The role of renin blockers in the prevention of diabetes.

OBJECTIVE To evaluate the role of renin blockers angiotensin converting enzymes inhibitors (ACEI) or angiotensin receptor blockers (ARB) in the prevention of diabetes. METHODS We did a meta-analysis using the Cochrane group methodology of all available randomized controlled trials (RCTs) that evaluated the role of renin blockers in which outcomes of new-onset diabetes was reported. This meta-analysis was conducted between April 2005-April 2006 at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. RESULTS Thirteen trials including 91,388 individuals met the inclusion criteria. There was a statistically significant reduction in the incidence of new-onset diabetes in patients receiving renin blockers compared to other antihypertensive agents [relative risks=0.79; 95% confidence interval=0.75-0.84). There was a statistically significant reduction in the incidence of new-onset diabetes in patients receiving renin-blockers compared to diuretics, conventional antihypertensive therapy (diuretics or beta-blockers), and calcium channel blockers. CONCLUSION Renin blockers reduce the incidence of new-onset diabetes and should be considered as first line therapy, when indicated, in patients at high risk for diabetes.