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Review: angiotensin converting enzyme inhibitors are beneficial in type 1 diabetes mellitus and microalbuminuria regardless of baseline risk factor status

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 QUESTION: In patients with type 1 diabetes mellitus and microalbuminuria, what is the effect of angiotensin converting enzyme (ACE) inhibitors independent of confounding variables?

Data sources

Studies were identified by searching Medline and bibliographies of relevant papers and by contacting authors.

Study selection

Studies were selected if they included ≥10 patients with type 1 diabetes and microalbuminuria (defined as having an albumin excretion rate of 20 to 200 μg/minute, or approximately 30 to 300 mg/day, who were judged not to be hypertensive at the time of the original trial), had a placebo or non-intervention control group, had follow up ≥1 year, and measured albumin excretion rate at baseline and at ≥1 follow up visit.

Data extraction

Authors were contacted to provide individual patient data on age, duration of diabetes, sex, baseline treatment assignment, albumin excretion rate at baseline and follow up, blood pressure, and glycaemic control.

Main results

12 studies …

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  • Source of funding: In part, Zeneca Pharmaceuticals

  • For correspondence: Dr N Chaturvedi, Department of Epidemiology and Public Health, Imperial College at St Mary's Norfolk Place, London W2 1PG, UK. Fax +44 (0)207 594 3392.