In this study we aimed to examine the effect of losartan, the prototype of type 1 angiotensin II receptor antagonist, on adrenal steroidogenesis and glucose metabolism in diabetic patients. Ten female patients with Type 2 diabetes mellitus, aged 60.5±8.4 years (range 51-73 years) were studied. The study consisted of an 8-week 50 mg/day losartan therapy. Before treatment and in at two-weekly intervals clinic visits heart rate and blood pressure measurements were taken and serum glucose, fructosamine, urea, creatinine, sodium, potassium, uric acid, AST, ALT, total and HDL cholesterol, triglyceride, ACTH, DHEA-S O4, androstenedione, 17-OH progesterone , aldosterone, and plasma renin activity levels were assayed. Basal and synacthenstimulated adrenal steroidogenesis were evaluated before and at the 8 th week of losartan treatment. Losartan produced a significant decrease in both systolic and diastolic blood pressures. There was no statistically significant difference between biochemical results before and after the therapy. Serum cortisol levels after ACTH stimulation displayed an almost equal elevation in pre and post-treatment periods. We conclude that the angiotensin II receptor blocker, losartan, at a dosage of 50 mg once daily was significantly effective in decreasing both systolic and diastolic blood pressure and can be used safely in diabetic patients. We also demonstrated that losartan does not have any detrimental effect on adrenal steroidogenesis.
Keywords: Losartan, Steroidogenesis, Type 2 Diabetes Mellitus, Hypertension