Official Journal of the College of Nursing, University of Mosul

Document Type : Original Articles



Background and objectives: Hypertension is an extremely common co-morbid condition in diabetes.
Peripheral insulin resistance (IR) plus compensatory hyperinsulinaemia is a common mechanism
underlying both hypertension and diabetes. The aim of this study was to compare the effects of
telmisartan and captopril on IR in type2 diabetes mellitus with hypertension.
Materials and Methods: This study was conducted in the Department of Pharmacology, Mosul College
of Medicine, University of Mosul and Al-Wafaa center for diabetes management, Mosul, Iraq, from 1
March, 2012 to 30 March, 2013. Sixty-eight patients on oral hypoglycemic agents were assigned to
receive two month treatment of either telmisartan (n = 34) or captopril (n = 34). Forty diabetic
normotensive patients, with age and BMI, matched to the diabetic hypertensive patients, served as a
control group. The oral hypoglycemic agents remained unchanged during the two- months study period.
Insulin resistance was estimated by homeostasis model assessment of insulin resistance (HOMA-IR) and
quantitative insulin sensitivity check index (QUICKI).
Results: This study showed that the two groups of diabetic hypertensive patients who were assigned to
receive captopril or telmisartan have a non-significant difference in fasting serum glucose (FSG), fasting
serum insulin (FSI), QUICKI and HOMA- IR before starting therapy. Telmisartan and captopril groups
showed insignificant change in body mass index (BMI). HOMA-IR, QUICKI, FSI and FSG were
changed non-significantly in telmisartan group; while FSI, FSG and HOMA-IR decreased significantly
(from 18.1± 9.69 to 15.14 ± 7.49, p=0.022; and from 187.32± 65.34 to 162.95 ± 56.87, p=0.048; and from
8.27 ± 6.28 to 6.02 ± 3.73, p-value= 0.027, respectively) and QUICKI increased significantly (from 0.293
± 0.024 to 0.306 ± 0.031, p-value = 0.022) in the captopril group versus baseline.
Conclusion: Captopril, but not telmisartan, significantly improves insulin sensitivity in diabetic
hypertensive patients.
Keywords: Captopril, HOMA-IR, telmisartan, type 2 diabetes.


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