This meta-analysis of randomized controlled trials was conducted to evaluate the effect of angiotensin converting enzyme inhibitors (ACEI) on the development of new-onset type 2 diabetes. Trials were identified by electronic and manual searches and nine trials with 92,404 patients (72,128 non-diabetic patients at baseline) were included for analysis. Incidence of new-onset diabetes was significantly reduced in the ACEI group (OR 0.80; 95% CI 0.71-0.91) compared to the control group and this was irrespective of achieved blood pressure levels at follow-up. ACEI therapy was associated with significant reduction in the risk of new-onset diabetes compared with beta-blockers/diuretics (OR 0.78; 95% CI 0.65-0.93), placebo (OR 0.79; 95% CI 0.64-0.96), or calcium channel blockers (OR 0.85; 95% CI 0.73-0.99). ACEI treatment was also associated with a significant reduction in the risk of new-onset diabetes in patients with hypertension (OR 0.80; 95% CI 0.68-0.93), coronary artery disease or cardiovascular disease (OR 0.83; 95% CI 0.68-1.00), and heart failure (OR 0.22; 95% CI 0.10-0.47). Therefore, ACEIs have beneficial effects in preventing new-onset diabetes and lowering the risk of new-onset diabetes in patients with hypertension, coronary artery disease, and other cardiovascular disease. Int J Cardiol. 2012 Jul 16. PMID: 22809536
