/day and 0.5 for > 5 cups; for women, RR 0.7 for > 3 cups/day). Tea consumption was not ass'd with DM risk (Ann. Int. Med. 140:1, 2004--JW)