Top

Current Diabetes Reports

Published in:

01-02-2018 | Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)

Type 2 Diabetes and Thiazide Diuretics

Author: André J. Scheen

Published in: Current Diabetes Reports | Issue 2/2018

Abstract

Purpose of Review

In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes.

Recent Findings

These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents.

Summary

Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension.

Roush GC, Kaur R, Ernst ME. Diuretics: a review and update. J Cardiovasc Pharmacol Ther. 2014;19(1):5–13. https://doi.org/10.1177/1074248413497257.PubMedCrossRef

Ferrannini E, Cushman WC. Diabetes and hypertension: the bad companions. Lancet. 2012;380(9841):601–10. https://doi.org/10.1016/S0140-6736(12)60987-8.PubMedCrossRef

McMurray JJ, Gerstein HC, Holman RR, Pfeffer MA. Heart failure: a cardiovascular outcome in diabetes that can no longer be ignored. Lancet Diabetes Endocrinol. 2014;2(10):843–51. https://doi.org/10.1016/S2213-8587(14)70031-2.PubMedCrossRef

Bahtiyar G, Gutterman D, Lebovitz H. Heart failure: a major cardiovascular complication of diabetes mellitus. Curr Diabetes Rep. 2016;16(11):116. https://doi.org/10.1007/s11892-016-0809-4.CrossRef

Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116(6):991–1006. https://doi.org/10.1161/CIRCRESAHA.116.305697.PubMedPubMedCentralCrossRef

Grossman E, Verdecchia P, Shamiss A, Angeli F, Reboldi G. Diuretic treatment of hypertension. Diabetes Care. 2011;34(Suppl 2):S313–9. https://doi.org/10.2337/dc11-s246.PubMedPubMedCentralCrossRef

Sica DA, Carter B, Cushman W, Hamm L. Thiazide and loop diuretics. J Clin Hypertens (Greenwich). 2011;13(9):639–43. https://doi.org/10.1111/j.1751-7176.2011.00512.x.CrossRef

Tamargo J, Segura J, Ruilope LM. Diuretics in the treatment of hypertension. Part 1: thiazide and thiazide-like diuretics. Expert Opin Pharmacother. 2014;15(4):527–47. https://doi.org/10.1517/14656566.2014.879118.PubMedCrossRef

Rosendorff C. Why are we still using hydrochlorothiazide? J Clin Hypertens (Greenwich). 2011;13(12):867–9. https://doi.org/10.1111/j.1751-7176.2011.00566.x.CrossRef

10.

DiNicolantonio JJ, Bhutani J, Lavie CJ, O’Keefe JH. Evidence-based diuretics: focus on chlorthalidone and indapamide. Futur Cardiol. 2015;11(2):203–17. https://doi.org/10.2217/fca.14.83.CrossRef

11.

Robinson DM, Wellington K. Indapamide sustained release: a review of its use in the treatment of hypertension. Drugs. 2006;66(2):257–71. https://doi.org/10.2165/00003495-200666020-00011.PubMedCrossRef

12.

Salvetti A, Ghiadoni L. Thiazide diuretics in the treatment of hypertension: an update. J Am Soc Nephrol. 2006;17(4 Suppl 2):S25–9. https://doi.org/10.1681/ASN.2005121329.PubMedCrossRef

13.

Whelton PK, Barzilay J, Cushman WC, Davis BR, Iiamathi E, Kostis JB, et al. Clinical outcomes in antihypertensive treatment of type 2 diabetes, impaired fasting glucose concentration, and normoglycemia: Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). Arch Intern Med. 2005;165(12):1401–9. https://doi.org/10.1001/archinte.165.12.1401.PubMedCrossRef

14.

Sica DA. Diuretic-related side effects: development and treatment. J Clin Hypertens (Greenwich). 2004;6(9):532–40.CrossRef

15.

Cooper-DeHoff RM. Thiazide-induced dysglycemia: it’s time to take notice. Expert Rev Cardiovasc Ther. 2008;6(10):1291–4. https://doi.org/10.1586/14779072.6.10.1291.PubMedPubMedCentralCrossRef

16.

Fathallah N, Slim R, Larif S, Hmouda H, Ben Salem C. Drug-induced hyperglycaemia and diabetes. Drug Saf. 2015;38(12):1153–68. https://doi.org/10.1007/s40264-015-0339-z.PubMedCrossRef

17.

Warram JH, Laffel LM, Valsania P, Christlieb AR, Krolewski AS. Excess mortality associated with diuretic therapy in diabetes mellitus. Arch Intern Med. 1991;151(7):1350–6. https://doi.org/10.1001/archinte.1991.00400070114014.PubMedCrossRef

18.

• Lin JJ, Chang HC, Ku CT, Chen HY. Hydrochlorothiazide hypertension treatment induced metabolic effects in type 2 diabetes: a meta-analysis of parallel-design RCTs. Eur Rev Med Pharmacol Sci. 2016;20(13):2926–46. This meta-analysis concludes that while thiazide diuretics are still a recommended medication of hypertension therapy for type 2 diabetes, treatment with low-dose HCTZ should be attempted to evaluate the effectiveness and adverse metabolic effects. PubMed

19.

•• Thomopoulos C, Parati G, Zanchetti A. Effects of blood-pressure-lowering treatment on outcome incidence in hypertension: 10—should blood pressure management differ in hypertensive patients with and without diabetes mellitus? Overview and meta-analyses of randomized trials. J Hypertens. 2017;35(5):922–44. https://doi.org/10.1097/HJH.0000000000001276. This systematic review compares the effects on cardiovascular and renal outcomes of blood pressure lowering by different drug classes in patients with and without diabetes mellitus. PubMedCrossRef

20.

• Liang W, Ma H, Cao L, Yan W, Yang J. Comparison of thiazide-like diuretics versus thiazide-type diuretics: a meta-analysis. J Cell Mol Med. 2017;21(11):2634–42. https://doi.org/10.1111/jcmm.13205. This comparative meta-analysis concludes that using thiazide-like diuretics is superior to thiazide-type diuretics in reducing blood pressure without increasing the incidence of metabolic disturbances. PubMedPubMedCentralCrossRef

21.

• Yang Y, Xu H. Comparing six antihypertensive medication classes for preventing new-onset diabetes mellitus among hypertensive patients: a network meta-analysis. J Cell Mol Med. 2017;21(9):1742–50. https://doi.org/10.1111/jcmm.13096. This network meta-analysis concludes that hydrochlorothiazide exhibits a reliable performance in comparison with other antihypertensive agents although RAS blockers appear superior. PubMedPubMedCentralCrossRef

22.

• Brunstrom M, Eliasson M, Nilsson PM, Carlberg B. Blood pressure treatment levels and choice of antihypertensive agent in people with diabetes mellitus: an overview of systematic reviews. J Hypertens. 2017;35(3):453–62. https://doi.org/10.1097/HJH.0000000000001183. This paper concludes that the available evidence supports treatment in people with type 2 diabetes and systolic blood pressure more than 140 mmHg, using any of the major antihypertensive drug classes, includinf thiazide diuretics. PubMedCrossRef

23.

• Zhang X, Zhao Q. Association of thiazide-type diuretics with glycemic changes in hypertensive patients: a systematic review and meta-analysis of randomized controlled clinical trials. J Clin Hypertens (Greenwich). 2016;18(4):342–51. https://doi.org/10.1111/jch.12679. This meta-analysis concludes that thiazide-type diuretics are associated with significant but small adverse glycemic effects in hypertensive patients and that a lower dose might reduce or avoid glycemic changes. CrossRef

24.

•• Remonti LR, Dias S, Leitao CB, Kramer CK, Klassman LP, Welton NJ, et al. Classes of antihypertensive agents and mortality in hypertensive patients with type 2 diabetes—network meta-analysis of randomized trials. J Diabetes Complicat. 2016;30(6):1192–200. https://doi.org/10.1016/j.jdiacomp.2016.04.020. This network meta-analysis concludes that there is no benefit of a single antihypertensive class in reduction of mortality in hypertensive patients with type 2 diabetes. PubMedCrossRef

25.

Mukete BN, Rosendorff C. Effects of low-dose thiazide diuretics on fasting plasma glucose and serum potassium-a meta-analysis. J Am Soc Hypertens. 2013;7(6):454–66. https://doi.org/10.1016/j.jash.2013.05.004.PubMedCrossRef

26.

Helderman JH, Elahi D, Andersen DK, Raizes GS, Tobin JD, Shocken D, et al. Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes. 1983;32(2):106–11. https://doi.org/10.2337/diab.32.2.106.PubMedCrossRef

27.

Zillich AJ, Garg J, Basu S, Bakris GL, Carter BL. Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension. 2006;48(2):219–24. https://doi.org/10.1161/01.HYP.0000231552.10054.aa.PubMedCrossRef

28.

Brown MJ, Williams B, Morant SV, Webb DJ, Caulfield MJ, Cruickshank JK, et al. Effect of amiloride, or amiloride plus hydrochlorothiazide, versus hydrochlorothiazide on glucose tolerance and blood pressure (PATHWAY-3): a parallel-group, double-blind randomised phase 4 trial. Lancet Diabetes Endocrinol. 2016;4(2):136–47. https://doi.org/10.1016/S2213-8587(15)00377-0.PubMedPubMedCentralCrossRef

29.

Roush GC, Ernst ME, Kostis JB, Tandon S, Sica DA. Head-to-head comparisons of hydrochlorothiazide with indapamide and chlorthalidone: antihypertensive and metabolic effects. Hypertension. 2015;65(5):1041–6. https://doi.org/10.1161/HYPERTENSIONAHA.114.05021.PubMedCrossRef

30.

Weir MR, Flack JM, Applegate WB. Tolerability, safety, and quality of life and hypertensive therapy: the case for low-dose diuretics. Am J Med. 1996;101(3A):83S–92S. https://doi.org/10.1016/S0002-9343(96)00271-9.PubMedCrossRef

31.

Price AL, Lingvay I, Szczepaniak EW, Wiebel J, Victor RG, Szczepaniak LS. The metabolic cost of lowering blood pressure with hydrochlorothiazide. Diabetol Metab Syndr. 2013;5(1):35. https://doi.org/10.1186/1758-5996-5-35.PubMedPubMedCentralCrossRef

32.

Eriksson JW, Jansson PA, Carlberg B, Hagg A, Kurland L, Svensson MK, et al. Hydrochlorothiazide, but not Candesartan, aggravates insulin resistance and causes visceral and hepatic fat accumulation: the mechanisms for the diabetes preventing effect of Candesartan (MEDICA) Study. Hypertension. 2008;52(6):1030–7. https://doi.org/10.1161/HYPERTENSIONAHA.108.119404.PubMedCrossRef

33.

Muiesan ML, Salvetti M, Belotti E, Paini A, Rosei CA, Aggiusti C, et al. Effects of barnidipine in comparison with hydrochlorothiazide on endothelial function, as assessed by flow mediated vasodilatation in hypertensive patients. Blood Press. 2011;20(4):244–51. https://doi.org/10.3109/08037051.2011.561072.PubMedCrossRef

34.

Officers A, Coordinators for the ACRGTA, Lipid-Lowering Treatment to Prevent Heart Attack. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288(23):2981–97.CrossRef

35.

Savage PJ, Pressel SL, Curb JD, Schron EB, Applegate WB, Black HR, et al. Influence of long-term, low-dose, diuretic-based, antihypertensive therapy on glucose, lipid, uric acid, and potassium levels in older men and women with isolated systolic hypertension: the Systolic Hypertension in the Elderly Program. SHEP Cooperative Research Group. Arch Intern Med. 1998;158(7):741–51.PubMedCrossRef

36.

Dell'Omo G, Penno G, Del Prato S, Pedrinelli R. Chlorthalidone improves endothelial-mediated vascular responses in hypertension complicated by nondiabetic metabolic syndrome. J Cardiovasc Pharmacol Ther. 2005;10(4):265–72. https://doi.org/10.1177/107424840501000406.PubMedCrossRef

37.

Leonetti G, Rappelli A, Salvetti A, Scapellato L. Long-term effects of indapamide: final results of a two-year Italian multicenter study in systemic hypertension. Am J Cardiol. 1990;65(17):67H–H71. https://doi.org/10.1016/0002-9149(90)90347-4.PubMedCrossRef

38.

Harrower AD, McFarlane G. Antihypertensive therapy in diabetic patients. The use of indapamide. Am J Med. 1988;84(1B):89–91.PubMed

39.

Osei K, Holland G, Falko JM. Indapamide. Effects on apoprotein, lipoprotein, and glucoregulation in ambulatory diabetic patients. Arch Intern Med. 1986;146(10):1973–7. https://doi.org/10.1001/archinte.1986.00360220131023.PubMedCrossRef

40.

Kuo SW, Pei D, Hung YJ, Hsieh AT, Wu LY, Hsieh CH, et al. Effect of indapamide SR in the treatment of hypertensive patients with type 2 diabetes. Am J Hypertens. 2003;16(8):623–8.PubMedCrossRef

41.

Krum H, Skiba M, Gilbert RE. Comparative metabolic effects of hydrochlorothiazide and indapamide in hypertensive diabetic patients receiving ACE inhibitor therapy. Diabet Med. 2003;20(9):708–12. https://doi.org/10.1046/j.1464-5491.2003.01023.x.PubMedCrossRef

42.

Vinereanu D, Dulgheru R, Magda S, Dragoi Galrinho R, Florescu M, Cinteza M, et al. The effect of indapamide versus hydrochlorothiazide on ventricular and arterial function in patients with hypertension and diabetes: results of a randomized trial. Am Heart J. 2014;168(4):446–56. https://doi.org/10.1016/j.ahj.2014.06.010.PubMedCrossRef

43.

Emdin CA, Anderson SG, Woodward M, Rahimi K. Usual blood pressure and risk of new-onset diabetes: evidence from 4.1 million adults and a meta-analysis of prospective studies. J Am Coll Cardiol. 2015;66(14):1552–62. https://doi.org/10.1016/j.jacc.2015.07.059. PubMedPubMedCentralCrossRef

44.

Ong KL, Barter PJ, Waters DD. Cardiovascular drugs that increase the risk of new-onset diabetes. Am Heart J. 2014;167(4):421–8. https://doi.org/10.1016/j.ahj.2013.12.025.PubMedCrossRef

45.

Mancia G, Grassi G, Zanchetti A. New-onset diabetes and antihypertensive drugs. J Hypertens. 2006;24(1):3–10. https://doi.org/10.1097/01.hjh.0000194119.42722.21.PubMedCrossRef

46.

Alderman MH. New onset diabetes during antihypertensive therapy. Am J Hypertens. 2008;21(5):493–9. https://doi.org/10.1038/ajh.2008.17.PubMedCrossRef

47.

Ueda S, Morimoto T, Ando S, Takishita S, Kawano Y, Shimamoto K, et al. A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study. BMJ Open. 2014;4(7):e004576. https://doi.org/10.1136/bmjopen-2013-004576.PubMedPubMedCentralCrossRef

48.

Lip S, Jeemon P, McCallum L, Dominiczak AF, McInnes GT, Padmanabhan S. Contrasting mortality risks among subgroups of treated hypertensive patients developing new-onset diabetes. Eur Heart J. 2016;37(12):968–74. https://doi.org/10.1093/eurheartj/ehv557.PubMedCrossRef

49.

Elliott WJ, Meyer PM. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet. 2007;369(9557):201–7. https://doi.org/10.1016/S0140-6736(07)60108-1.PubMedCrossRef

50.

Nizamuddin M, Elliott WJ. Incident diabetes with antihypertensive drugs: updated network and Bayesian meta-analyses of clinical trial data. J Am Soc Hypertension. 2015;9(Suppl):e24. https://doi.org/10.1016/j.jash.2015.03.057.CrossRef

51.

Gurwitz JH, Bohn RL, Glynn RJ, Monane M, Mogun H, Avorn J. Antihypertensive drug therapy and the initiation of treatment for diabetes mellitus. Ann Intern Med. 1993;118(4):273–8. https://doi.org/10.7326/0003-4819-118-4-199302150-00005.PubMedCrossRef

52.

Barzilay JI, Cutler JA, Davis BR. Antihypertensive medications and risk of diabetes mellitus. Curr Opin Nephrol Hypertens. 2007;16(3):256–60. https://doi.org/10.1097/MNH.0b013e328057dea2.PubMedCrossRef

53.

Redon J, Cifkova R, Laurent S, Nilsson P, Narkiewicz K, Erdine S, et al. The metabolic syndrome in hypertension: European Society of Hypertension Position Statement. J Hypertens. 2008;26(10):1891–900. https://doi.org/10.1097/HJH.0b013e328302ca38.PubMedCrossRef

54.

Owen JG, Reisin E. Anti-hypertensive drug treatment of patients with and the metabolic syndrome and obesity: a review of evidence, meta-analysis, post hoc and guidelines publications. Curr Hypertens Rep. 2015;17(6):558. https://doi.org/10.1007/s11906-015-0558-9. PubMedCrossRef

55.

Arroll B, Kenealy T, Elley CR. Should we prescribe diuretics for patients with prediabetes and hypertension? BMJ. 2008;337(aug21 1):a679. https://doi.org/10.1136/bmj.a679.PubMedCrossRef

56.

Carter BL, Ernst ME, Cohen JD. Hydrochlorothiazide versus chlorthalidone: evidence supporting their interchangeability. Hypertension. 2004;43(1):4–9. https://doi.org/10.1161/01.HYP.0000103632.19915.0E.PubMedCrossRef

57.

Musini VM, Nazer M, Bassett K, Wright JM. Blood pressure-lowering efficacy of monotherapy with thiazide diuretics for primary hypertension. Cochrane Database Syst Rev. 2014;5:CD003824. https://doi.org/10.1002/14651858.CD003824.pub2.

58.

Psaty BM, Lumley T, Furberg CD, Schellenbaum G, Pahor M, Alderman MH, et al. Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis. JAMA. 2003;289(19):2534–44. https://doi.org/10.1001/jama.289.19.2534.PubMedCrossRef

59.

Psaty BM, Lumley T, Furberg CD. Meta-analysis of health outcomes of chlorthalidone-based vs nonchlorthalidone-based low-dose diuretic therapies. JAMA. 2004;292(1):43–4. https://doi.org/10.1001/jama.292.1.43-c.PubMedCrossRef

60.

• Chen P, Chaugai S, Zhao F, Wang DW. Cardioprotective effect of thiazide-like diuretics: a meta-analysis. Am J Hypertens. 2015;28(12):1453–63. https://doi.org/10.1093/ajh/hpv050. This meta-analysis concludes that thiazide-like diuretics have greater protective effect against cardiovascular events than thiazide-type diuretics, especially on heart failure. PubMedCrossRef

61.

• Olde Engberink RH, Frenkel WJ, van den Bogaard B, Brewster LM, Vogt L, van den Born BJ. Effects of thiazide-type and thiazide-like diuretics on cardiovascular events and mortality: systematic review and meta-analysis. Hypertension. 2015;65(5):1033–40. https://doi.org/10.1161/HYPERTENSIONAHA.114.05122. This systematic review concludes that the best available evidence seems to favor thiazide-like diuretics as the drug of choice when thiazide treatment is considered for hypertension. PubMedCrossRef

62.

Vongpatanasin W. Hydrochlorothiazide is not the most useful nor versatile thiazide diuretic. Curr Opin Cardiol. 2015;30(4):361–5. https://doi.org/10.1097/HCO.0000000000000178. PubMedPubMedCentral

63.

•• de Boer IH, Bangalore S, Benetos A, Davis AM, Michos ED, Muntner P, et al. Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes Care. 2017;40(9):1273–84. https://doi.org/10.2337/dci17-0026. This Position Statement is intended to update the assessment and treatment of hypertension among patients with diabetes, including advances in care. PubMedCrossRef

64.

Bangalore S, Fakheri R, Toklu B, Messerli FH. Diabetes mellitus as a compelling indication for use of renin angiotensin system blockers: systematic review and meta-analysis of randomized trials. BMJ. 2016;352:i438. https://doi.org/10.1136/bmj.i438.PubMedPubMedCentralCrossRef

65.

American Diabetes Association. Standards of medical care in diabetes—2017. Diabetes Care. 2017;40(Suppl 1):S1–S135.

66.

Lievre M, Gueyffier F, Ekbom T, Fagard R, Cutler J, Schron E, et al. Efficacy of diuretics and beta-blockers in diabetic hypertensive patients. Results from a meta-analysis. The INDANA Steering Committee. Diabetes Care. 2000;23(Suppl 2):B65–71.PubMed

67.

Curb JD, Pressel SL, Cutler JA, Savage PJ, Applegate WB, Black H, et al. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA. 1996;276(23):1886–92. https://doi.org/10.1001/jama.1996.03540230036032.PubMedCrossRef

68.

Kostis JB, Wilson AC, Freudenberger RS, Cosgrove NM, Pressel SL, Davis BR, et al. Long-term effect of diuretic-based therapy on fatal outcomes in subjects with isolated systolic hypertension with and without diabetes. Am J Cardiol. 2005;95(1):29–35. https://doi.org/10.1016/j.amjcard.2004.08.059.PubMedCrossRef

69.

Patel A, MacMahon S, Chalmers J, Neal B, Woodward M, Billot L, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370(9590):829–40. https://doi.org/10.1016/S0140-6736(07)61303-8.PubMedCrossRef

70.

Niskanen L, Hedner T, Hansson L, Lanke J, Niklason A, Group CS. Reduced cardiovascular morbidity and mortality in hypertensive diabetic patients on first-line therapy with an ACE inhibitor compared with a diuretic/beta-blocker-based treatment regimen: a subanalysis of the Captopril Prevention Project. Diabetes Care. 2001;24(12):2091–6.PubMedCrossRef

71.

Lindholm LH, Hansson L, Ekbom T, Dahlof B, Lanke J, Linjer E, et al. Comparison of antihypertensive treatments in preventing cardiovascular events in elderly diabetic patients: results from the Swedish Trial in Old Patients with Hypertension-2. STOP Hypertension-2 Study Group. J Hypertens. 2000;18(11):1671–5. https://doi.org/10.1097/00004872-200018110-00020.PubMedCrossRef

72.

Mancia G, Brown M, Castaigne A, de Leeuw P, Palmer CR, Rosenthal T, et al. Outcomes with nifedipine GITS or Co-amilozide in hypertensive diabetics and nondiabetics in Intervention as a Goal in Hypertension (INSIGHT). Hypertension. 2003;41(3):431–6. https://doi.org/10.1161/01.HYP.0000057420.27692.AD.PubMedCrossRef

73.

Weber MA, Bakris GL, Jamerson K, Weir M, Kjeldsen SE, Devereux RB, et al. Cardiovascular events during differing hypertension therapies in patients with diabetes. J Am Coll Cardiol. 2010;56(1):77–85. https://doi.org/10.1016/j.jacc.2010.02.046.PubMedCrossRef

74.

Puig JG, Marre M, Kokot F, Fernandez M, Jermendy G, Opie L, et al. Efficacy of indapamide SR compared with enalapril in elderly hypertensive patients with type 2 diabetes. Am J Hypertens. 2007;20(1):90–7. https://doi.org/10.1016/j.amjhyper.2006.05.018.PubMedCrossRef

75.

Zhang Y, Agnoletti D, Wang JG, Xu Y, Safar ME. Natriuresis and blood pressure reduction in hypertensive patients with diabetes mellitus: the NESTOR study. J Am Soc Hypertens. 2015;9(1):21–8. https://doi.org/10.1016/j.jash.2014.10.003.PubMedCrossRef

76.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358(18):1887–98. https://doi.org/10.1056/NEJMoa0801369.PubMedCrossRef

77.

Farsang C. Efficacy and tolerability of fixed-dose combination of perindopril/indapamide in type 2 diabetes mellitus: PICASSO trial. Adv Ther. 2014;31(3):333–44. https://doi.org/10.1007/s12325-014-0107-y.PubMedPubMedCentralCrossRef

78.

Jentzer JC, DeWald TA, Hernandez AF. Combination of loop diuretics with thiazide-type diuretics in heart failure. J Am Coll Cardiol. 2010;56(19):1527–34. https://doi.org/10.1016/j.jacc.2010.06.034.PubMedCrossRef

79.

Patterson JH, Adams KF Jr. Investigating the role of thiazide-like diuretics in acute heart failure: potential approach to an unmet need. J Card Fail. 2016;22(7):537–8. https://doi.org/10.1016/j.cardfail.2016.05.001.PubMedCrossRef

80.

Trullas JC, Morales-Rull JL, Casado J, Freitas Ramirez A, Manzano L, Formiga F, et al. Rationale and design of the “Safety and Efficacy of the Combination of Loop with Thiazide-type Diuretics in Patients with Decompensated Heart Failure (CLOROTIC) Trial”: a double-blind, randomized, placebo-controlled study to determine the effect of combined diuretic therapy (loop diuretics with thiazide-type diuretics) among patients with decompensated heart failure. J Card Fail. 2016;22(7):529–36. https://doi.org/10.1016/j.cardfail.2015.11.003.PubMedCrossRef

81.

Sica DA. Diuretic use in renal disease. Nat Rev Nephrol. 2011;8(2):100–9. https://doi.org/10.1038/nrneph.2011.175.PubMedCrossRef

82.

Izzo JL Jr, Tobe SW. Is there a preferred diuretic class for patients with renal impairment and hypertension? J Am Soc Hypertens. 2016;10(4):282–4. https://doi.org/10.1016/j.jash.2016.02.008.PubMedCrossRef

83.

Elliott WJ, Jurca S. Loop diuretics are most appropriate for hypertension treatment in chronic kidney disease. J Am Soc Hypertens. 2016;10(4):285–7. https://doi.org/10.1016/j.jash.2016.02.007.PubMedCrossRef

84.

Karadsheh F, Weir MR. Thiazide and thiazide-like diuretics: an opportunity to reduce blood pressure in patients with advanced kidney disease. Curr Hypertens Rep. 2012;14(5):416–20. https://doi.org/10.1007/s11906-012-0293-4.PubMedCrossRef

85.

Kwakernaak AJ, Krikken JA, Binnenmars SH, Visser FW, Hemmelder MH, Woittiez AJ, et al. Effects of sodium restriction and hydrochlorothiazide on RAAS blockade efficacy in diabetic nephropathy: a randomised clinical trial. Lancet Diabetes Endocrinol. 2014;2(5):385–95. https://doi.org/10.1016/S2213-8587(14)70030-0.PubMedCrossRef

86.

Hoshino T, Ookawara S, Miyazawa H, Ito K, Ueda Y, Kaku Y, et al. Renoprotective effects of thiazides combined with loop diuretics in patients with type 2 diabetic kidney disease. Clin Exp Nephrol. 2015;19(2):247–53. https://doi.org/10.1007/s10157-014-0981-2.PubMedCrossRef

87.

Donnelly R, Molyneaux LM, Willey KA, Yue DK. Comparative effects of indapamide and captopril on blood pressure and albumin excretion rate in diabetic microalbuminuria. Am J Cardiol. 1996;77(6):26B–30B. https://doi.org/10.1016/S0002-9149(97)89237-5.PubMedCrossRef

88.

Marre M, Puig JG, Kokot F, Fernandez M, Jermendy G, Opie L, et al. Equivalence of indapamide SR and enalapril on microalbuminuria reduction in hypertensive patients with type 2 diabetes: the NESTOR Study. J Hypertens. 2004;22(8):1613–22. https://doi.org/10.1097/01.hjh.0000133733.32125.09.PubMedCrossRef

89.

Mogensen CE, Viberti G, Halimi S, Ritz E, Ruilope L, Jermendy G, et al. Effect of low-dose perindopril/indapamide on albuminuria in diabetes preterax in albuminuria regression: PREMIER. Hypertension. 2003;41(5):1063–71. https://doi.org/10.1161/01.hyp.0000064943.51878.58.PubMedCrossRef

90.

Heerspink HJ, Ninomiya T, Perkovic V, Woodward M, Zoungas S, Cass A, et al. Effects of a fixed combination of perindopril and indapamide in patients with type 2 diabetes and chronic kidney disease. Eur Heart J. 2010;31(23):2888–96. https://doi.org/10.1093/eurheartj/ehq139.PubMedCrossRef

91.

Scheen AJ. Pharmacodynamics, efficacy and safety of sodium-glucose co-transporter type 2 (SGLT2) inhibitors for the treatment of type 2 diabetes mellitus. Drugs. 2015;75(1):33–59. https://doi.org/10.1007/s40265-014-0337-y.PubMedCrossRef

92.

Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117–28. https://doi.org/10.1056/NEJMoa1504720.PubMedCrossRef

93.

McMurray J. EMPA-REG—the “diuretic hypothesis”. J Diabetes Complicat. 2016;30(1):3–4. https://doi.org/10.1016/j.jdiacomp.2015.10.012.PubMedCrossRef

94.

Scheen AJ. Reappraisal of the diuretic effect of empagliflozin in EMPA-REG OUTCOME: comparison with classic diuretics. Diabetes Metab. 2016;42(4):224–33. https://doi.org/10.1016/j.diabet.2016.05.006.PubMedCrossRef

95.

Scheen AJ, Delanaye P. Effects of reducing blood pressure on renal outcomes in patients with type 2 diabetes: focus on SGLT2 inhibitors and EMPA-REG OUTCOME. Diabetes Metab. 2017;43(2):99–109. https://doi.org/10.1016/j.diabet.2016.12.010.PubMedCrossRef

96.

Devineni D, Vaccaro N, Polidori D, Rusch S, Wajs E. Effects of hydrochlorothiazide on the pharmacokinetics, pharmacodynamics, and tolerability of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in healthy participants. Clin Ther. 2014;36(5):698–710. https://doi.org/10.1016/j.clinthera.2014.02.022.PubMedCrossRef

97.

Lambers Heerspink HJ, de Zeeuw D, Wie L, Leslie B, List J. Dapagliflozin a glucose-regulating drug with diuretic properties in subjects with type 2 diabetes. Diabetes Obesity Metab. 2013;15(9):853–62. https://doi.org/10.1111/dom.12127.CrossRef

98.

Amin NB, Wang X, Mitchell JR, Lee DS, Nucci G, Rusnak JM. Blood pressure-lowering effect of the sodium glucose co-transporter-2 inhibitor ertugliflozin, assessed via ambulatory blood pressure monitoring in patients with type 2 diabetes and hypertension. Diabetes Obesity Metab. 2015;17(8):805–8. https://doi.org/10.1111/dom.12486.CrossRef

99.

Heise T, Mattheus M, Woerle HJ, Broedl UC, Macha S. Assessing pharmacokinetic interactions between the sodium glucose cotransporter 2 inhibitor empagliflozin and hydrochlorothiazide or torasemide in patients with type 2 diabetes mellitus: a randomized, open-label, crossover study. Clin Ther. 2015;37(4):793–803. https://doi.org/10.1016/j.clinthera.2014.12.018.PubMedCrossRef

100.

Heise T, Jordan J, Wanner C, Heer M, Macha S, Mattheus M, et al. Acute pharmacodynamic effects of empagliflozin with and without diuretic agents in patients with type 2 diabetes mellitus. Clin Ther. 2016;38(10):2248–64 e5. https://doi.org/10.1016/j.clinthera.2016.08.008.PubMedCrossRef

101.

Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(7):644–57. https://doi.org/10.1056/NEJMoa1611925.PubMedCrossRef

Title: Type 2 Diabetes and Thiazide Diuretics
Author: André J. Scheen
Publication date: 01-02-2018
Publisher: Springer US
Published in: Current Diabetes Reports / Issue 2/2018
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-018-0976-6

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

Please log in to get access to this content

Other articles of this Issue 2/2018

Implications of Lipids in Neonatal Body Weight and Fat Mass in Gestational Diabetic Mothers and Non-Diabetic Controls

Introductory Overview of the Natural Experiments for Translation in Diabetes 2.0 (NEXT-D2) Network: Examining the Impact of US Health Policies and Practices to Prevent Diabetes and Its Complications

Sleep in Type 1 Diabetes: Implications for Glycemic Control and Diabetes Management

Cannabinoid Receptors in Diabetic Kidney Disease

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage