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Reversal of diuretic-associated impaired glucose tolerance and new-onset diabetes: results of the STAR-LET study.

Author(s): Bakris G, Molitch M, Zhou Q, Sarafidis P, Champion A, Bacher P, Sowers JR

Affiliation(s): University of Chicago Pritzker School of Medicine, Chicago, IL 60612, USA. gbakris@earthlink.net

Publication date & source: 2008-01, J Cardiometab Syndr., 3(1):18-25.

Publication type: Multicenter Study; Randomized Controlled Trial

Reversal of new-onset diabetes secondary to thiazide diuretic use remains questionable. STAR-LET was a 6-month extension of the Study of Trandolapril/Verapamil SR and Insulin Resistance (STAR), which assessed the effects of a fixed-dose renin-angiotensin system inhibitor (RASI)/hydrochlorothiazide (HCTZ) combination on changes in 2-hour oral glucose tolerance test (OGTT) results. STAR-LET explored whether the glycemic impact of HCTZ could be reversed by conversion to a RASI/verapamil combination. The primary outcome was change in 2-hour OGTT results. Fifty-one percent of the STAR patients were enrolled in STAR-LET. The 2-hour OGTT value (mmol/L) was unchanged from STAR baseline in the RASI/verapamil group (7.7+/-2.4 vs 8.1+/-3.3; P=.18) and improved in those who were switched from RASI/HCTZ to RASI/verapamil (8.5+/-3.0 vs 7.2+/-2.3; P<.001). This exploratory study suggests that the impairment in glycemic control seen with use of a thiazide diuretic combined with a RASI can be reversed by switching to a regimen that does not include a diuretic.

Page last updated: 2008-06-22

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