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Reversal of Diuretic-Associated Impaired Glucose Tolerance and New-Onset Diabetes: Results of the STAR-LET Study

  1. George Bakris MD,
  2. Mark Molitch MD,
  3. Qian Zhou PhD,
  4. Pantelis Sarafidis MD, PhD,
  5. Annette Champion MBA,
  6. Peter Bacher MD, PhD,
  7. James R. Sowers MD

Article first published online: 20 MAR 2008

DOI: 10.1111/j.1559-4572.2008.07819.x

Issue

Journal of the CardioMetabolic Syndrome

Journal of the CardioMetabolic Syndrome

Volume 3, Issue 1, pages 18–25, Winter 2008

Additional Information

How to Cite

Bakris, G., Molitch, M., Zhou, Q., Sarafidis, P., Champion, A., Bacher, P. and Sowers, J. R. (2008), Reversal of Diuretic-Associated Impaired Glucose Tolerance and New-Onset Diabetes: Results of the STAR-LET Study. Journal of the CardioMetabolic Syndrome, 3: 18–25. doi: 10.1111/j.1559-4572.2008.07819.x

Author Information

  1. From the Hypertensive Diseases Center, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Pritzker School of Medicine, Chicago, IL;1the Endocrine Division, Department of Medicine, Northwestern University Medical Center, Chicago, IL;2Global Pharmaceutical Research and Development, Abbott Laboratories, Abbott Park, IL;3the Department of Preventive Medicine, Rush University Hypertension Center, Chicago, IL;4 and the Diabetes and Cardiovascular Center, Department of Medicine, Physiology, and Pharmacology, University of Missouri-Columbia, Columbia, MO5

*George Bakris, MD, Hypertension Center, Section of Endocrinology, Diabetes, and Metabolism, University of Chicago Pritzker School of Medicine, 5841 South Maryland Avenue, Chicago, IL 60612 E-mail: gbakris@earthlink.net

Publication History

  1. Issue published online: 20 MAR 2008
  2. Article first published online: 20 MAR 2008
  3. Manuscript received October 5, 2007; revised November 20, 2007; accepted December 3, 2007

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Reversal of new-onset diabetes secondary to thiazide diuretic use remains questionable. STAR-LET was a 6-month extension of the Study of Trandolapril/Verapamil SR and Insulin Resistance (STAR), which assessed the effects of a fixed-dose renin-angiotensin system inhibitor (RASI)/hydrochlorothiazide (HCTZ) combination on changes in 2-hour oral glucose tolerance test (OGTT) results. STAR-LET explored whether the glycemic impact of HCTZ could be reversed by conversion to a RASI/verapamil combination. The primary outcome was change in 2-hour OGTT results. Fifty-one percent of the STAR patients were enrolled in STAR-LET. The 2-hour OGTT value (mmol/L) was unchanged from STAR baseline in the RASI/verapamil group (7.7±2.4 vs 8.1±3.3; P=.18) and improved in those who were switched from RASI/HCTZ to RASI/verapamil (8.5±3.0 vs 7.2±2.3; P<.001). This exploratory study suggests that the impairment in glycemic control seen with use of a thiazide diuretic combined with a RASI can be reversed by switching to a regimen that does not include a diuretic.

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