Current Cardiology Reports

, Volume 12, Issue 6, pp 464-471

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

The Role of Renin-Angiotensin Agents in Altering the Natural History of Type 2 Diabetes Mellitus

  • Joel A. LardizabalAffiliated withDivision of Cardiology, Department of Medicine, University of California in San Francisco (Fresno-MEP)
  • , Prakash C. DeedwaniaAffiliated withUniversity of California in San FranciscoCardiology Division, VACCHS Medical Center Email author 


Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular disease (CVD) morbidity and mortality worldwide. Renin-angiotensin system (RAS) blockers have been indispensable in diminishing the macrovascular and microvascular complications of diabetes. In addition, cumulative evidence from retrospective studies pointed toward a beneficial effect of RAS agents in preventing the development and progression of T2DM. This disease-modifying potential of RAS blockers has been substantiated by recent prospective trials. Contemporary concepts regarding the natural history of T2DM and the pathophysiologic processes involved have increased our understanding of the mechanisms underlying the therapeutic potential of these agents in diabetes management. In addition to their established roles in the primary prevention of CVD in patients with diabetes, RAS blockers might be considered a suitable therapeutic choice for preventing the development of frank diabetes in high-risk patients.


Type 2 diabetes mellitus Diabetes natural history Angiotensin-converting enzyme inhibitor Angiotensin receptor blocker Renin-angiotensin system Impaired fasting glucose Impaired glucose tolerance Insulin resistance