EFFECT OF ENALAPRIL ON GLUCOSE METABOLISM IN NORMOTENSIVE NIDDM PATIENTS

To determine the effects of the angiotensin_converting enzyme inhibitor, enalapril, on insulin action and glycemic control in normotensive NIDDM patients, a single_blind, placebo_controlled trial was conducted in 34 such subjects who were given either enalapril (20 mg/d) or placebo for six months. Both insulin release and the degree of peripheral insulin sensitivity were evaluated simultaneously with oral glucose tolerance test. At the end of the study, the levels of blood glucose, glycated hemoglobin and plasma insulin decreased markedly and the degree of peripheral insulin sensityvity increased significantly in the enalapril_treated patients, as compared with the pre_treatment values in the enalapril group and with the as placebo_treated patients. The insulin release, renal function and blood pressure remained unchanged after enalapril treatment. The results suggest that long_term enalapril administration enhances utilization of insulin by peripheral tissues, decreases peripheral insulin resistance and improves glucose metabolism.