PREVENTION OF DIABETES MELLITUS

Ramipril for prevention of Type 2 DM in pts with vascular disease:

• "HOPE" Study--5720 pts > 55yo with h/o CAD, CVA, or PVD randomized to Ramipril 10mg QD vs. placebo. Over mean 4.5y f/u, RR for new dx of DM was 0.66 with Ramipril (sig.) (JAMA 286:1882, 2001--abst)
• In a study in 5,269 pts > 30yo with impaired fasting glucose or impaired glucose tolerance but no h/o cardiovascular disease or DM randomized to ramipril 15mg/d vs. placebo, after median 3y f/u, incidence of progression to DM was not significantly different in Ramipril recipients ("Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication" ("DREAM") Trial; NEJM 355:1551,2006--JW).

Angiotensin Receptor Blockers for prevention of DM-Click on link for details

Prevention of progression of Impaired Glucose Tolerance to Type 2 DM-Click on link for details

Coffee and tea and risk of diabetes mellitus:

• In a prospective cohort study of 41,934 men and 84,276 women (in the Health Professionals' Follow-up Study and Nurses' Health Study, respectively), caffeinated coffee consumption was inversely ass'd, in multivariate analysis adjusting for potential confounders, with risk for type 2 DM (for men, RR 0.7 for 4-5 cups/day and 0.5 for > 5 cups; for women, RR 0.7 for > 3 cups/day). Tea consumption was not ass'd with DM risk (Ann. Int. Med. 140:1, 2004--JW)
• In a meta-analysis of 20 studies involving 517,325 participants, with median f/u of 2-20y,  after adjustment for potential confounders, there was a sig. and dose-dependent risk reduction in incidence of new-onset type 2 DM with coffee consumption (7% risk reduction for each cup of coffee consumed daily).  Also, consumption of decaffeinated coffee was also associated with sig. risk reduction (RR 0.64 in those who drank > 3-4 cups/day c/w those who consumed no decaffeinated coffee) and ditto for tea (RR 0.82 with consumption of  3-4 cups/day c/w none) (Arch. Int. Med. 169:2053, 2009-AFP)