New clinical trial data suggests certain blood pressure medications can significantly slow the progression of diabetic eye disease.
US researchers have published data from a five-year multi-center clinical trial that demonstrates that the use medications commonly used to treat high pressure can help to prevent and slow progression of diabetic retinopathy.
The two medications – losartan and enalapril – work by targeting the rennin-angiotensin system, a hormone system that is controlled by the kidneys and that helps to regulate blood pressure within the body.
The trial, the longest ever to be conducted in this area of research, involved trial participants living with type 1 diabetes but with no detectable incidence of kidney disease or hypertension and minimal eye disease. Patients were randomly assigned to receive a daily dose of either losartan, enalapril or a placebo, and were monitored for five years.
Results showed that people given either medication were at least two times less likely to experience progression of their eye disease, a significant result. Interestingly, neither intervention showed a prevention of diabetic kidney disease – a surprising result that is contradictory to previous research.
According to Dr Paul Strumph, Chief Medical Officer of JDRF International, this study adds to the existing body of knowledge available about treating and preventing type 1 diabetes complications but emphasizes that work still needs to be done.
“This study adds to our understanding of the progression of eye disease in some people with type 1 diabetes – those with normal blood pressure, no detectable kidney disease and very mild eye disease.”
“Because the study did not evaluate the drugs effects on eye and kidney disease in people already experiencing diabetes complications such as elevated blood pressure, kidney disease and eye disease, it will not impact on clinical practice guidelines for that group.”
Future research will concentrate on identifying which groups of people with type 1 diabetes will benefit most from taking these medications in relation to any risks involved with ongoing use of the drug treatment.
New England Journal of Medicine. 2009 Jul 2;361(1):40-51.