Angiotensin receptor blockers (ARBs) do not raise blood sugar levels according to manufacturers.1-8 Irbesartan and losartan are approved by the Food and Drug Administration to treat diabetic nephropathy in people with type 2 diabetes and hypertension.9
A 2017 meta-analysis looked at the glycemic effects of cardiovascular drugs including ARBs.10 It concluded that studies show that ARBs do not increase the risk of incident diabetes or have negative effects on glucose control. Whether ARBs have a neutral effect or improve glucose control is unclear.
The 2017 hypertension guidelines11 from the American College of Cardiology and American Heart Association list ARBs as one of the four antihypertensive agents recommended for first-line treatment of hypertension for adults with diabetes mellitus [Strong Recommendation (Level A)]. Further evidence supports the recommendation that ARBs or angiotensin-converting enzyme inhibitors should be considered for these adults who have albuminuria.
A 2015 network meta-analysis found ARB monotherapy significantly reduced progression to end-stage renal disease in people with diabetes compared to placebo (odds ratio [OR] 0.77, 95% confidence interval [0.65 – 0.92]).12
- Diovan [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corp; 2017.
- Edarbi [package insert]. Atlanta, GA: Arbor Pharmaceuticals, LLC; 2016.
- Atacand [package insert]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2016.
- Avapro [package insert]. Bridgewater, NJ: Sanofi-Aventis U.S. LLC; 2016.
- Cozaar [package insert]. Whitehouse Station, NJ: Merck Sharp & Dohme Corp; 2015.
- Teveten [package insert]. North Chicago, IL: AbbVie Inc.; 2014.
- Micardis [package insert]. Ridgefield, CT: Boehringer Ingelheim Pharmaceuticals, Inc.; 2014.
- Benicar [package insert]. Parsippany, NJ: Daiichi Sankyo, Inc; 2009.
- Angiotensin II receptor antagonists. Drug Facts and Comparisons [online database]. Wolters Kluwer Health, Inc; 2017. Accessed May 17, 2017.
- Grodzinsky A, Arnold SV, Jacob D, Draznin B, Kosiborod M. The impact of cardiovascular drugs on glycemic control: a review. Endocr Pract 2017; 23 (3): 363-371.
- Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2017.
- Palmer SC, Mavridis D, Navarese E, et al. Comparative efficacy and safety of blood pressure-lowering agents in adults with diabetes and kidney disease: a network meta-analysis. Lancet 2015; 385 (9982): 2047-2056.