Introduction: The purpose of this project is to review trials testing the effectiveness of various angiotensin-converting enzyme inhibitors (ACE inhibitors) in patients with type 2 diabetes mellitus (DM) to prevent cardiac complications.

Background: Just as aspirin has prophylactic benefits for the cardiovascular system, antihypertensives reduce the mortality in persons with diabetes. Since patients with type 2 DM are at risk for developing nephropathy, ACE Inhibitors are chosen owing to their protective effects on kidneys. If hypertension in people with type II diabetes is not adequately controlled by antihypertensives, there is a greater risk of developing microvascular and macrovascular complications. ACE inhibitors have been shown to significantly reduced hypertension and have the potential to significantly improve the quality of life and increase life expectancy in patients with type 2 DM.

Methods: A review of literature in studies of DM patients treated with antihypertensives, and specifically ACE inhibitors, was conducted. Literature was identified through a focused search utilizing the Ovid Medline and EBM Reviews-Cochrane Database. Keywords used were diabetes combined with antihypertensives. The keyword ACE inhibitors was also used to focus the search.

Implications for Practice: Randomized controlled trails and cohort studies showed that specific interventions are effective for preventing and treating macrovascular and microvascular complications in patients with type 2 DM. Studies showed that ACE inhibitors independently reduce renal disease progression in type 2 diabetes. The CNS can impact all 3 spheres of influence: nurses can be instructed about the benefits of ACE inhibitors; the CNS can inform the organization through committee work and implement a policy incorporating ACE inhibitor use; and the patient will be impacted when the CNS educates about ACE inhibitors.