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The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker.
Curr Med Res Opin 2007; 23(6):1239-44CM

Abstract

OBJECTIVE

It has been acknowledged that patients who receive a beta-blocker or diuretic based regimen are at increased risk of developing new-onset diabetes. Recently, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to decrease patients' odds of developing new-onset type 2 diabetes. A number of large placebo-controlled multi-center trials in post-myocardial infarction and heart failure patients have shown the ability of renin-angiotensin-aldosterone system medications to reduce the onset of type 2 diabetes. Pharmacologic data has shown improved insulin sensitivity with ACEIs and ARBs. Controversy persists regarding the influence of calcium channel blockers on the development of new-onset diabetes.

RESEARCH DESIGN AND METHODS

Two reviewers conducted a systematic literature search of Medline, EMBASE, CINAHL, and the Cochrane Library (1966 to December 2006) to extract a consensus of trial data involving calcium channel blockers versus diuretics or beta-blockers with an endpoint of new-onset type 2 diabetes. Studies were included if they were randomized controlled trials versus routine treatment, not observational studies of clinical practice. A random-effects model was utilized. Subgroup and sensitivity analyses were conducted.

RESULTS

Out of 1721 trials, six meeting inclusion criteria were identified, including 99 006 patients. Calcium channel blockers were associated with a reduced incidence of new-onset type 2 diabetes (odds ratio 0.81; 95% confidence interval [CI] 0.73-0.90; p = 0.0001) compared with diuretic or beta-blocker therapy. The reduction in new-onset type 2 diabetes was maintained when a calcium channel blocker was compared to only thiazide diuretics (OR 0.86; 95% CI 0.75-0.99; p = 0.0346). The meta-analysis was limited by the varying definition of new-onset type 2 diabetes mellitus, as well as the potential for publication bias, which is a limit of any meta-analysis.

CONCLUSIONS

Calcium channel blockers may be associated with reduced odds of developing new-onset type 2 diabetes compared to diuretics and beta-blockers.

Authors+Show Affiliations

School of Pharmacy, University of Connecticut, Storrs, CT, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

17559720

Citation

Kuti, Effie L., et al. "The Development of New-onset Type 2 Diabetes Associated With Choosing a Calcium Channel Blocker Compared to a Diuretic or Beta-blocker." Current Medical Research and Opinion, vol. 23, no. 6, 2007, pp. 1239-44.
Kuti EL, Baker WL, White CM. The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. Curr Med Res Opin. 2007;23(6):1239-44.
Kuti, E. L., Baker, W. L., & White, C. M. (2007). The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. Current Medical Research and Opinion, 23(6), pp. 1239-44.
Kuti EL, Baker WL, White CM. The Development of New-onset Type 2 Diabetes Associated With Choosing a Calcium Channel Blocker Compared to a Diuretic or Beta-blocker. Curr Med Res Opin. 2007;23(6):1239-44. PubMed PMID: 17559720.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The development of new-onset type 2 diabetes associated with choosing a calcium channel blocker compared to a diuretic or beta-blocker. AU - Kuti,Effie L, AU - Baker,William L, AU - White,C Michael, Y1 - 2007/04/23/ PY - 2007/6/15/pubmed PY - 2008/7/10/medline PY - 2007/6/15/entrez SP - 1239 EP - 44 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 23 IS - 6 N2 - OBJECTIVE: It has been acknowledged that patients who receive a beta-blocker or diuretic based regimen are at increased risk of developing new-onset diabetes. Recently, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been shown to decrease patients' odds of developing new-onset type 2 diabetes. A number of large placebo-controlled multi-center trials in post-myocardial infarction and heart failure patients have shown the ability of renin-angiotensin-aldosterone system medications to reduce the onset of type 2 diabetes. Pharmacologic data has shown improved insulin sensitivity with ACEIs and ARBs. Controversy persists regarding the influence of calcium channel blockers on the development of new-onset diabetes. RESEARCH DESIGN AND METHODS: Two reviewers conducted a systematic literature search of Medline, EMBASE, CINAHL, and the Cochrane Library (1966 to December 2006) to extract a consensus of trial data involving calcium channel blockers versus diuretics or beta-blockers with an endpoint of new-onset type 2 diabetes. Studies were included if they were randomized controlled trials versus routine treatment, not observational studies of clinical practice. A random-effects model was utilized. Subgroup and sensitivity analyses were conducted. RESULTS: Out of 1721 trials, six meeting inclusion criteria were identified, including 99 006 patients. Calcium channel blockers were associated with a reduced incidence of new-onset type 2 diabetes (odds ratio 0.81; 95% confidence interval [CI] 0.73-0.90; p = 0.0001) compared with diuretic or beta-blocker therapy. The reduction in new-onset type 2 diabetes was maintained when a calcium channel blocker was compared to only thiazide diuretics (OR 0.86; 95% CI 0.75-0.99; p = 0.0346). The meta-analysis was limited by the varying definition of new-onset type 2 diabetes mellitus, as well as the potential for publication bias, which is a limit of any meta-analysis. CONCLUSIONS: Calcium channel blockers may be associated with reduced odds of developing new-onset type 2 diabetes compared to diuretics and beta-blockers. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/17559720/The_development_of_new_onset_type_2_diabetes_associated_with_choosing_a_calcium_channel_blocker_compared_to_a_diuretic_or_beta_blocker_ DB - PRIME DP - Unbound Medicine ER -