Like many African Americans, Robert Coker has adult onset or type two diabetes; he’s known so for at least ten years now. But he’s always felt fine. “Diabetes is like a silent killer, you really don’t get much symptoms. Unless your blood sugar is way up or way down,” says Robert. Or, you finally find out when complications set in, like kidney failure, or a heart attack.
And even heart attacks in diabetics can occur quietly, without any symptoms whatsoever! That’s why Robert knows he needs to be vigilant with his medications and diet. “If want to stay around here I got to continue with what I got to do,” he says. And one of the most important things diabetics like Robert needs to be on is either an ace-inhibitor or an angiotensin receptor blocker...they’re closely related in how they work.
“To be honest with you I don’t know what an ACE-inhibitor is. So you will have to explain that to me,” Robert states. These are drugs like captopril, vasotec, lisinopril, there are others. The angiotensin receptor blockers, the ARB’s, the newer kids on the block, include atacand and cozaar, among others. One major study found 92% of diabetics had at least one of the indications for ACE-inhibitor or ARB use.
In other words, pretty much every diabetic should be on one of these medicines. Dr. Sandy Baldwin, head of the primary care clinic at North Shore University Hospital, says, “Even in the absence of protein urea, or protein in the urine there is evidence now that says all diabetics should be on this as primary prevention of kidney disease and some would even argue cardio-protective as well.”
The drugs will lower one’s risk for heart attack, stroke, kidney failure, and death from all causes, including cardiovascular deaths. Yet, research has shown that only 4 in even ten are being prescribed the medicines. Whatever the reason, the failure to prescribe and use ace-inhibitors in particular has created a huge concern among health care experts. “If diabetics are not aggressive treated—this is one group of patients who we need to be proactive for the majority of the time.
Pro-activity is the best, I think it gets us the best results. If left untreated their diseases can be fatal or certainly severely disabling,” states Dr. Baldwin. Robert says, “I think it is very important for me to look into ACE inhibitors and that is what I’m going to do!" If you have diabetes, or are with someone who is diabetic or even pre-diabetic, please go to your doctor and ask him or her about being prescribed an ACE-inhibitor.