Review: The potential benefits of aldosterone antagonism in Type 2 diabetes mellitus

Abstract

Interest in the renin-angiotensin-aldosterone system (RAAS) has increased since the development of angiotensin-converting enzyme (ACE) inhibitors. It has been discovered that the potential uses of this class of treatment extend far beyond their initial developmental role as antihypertensives, and they are now used routinely in the treatment of heart failure, nephropathy, myocardial infarction and diabetes. However, there is more to RAAS blockade than just inhibition of angiotensin II, and inhibition of aldosterone is becoming recognised as an additional therapeutic manoeuvre in chronic heart failure.1 Since inhibition of the RAAS at the level of ACE is now seen to be an important therapy in diabetes; 2 the purpose of this article is to explore the potential benefits of additional aldosterone inhibition in Type 2 diabetes mellitus.