ACE Inhibitors and Statins in Teen Type 1 Diabetes Linked with No Albumin Drop


Dr Ramesh Hotchandani    06 November 2017

A study published recently in the New England Journal of Medicine reported that among 10 to 16 year olds with type 1 diabetes who were at risk of microalbuminuria statin or ACE inhibitor therapy or both for a few years did not significantly decrease albumin excretion compared with placebo. Researchers stated that neither agent significantly reduced the primary outcome i.e. the albumin to creatinine ratio during the 2 to 4 year trial. These are the findings from more than 400 participants in three countries in the Adolescent Type 1 Diabetes Cardio Renal Intervention Trial AdDIT . While the primary outcome was negative some of the secondary outcomes suggested that the drugs might exert significant benefits. Researchers speculate that early implementation of cardiorenal interventions in the AdDIT cohort could potentially reduce long term vascular complications through a similar legacy effect reported in adults with diabetes treated with blood and lipid lowering drugs however this needs to be evaluated in further study. There was no significant effect of the ACE inhibitor or the statin or both on the primary outcome change in albumin excretion. But treatment with the ACE inhibitor led to a 43 reduction in the rates of progression to microalbuminuria. This could have important clinical implications. Statin led to significant reductions in total LDL and non HDL cholesterol and triglycerides and apolipoprotein B to apolipoprotein A1 ratio. This could have a role in reducing long term risk for cardiovascular complications.

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