The Effect of Renin Inhibition on Nerve Function in Diabetes

Effect of Renin Inhibition on Cardiovascular Autonomic Nerve Function in Diabetes

This study will assess the effect of direct renin inhibition on nerve function in persons with diabetes using a double-blind, placebo-controlled randomized trial involving two treatment arms (i.e., [1] 30 participants enrolled and randomized to 300 mg of Aliskiren; [2] 30 participants enrolled and randomized to placebo).

Inclusion Criteria:

• Individuals >18 years old with type 1 or type 2 diabetes mellitus.

Exclusion Criteria:

• Individuals currently taking the maximum dose of an ACE inhibitor or an ARB.
• Individuals with a history of a MI, percutaneous coronary interventions, coronary artery bypass graft (CABG) surgery, acute coronary syndromes, recent/on going atrial fibrillation, frequent atrial arrhythmias, frequent ventricular arrhythmias, or acute myocardial ischemia changes.
• Individuals whose treatment dosage changes 2 months prior to the study for antihypertensive and antidiabetes medications, and the following medications that may affect the ANS: anti-tuberculosis drugs, nitrofurantoin, metronidazole, chloramphenicol, perhexiline maleate, amiodarone, clofibrate, tricyclic antidepressants, phenytoin, barbiturates, neuroleptic, antiparkinsonism drugs, and nitrated drugs.
• Pregnant or lactating females.
• Individuals with impaired renal function (i.e., creatinine >1.5 mg/dl), a history of dialysis, nephritic syndrome or renovascular hypertension.
• Individuals with potassium levels within 0.5 mmol/L of the upper limit of normal (i.e., hyperkalemia).