AIIRA and Incident Diabetes Mellitus

The prevalence of type 2 diabetes mellitus continues to increase worldwide. In 2000 the number of patients with DM about 171 million people, while the year 2030 is expected to reach 366 million people. As already known DM has a very important effect on the health and quality of human life, and therefore efforts to reduce the incidence of diabetes is very important.

The results of various large clinical trials have shown that treatment with ACE inhibitors or AIIRA (Cancer groups) can prevent or slow the onset of diabetes, which reduce about 15-30% of new-onset diabetes mellitus.

Research on losartan alone (LIFE: Losartan Intervention For Endpoint Reduction) reduced the risk of new-onset diabetes about 25%.

Although the exact mechanism is not known clearly, allegedly the renin-angiotensin-aldosterone system plays an important role in glucose homeostasis.

Several mechanisms RAA system inhibitors in reducing the incidence of new-onset diabetes, among others:

Protective effect against the cell? pancreas by inhibiting vasoconstriction and fibrotic effects of angiotensin II in the pancreas.
Improves insulin sensitivity by increasing blood flow to skeletal muscle.
Inhibit the adverse effects of angiotensin II on insulin signaling pathway via protein kinase C signaling in skeletal muscle and cardiovascular tissue (causing insulin resistance).
Improving glucose transport by increasing the expression of muscle GLUT -4.
Activation of PPARg system (regulate the metabolism of carbohydrates and fats).
Facilitating change of preadiposit into mature adipocytes cells (angiotensin II is known to inhibit the change preadiposit into mature adipocytes cell, which would lead to accumulation of fat in tissues other than mature adipocytes, the liver, muscle and pancreas so that it will lead to insulin resistance