Minor
Probable
Descripción
ACE inhibitors may increase insulin sensitivity and reduce blood glucose, occasionally causing hypoglycemia in diabetic patients also using antidiabetic agents including metformin.
Mecanismo
ACE inhibitor-mediated improvement in insulin receptor sensitivity and glucose transport may potentiate antidiabetic drug effects; the mechanism is not fully elucidated.
Relevancia clínica
The interaction is generally minor; most diabetic patients actually benefit from the combined cardiorenal protective effects of ACE inhibitors and metformin.
Manejo clínico
Monitor blood glucose when initiating ACE inhibitors in diabetic patients on antidiabetic therapy; adjust antidiabetic doses if hypoglycemia occurs.