An ace in the hospital

ACE inhibitors, used to treat heart disease, may account for 14 per cent of all hospital admissions for hypoglycemia (low blood sugar) among diabetic patients.

The drugs were introduced as a treatment for heart problems among diabetics because of their insulin sensitivity, and so were thought not to trigger a hypoglycemic attack. Insulin is a hormone which reduces blood-sugar levels.

But anecdotal reports soon started to appear which began linking the drugs to hypoglycemia, and now researchers from Utrecht University in the Netherlands have confirmed everyone's worst fears.

By examining the records of patients, they discovered that 13.8 per cent of all hospital admissions for hypoglycemia might be caused by ACE

inhibitors.

Diabetic patients commonly suffer from some heart complaint, such as hypertension, heart attacks and congestive heart failure. ACE (angiotensin-converting-enzyme) inhibitors soon became the preferred treatment for diabetics because they did not seem to effect glucose metabolism.

But the Utrecht team estimates that they may double or even quadruple the risks of hypoglycemia for a patient who has been using the inhibitors for more than a year.

Their findings almost mirror those of a French study, which discovered that ACE inhibitors could account for 10 per cent of all cases of hypoglycemia (The Lancet, May 13, 1995).