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II receptor antagonist or angiotensin-converting enzyme inhibitor treatment in type 2 diabetes.
Recent results suggest that type 2 diabetes mellitus is a heterogeneous condition with different phenotypes that have a common pathophysiological basis in obesity and the metabolic syndrome. Insulin resistance with resultant hyperinsulinaemia is an important characteristic of all the phenotypes. First-line therapy in type 2 diabetes is probably a thiazolidinedione or insulin in combination with metformin. Over the past few years, the renin-angiotensin-aldosterone system and antihypertensive treatment have emerged as possible therapeutic targets. However, conclusive evidence on the effect of renin-angiotensin-aldosterone system blockade on morbidity and mortality is lacking, and although aldosterone excess has been implicated in the pathogenesis of insulin resistance and diabetes, there is no evidence that blocking aldosterone synthesis improves insulin resistance or glucose tolerance. On the other hand, renin-angiotensin-aldosterone system blockade does not always normalise insulin sensitivity in type 2 diabetes, and the results of studies with the angiotensin-converting enzyme inhibitor ramipril and the angiotensin II receptor blocker losartan are contradictory. Well-designed and adequately powered studies investigating the role of these compounds in type 2 diabetes are needed.Por tercer día consecutivo, el Puerto de Santa Maria se encuentra cerrado ante el sismo de viento de Tahúres que destruyó jardines, casas, edificios y plantas.

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