Does losartan raise blood sugar

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The Impact of Losartan on Blood Sugar Levels

Introduction to Losartan and Blood Sugar

Losartan, an angiotensin II receptor blocker (ARB), is primarily used to manage hypertension and protect kidney function in patients with diabetes. However, its effects on blood sugar levels have been a subject of investigation, with studies providing insights into its impact on glucose metabolism and insulin sensitivity.

Losartan and Insulin Sensitivity

Improvement in Insulin Sensitivity

Several studies have demonstrated that losartan can improve insulin sensitivity and glucose homeostasis. In a study involving subjects with type 2 diabetes and nephropathy, losartan significantly decreased fasting blood glucose, HbA1c, and urinary protein levels while increasing insulin sensitivity and the insulin-to-glucose ratio . Another study found that losartan enhanced glucose metabolic clearance rate and whole-body glucose disposal in insulin-resistant hypertensive patients, indicating improved insulin action .

Mechanisms of Action

The improvement in insulin sensitivity with losartan is attributed to its ability to increase non-oxidative glucose metabolism and blood flow. This was observed in hypertensive patients where losartan administration led to a significant increase in insulin-mediated glucose uptake and blood flow . Additionally, losartan's effect on reducing hyperinsulinemia in fructose-fed rats further supports its role in improving insulin sensitivity .

Losartan and Blood Sugar Levels

Neutral or Beneficial Effects

Most studies indicate that losartan does not raise blood sugar levels. In fact, it appears to have a neutral or beneficial effect on glucose metabolism. A randomized, double-blind study comparing losartan with metoprolol found no significant adverse effects on insulin secretion, glucose tolerance, or lipid metabolism, suggesting that losartan is metabolically neutral .

Case of Hypoglycemia

Interestingly, there has been a reported case of severe hypoglycemia in a non-diabetic patient attributed to losartan. The patient experienced persistent hypoglycemia, which resolved upon discontinuation of losartan, indicating a potential, albeit rare, risk of hypoglycemia with losartan use .

Conclusion

In summary, losartan generally improves insulin sensitivity and glucose homeostasis, particularly in patients with type 2 diabetes and hypertension. It does not raise blood sugar levels and is considered metabolically neutral. However, there are rare instances where losartan may induce hypoglycemia, highlighting the need for careful monitoring in certain patients. Overall, losartan's benefits in managing blood pressure and improving insulin sensitivity make it a valuable therapeutic option for patients with diabetes and hypertension.

Sources and full results

Most relevant research papers on this topic

Angiotensin type-1 receptor blockade with losartan increases insulin sensitivity and improves glucose homeostasis in subjects with type 2 diabetes and nephropathy.

Losartan at 100 mg daily increases insulin sensitivity and improves glucose homeostasis in subjects with type 2 diabetic nephropathy, reducing urinary protein excretion.

RCT

2007·

40citations

·H. Jin et al.

Losartan mediated improvement in insulin action is mainly due to an increase in non-oxidative glucose metabolism and blood flow in insulin-resistant hypertensive patients

Losartan improves insulin-mediated glucose uptake in hypertensive patients by increasing non-oxidative glucose metabolism and blood flow.

RCT

1997·

69citations

·G. Paolisso et al.

Effects of losartan on insulin sensitivity in hypertensive subjects.

Losartan effectively lowers blood pressure without significantly affecting insulin sensitivity or glucose metabolism in hypertensive subjects.

RCT

1996·

60citations

·M. Laakso et al.

Losartan Induced Hypoglycemia in the Absence of Diabetes Mellitus - a Concealed Diagnosis

Losartan can cause severe hypoglycemia in nondiabetic patients, a concealed diagnosis that can be resolved by discontinuing the drug.

Case ReportRigorous Journal

2021·

0citations

·S. Syed et al.

Effects of losartan on blood pressure, metabolic alterations, and vascular reactivity in the fructose-induced hypertensive rat.

Losartan treatment prevents blood pressure elevation and hyperinsulinemia in fructose-fed rats, but not triglyceride elevation, while also reducing vascular reactivity.

Highly Cited

1995·

103citations

·J. Navarro‐Cid et al.

A low-sodium diet potentiates the effects of losartan in type 2 diabetes.

A low-sodium diet enhances the antihypertensive and antiproteinuric effects of losartan in type 2 diabetes patients, with similar blood pressure reduction to that of a second antihypertensive agent.

RCTHighly Cited

2002·

142citations

·Christine A. Houlihan et al.

The Effect of Losartan and Telmisartan on Blood Sugar and Blood Lipid in Syndrome X Rats

Losartan and telmisartan can reduce blood pressure, improve insulin resistance, and correct abnormal sugar and lipid metabolism in syndrome X rats.

RCTAnimal Study

2007·

0citations

·Chen Ya-qi

Effects of losartan on blood pressure, plasma renin activity, and angiotensin II in volunteers.

Losartan administration (100 mg/day for eight doses over 9 days) leads to treatment-related decreases in blood pressure and increases in plasma renin activity and angiotensin II octapeptide in healthy male volunteers.

RCTHighly Cited

1993·

141citations

·M. R. Goldberg et al.

Study of Losartan’s Effects on Different Biochemical Parameters in Essential Hypertensive Patients

Losartan therapy significantly increases HDL cholesterol and decreases serum uric acid levels in essential hypertensive patients, but does not significantly affect blood sugar or electrolyte levels.

Non-RCT

2021·

0citations

·Pratibha S. Salve et al.

Losartan may prevent the elevation of plasma glucose levels induced by chronic stress.

Losartan can prevent chronic stress-induced blood glucose levels in rats by decreasing the excessive sympathetic response to stress.

Non-RCTAnimal Study

2004·

5citations

·Y. Uresin et al.

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