Multiple interventions can retard the progression or prevent the development of microvascular and macrovascular complications in patients with diabetes, but the effects of early glycaemic control seem to be longer lasting than those of blood pressure control. Cherney et al. now report that renin–angiotensin system blockade has sustained beneficial effects in patients with type 1 diabetes mellitus.
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References
Mauer, M. et al. Renal and retinal effects of enalapril and losartan in type 1 diabetes. N. Engl. J. Med. 361, 40–51 (2009).
Cherney, D. Z. et al. Long-term hemodynamic and molecular effects persist after discontinued renin-angiotensin system blockade in patients with type 1 diabetes mellitus. Kidney Int. http://dx.doi.org/10.1038/ki.2013.221.
de Boer, I. H. et al. Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes. N. Engl. J. Med. 365, 2366–2376 (2011).
Holman, R. R. et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N. Engl. J. Med. 359, 1577–1589 (2008).
Ismail-Beigi, F. et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet 376, 419–430 (2010).
Holman, R. R. et al. Long-term follow-up after tight control of blood pressure in type 2 diabetes. N. Engl. J. Med. 359, 1565–1576 (2008).
Mancia, G. et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J. Hypertens. 31, 1281–1357 (2013).
Bosch, J. et al. Long-term effects of ramipril on cardiovascular events and on diabetes: results of the HOPE study extension. Circulation 112, 1339–1346 (2005).
Ruggenenti, P. et al. Measurable urinary albumin predicts cardiovascular risk among normoalbuminuric patients with type 2 diabetes. J. Am. Soc. Nephrol. 23, 1717–1724 (2012).
Gaede, P. et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N. Engl. J. Med. 358, 580–591 (2008).
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The work of the authors is supported by the European Union (HEALTH-2011-278249-EU-MASCARA).
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J. Menne has received lecture fees from the following companies: Berlin Chemie, Daiichi Sankyo, Novartis. C. Chatzikyrkou declares no competing interests.
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Chatzikyrkou, C., Menne, J. Legacy effects of RAS blockade in diabetes mellitus. Nat Rev Nephrol 9, 566–568 (2013). https://doi.org/10.1038/nrneph.2013.173
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DOI: https://doi.org/10.1038/nrneph.2013.173