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