Renal function, glycaemic control and perindopril in diabetic patients

We studied the effect of perindopril, administered during 9 months on the renal function, albuminuria and glycaemic control of diabetic subjects with a mild to moderate hypertension. After 1 month placebo, 40 insulin-treated patients were divided in 3 groups based upon the level of albuminuria. Group I had a normoalbuminuria (less than 15 mg/24 hrs). group II had a pathological microalbuminuria (15-150 mg/24 hrs) and group III had a macroproteinuria (greater than 150 mg/24 hrs). They were given perindopril (4 or 8 mg) once daily. Diastolic blood pressure was normalized within the first 3 months in 80 p. 100 of the patients. From these, 29 (13, 9 and 7 from groups I, II and III, respectively) were followed during a total treatment period of 9 months. They were matched for age, durations of diabetes and hypertension, daily insulin dose, systolic and diastolic blood pressures and quality of glycaemic control. Diastolic blood pressure was decreased by 14 and 17 p. 100 at 1 and 9 months, respectively. Heart rate was not significantly modified. At 3 months, the activity of angiotensin-converting enzyme was markedly inhibited while plasma renin activity was increased. In patients of group II, microalbuminuria was reduced from 59 +/- 13 to 32 +/- 6 mg/24 hrs after 1 month and this effect was maintained at 9 months. Despite similar decreases in blood pressure, no significant change of the albuminuria excretion rate was observed in patients of group I or III, respectively. Creatinine clearance remained stable and glycaemic control did not change throughout the study in the 3 groups.(ABSTRACT TRUNCATED AT 250 WORDS)