| Diuretics and diabetes incidence--an appeal against the reluctance to prescribe a medication that is safe and proven. | |
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MedLine Citation:
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PMID: 20546254 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The publication of the scientific report of the Institute for Quality and Efficiency in Health Care (IQWiG) in Germany on the 'Comparative evaluation of the benefits and harms of different antihypertensive drug classes [diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, calcium-channel blockers and angiotensin II (AT-II) blockers] as first-choice therapy for patients with essential hypertension' raised an enormous public debate, particularly as diabetes incidence was not judged to be a patient-relevant outcome. In this assessment, the overall view of the patient-relevant results was that diuretics can be used as first-line antihypertensive treatment. Diabetes incidence is highest with diuretics, but minimal differences in fasting plasma glucose of approximately 0.28 mmol/l are magnified by the transformation of continuous blood glucose values into categorical data: with the establishment of thresholds, the diagnosis of diabetes depends on being above a certain blood glucose value. The protective cardiovascular effects of diuretics do not seem to be reduced in hypertensive patients who develop new-onset diabetes during treatment. Since blood pressure control is often worse, detection, treatment and control should be urgently improved. The debate on antihypertensive agents is mainly of scientific interest and has only minor clinical relevance for everyday patient care. |
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Authors:
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A Siebenhofer; K Jeitler; I Rakovac; K Horvath |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: 27 ISSN: 1464-5491 ISO Abbreviation: Diabet. Med. Publication Date: 2010 Feb |
Date Detail:
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Created Date: 2010-06-15 Completed Date: 2010-10-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: England |
Other Details:
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Languages: eng Pagination: 130-5 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Medical University of Graz, Graz, Austria. siebenhofer@allgemeinmedizin.uni-frankfurt.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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therapeutic use* Blood Glucose / drug effects Diabetes Mellitus, Type 1 / blood, complications*, epidemiology* Diabetic Angiopathies / drug therapy* Diuretics / therapeutic use* Humans Hypertension / drug therapy*, etiology Incidence |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Blood Glucose; 0/Diuretics |
| Comments/Corrections | |
Comment In:
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Diabet Med. 2010 Feb;27(2):127-9
[PMID:
20546253
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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