None of the sites I researched list diabetes as a side effect of
Cardace. Neuropathy and paresthesia are listed however, which may
contribute your cold sensitivity. Other than elevated blood glucose, I
see no evidence that Cardace causes diabetes. In fact, one study of
over 9,000 patients, Ramipril (Cardace) was found to REDUCE the
incidence of diabetes. Drugs like Ramipril can help diabetics avoid
diabetic kidney damage.
Has your doctor ordered a glycosylated hemoglobin (HbA1C) test on
you? This can help determine your blood glucose over a period of
time, as opposed to a random, a post prandial or fasting glucose. Do
you have family members with diabetes? Has your doctor diagnosed you
as a diabetic? Are you taking insulin or medication? Diabetics are
prone to high blood pressure.
If you are now diabetic, it is unlikely that Cardace was the cause.
?Patients on ramipril had a 30% lower risk of developing diabetes,
making it the first drug ever to be effective in preventing the onset
Diabetes, Type 1 is not reversible. Type 2 can be controlled with diet
?The two major forms of diabetes are type 1 (previously called
insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes)
and type 2 (previously called noninsulin-dependent diabetes mellitus
(NIDDM) or maturity-onset diabetes).?
?? Over time, the pancreas becomes unable to produce enough insulin
to overcome resistance. In type 2 diabetes, the initial effect of this
stage is usually an abnormal rise in blood sugar right after a meal
(called postprandial hyperglycemia). This effect is now believed to be
particularly damaging to the body.
? Eventually, the cycle of elevated glucose further impairs and
possibly destroys beta cells, thereby stopping insulin production
completely and causing full-blown diabetes. This is made evident by
fasting hyperglycemia, in which elevated glucose levels are present
most of the time.?
"Patient education is essential to help persons with diabetes achieve
glycemic control, but care should be taken initially to avoid
overwhelming the patient and family with information. This article
discusses the management approach during the early days and weeks
following the diagnosis of diabetes."
"During the early period following diagnosis, the support of a social
worker or psychologist may occasionally be helpful. The patient should
be asked about stressors at home or work to elicit information that
would suggest the need for appropriate referral. Initial assessment
should also address the patient's health care beliefs, educational
level and cultural background. Support systems and financial
circumstances, as well as lifestyle and eating habits, are important
Diabetes Learning Center
Cardace is an ACE inhibitor, a class of blood pressure
?Ramipril belongs in a class of drugs called angiotensin converting
enzyme (ACE) inhibitors which are used for treating high blood
pressure and heart failure and for preventing kidney failure due to
high blood pressure and diabetes. Other ACE inhibitors are enalapril
(Vasotec), quinapril (Accupril), captopril (Capoten), fosinopril
(Monopril), benazepril (Lotensin), lisinopril (Zestril, Prinivil),
moexipril (Univasc) and trandolapril (Mavik). ACE is important because
it produces the protein, angiotensin II. Angiotensin II contracts the
muscles of most arteries in the body, including the heart, thereby
narrowing the arteries and elevating the blood pressure. In the
kidney, the narrowing caused by angiotensin II also increases blood
pressure and decreases the flow of blood. ACE inhibitors such as
ramipril lower blood pressure by reducing the production of
angiotensin II, thereby relaxing the arterial muscles and enlarging
?ACE inhibitors may slow the progress of diabetic kidney disease in
middle-aged persons with type 2 diabetes. Some (but not all) experts
have therefore recommended giving ACE inhibitors to all middle-aged
type 2 diabetics.?
Historically, it is interesting that the ACE inhibitors were
originally developed from the venom of a poisonous Brazilian snake.?
?High blood pressure (hypertension) is often associated with
diabetes and it poses a greater threat to people with diabetes than it
does to people without diabetes. This is because high blood pressure
is one of the major factors influencing nephropathy (damage to the
kidneys) and people with diabetes are already at a greater risk of
developing nephropathy. High blood pressure is also associated with
eye and cardiovascular disease, which are also high risk areas for
people with diabetes.?
?ACE Inhibitors also have no adverse effects on the rates at which
carbohydrate is broken down and used, unlike some other medicines. For
people with insulin dependent diabetes, small doses can be given which
protect the kidneys without drastically lowering the blood pressure,
which means that they can be given to people who do not have high
blood pressure but are showing signs of kidney damage. This may also
prevent increases in blood pressure in the future. This effect has not
been seen in people with non-insulin dependent diabetes but the fact
that ACE Inhibitors do not affect insulin resistance makes them a
useful way of controlling blood pressure for this group of people.?
?Drugs of this type include Captopril, Enalapril, Lisinopril,
Perindopril and Ramipril amongst others. All need to be started very
carefully, in small doses and then increased to achieve the best
effect for the individual. The doctor should then monitor the blood
pressure and urine three to six monthly to ensure there is no kidney
damage and may wish to carry out some blood tests, in the early stages
?These drugs can help people with diabetes reduce their risk of heart
attack, stroke, and premature death. They may also delay the onset and
progression of kidney disease. In addition, ACE inhibitors can help
reduce other complications of diabetes, such as foot ulcers and eye
damage (retinopathy). Retinopathy is the leading cause of blindness
for people with diabetes. They can help prevent diabetic complications
in people who do not have high blood pressure.?
Cardace, Altace (ramipril)
?SIDE EFFECTS: Ramipril generally is well tolerated, and side effects
are usually mild and transient. A dry, persistent cough has been
reported with the use of ramipril and other ACE inhibitors. Coughing
resolves after discontinuing the drug. Other side effects include
abdominal pain, constipation, diarrhea, rash, dizziness, fatigue,
headache, loss of taste, loss of appetite, nausea, vomiting, fainting
and numbness or tingling in the hands or feet. Ramipril and other ACE
inhibitors also may cause kidney failure and increased levels of
potassium in the blood. The most serious but, fortunately, very rare
side effects are liver failure and angioedema (swelling of lips and
throat that can obstruct breathing).?
?Since ramipril decreases aldosterone secretion, elevation of serum
potassium can occur. Potassium supplements and potassium-sparing
diuretics should be given with caution, and the patient?s serum
potassium should be monitored frequently?
?Elevations of liver enzymes, serum bilirubin, uric acid, and blood
glucose have been reported, as have cases of hyponatremia and
scattered incidents of leukopenia, eosinophilia, and proteinuria. In
US trials, less than 0.2% of patients discontinued treatment for
laboratory abnormalities; all of these were cases of proteinuria or
abnormal liver-function tests.?
?Elevations of liver enzymes, serum bilirubin, uric acid, and blood
glucose have been reported, as have cases of hyponatremia and
scattered incidents of leukopenia, eosinophilia, and proteinuria.?
?Osteoporosis Common in Diabetes Patients, on Thursday, June 17 @ 13:04:41 EDT
Australian doctors are urging clinicians to consider screening their
diabetic patients for osteoporosis.
Dr. Wendy Davis, from the University of Western Australia in
Fremantle, and colleagues, issued the recommendation following
research that found that previously unrecognized osteoporosis is
common in patients with diabetes.
She presented her findings at the 63rd Scientific Sessions of the
American Diabetes Association.
"The relationship between diabetes and osteoporosis appears complex,"
Dr. Davis said. "In type 1 diabetes, there is evidence of low bone
mineral density [BMD] at peripheral sites which is associated with
diabetes diagnosis before puberty, poor glycemic control, high insulin
requirements, and microvascular complications," she added. "In type 2
diabetes, there is normal or even increased BMD [bone mineral
?High dietary intake of potassium from fruits and vegetables
throughout one's life helps to preserve bone mass thereby preventing
bone loss that can lead to osteoporosis.?
Since Cardace increases serum potassium, it?s not likely that this
medication is the cause of your loss of bone density.
?Nevertheless, it is important to remember that men may also be at
risk for osteoporosis, especially if they have certain illnesses, a
low testosterone level, are smokers, take certain medications, or are
?First, we need to define just what osteoporosis is. It is a bone
condition defined by low bone mass, increased fragility, decreased
bone quality, and an increased risk for bone fracture. It is the most
prevalent metabolic bone disease in the United States.?
?Type 1 diabetes has long been associated with low bone density.?
?A third of men with type 2 diabetes have low testosterone levels, a
new study suggests.
Testosterone helps men reduce body fat and improves the way their
bodies handle insulin. So low testosterone levels may have serious
consequences for men with diabetes, suggests Sandeep Dhindsa, MD, of
State University of New York at Buffalo.?
Low testosterone can increase bone loss in men. Testosterone decreases as men age.
?Also men clinically diagnosed with hypogonadism consistently have low
bone density. Measurements of testosterone in men with hip fractures
show low levels of free testosterone. Bone biopsies from hypogonadal
men with osteoporosis show a high bone turnover rate, as compared with
eugonadal osteoporotic men.?
Osteoporosis can affect 1 in 12 men. ?These conditions include low
levels of the hormone testosterone (hypogonadism), long term use of
oral corticosteroid tablets, prolonged immobility, excessive alcohol
intake and malabsorption of essential minerals and vitamins due to
other medical conditions e.g. Crohns disease, after major surgery on
the stomach and also coeliac disease.?
?Hypogonadism is a lack of the male sex hormone testosterone, which is
made in the testes (both testicles).
Hypogonadism in men can be due to a problem with the testes
themselves or the pituitary gland, which controls the hormone systems.
Disease or damage to the testes may stop them from responding to the
stimulation from the pituitary gland. This includes genetic disorders
of the testes e.g. Klinefelters syndrome, inflammation of the testes
(orchitis), radiation or chemotherapy and alcohol abuse. Removal of
both testicles, injury to both testicles and undescended testicles are
all causes of hypogonadism.?
?The risk of osteoporosis increases as a consequence of declining
testosterone levels that occur with increasing age, and the coincident
decrease in BMD. In men with hypogonadism, BMD is generally low, and
can be improved with testosterone replacement therapy. However, there
are no prospective studies on fracture prevention with testosterone
supplementation either in patients with established hypogonadism, or
the broader group of elderly male patients without diagnosed
hypogonadism.27 In one randomized study of changes in BMD of the
lumbar spine among 108 men over the age of 65 years, who were
randomized to receive either a testosterone or placebo patch for 36
months, BMD did not increase among those men with normal pretreatment
testosterone levels (400 ng/dL), while among those with a low
pretreatment testosterone level (200 ng/dL or less), the testosterone
therapy was associated with an increase in BMD.?
I hope this has helped you. Please read over each posted site ? I
am unable to post complete articles due to copyright protection. If
you will reply to my clarification regarding the second drug, I can
research it further for you.
It appears that you may (note - **MAY** ? you can not be diagnosed
online!) have developed diabetes, but it is not likely that the
Cardace precipitated it. It appears coincidental.
*If* you HAVE developed diabetes, it is not reversible. If you have
developed Type 1, you will need to be tested further and placed on
insulin. Type 2, as I stated earlier, can usually be controlled by
diet and exercise, or if not, oral tablets can be prescribed ? no
insulin injections needed. The silver lining is? if you actually have
diabetes, Type 1, learning so now can save your life! Starting
treatment can prevent diabetic episodes, kidney and heart disease!
This answer is for information purposes only and is not intended to
diagnose or replace medical advice from a licensed physician.
If any part of my answer is unclear, please request an Answer
Clarification, and allow me to respond, before you rate this answer. I
will be glad to assist you further, on this question, before you rate.
I wish you good health!
Hypertensive drugs + list
ACE inhibitors + osteoporosis
ACE inhibitors + diabetes
Cardace + side effects
Cardace + diabetes
Diabetes + osteoporosis
Testosterone + osteoporosis
Clarification of Answer by
19 Jan 2006 11:07 PST
I did note the "H", but had wrongly assumed it was a typo or
stood for a brand name. This is the reason I asked for your country,
and a clarification! Often, a reasearcher and a customer need to
maintain a dialogue in order to impart information on both sides, to
allow for a complete answer.
As I noted in my original answer, nothing will reverse diabetes.
If a medication causes a transient rise in glucose levels, stopping
the drug usually returns the levels to normal. However, if it is a
true diabetes, nothing will reverse or cure it. It also appears very
unlikely that Cardace H has caused you to develop diabetes. Please
I found on a site from India thet the "H" stands for
"Hydrochlorothiazide". It is a diuretic, what some people call a
"water pill". Many people who have elevated blood pressure retain
fluid, and the "H" helps rid the body of excess fluid. Excess fluid
makes it harder for the heart to pump - not good for people with high
Researching hydrochlorothiazide and diabetes, I find:
Side effects include:
Frequent urination should go away after you take hydrochlorothiazide
for a few weeks. Tell your doctor if any of these symptoms are severe
or do not go away:
* muscle weakness
* stomach pain
* upset stomach
* loss of appetite
* hair loss
If you experience any of the following symptoms, call your doctor immediately:
* sore throat with fever
* unusual bleeding or bruising
* severe skin rash with peeling skin
* difficulty breathing or swallowing
" If you have diabetes hydrochlorothiazide may affect your blood sugar
levels. Test your urine or blood regularly and report any extreme
changes to your doctor.
# Hydrochlorothiazide may cause your skin to become more sensitive to
sunlight than it is usually. Try to avoid bright sunlight and sunbeds
or use a sun cream higher than factor 15 until you know how your skin
# ake hydrochlorothiazide exactly as directed by your doctor.
# Always read the manufacturer's information leaflet, if possible,
before beginning treatment.
# Hydrochlorothiazide will make you urinate (pass water) more often,
so your doctor or pharmacist will usually advise you to take your dose
in the morning so as not to disturb your sleep. If you take more than
one dose per day, take the last dose before 6pm in the evening.
# Never take more than the prescribed dose. If you suspect that you or
someone else has taken an overdose of hydrochlorothiazide contact your
doctor or go to the accident and emergency department of your local
hospital at once. Always take the container with you, if possible,
even if it is empty.
# Hydrochlorothiazide is for you. Never give it to others, even if
their condition appears to be the same as yours."
Note that every site advises you to tell your doctor if you are
diabetic before starting the "H" medicine. This is so the doctor has
you monitor your blood glucose extra vigiantly.
This site clearly explains the relationship between
hyperglycemia(elevated glucose level) and hydrochlorothiazide. Note
the comment that the "H" drug itself does not cause hyperglycemia, but
prevents diabetes medication from working effectively. You do not say
you are on insulin or oral medication for diabetes.
So, unless you are a diabetic already taking medication, Cardace H
does not CAUSE diabetes. Thye "H" may cause elevated glucose in those
taking insulin or pills.
If you have developed diabetes, and are taking insulin or pills, you
should either stop taking Cardace H and/or monitor your blood glucose
more often and adjust your medication accordingly.
Your doctor will weigh the benefits of keeping you on Cardace H versus
the effects it may cause. If you do NOT have diabetes, Cardace H will
not cause it. There are numerous other blood pressure medications, and
often patients go through a trial and error process in order to find
the correct one for them.
If you truly feel this medication has caused you to have
hyperglycemia, have your doctor prescribe a different medication for
Again please consider:
Cardace H will not cause diabetes, but can raise blood glucose levels in diabetics
The disease Diabetes, is irreversible. I noted that in my answer.
There are millions of diabetics, the world around, that wish it was
You can't be diagnosed online - I do not know what other medications
you are taking, or your medical history.
If you need further assistance on this question, please clarify the following:
In which country do you live?
Have you already been diagnosed with diabetes?
Do you take insulin or oral medication?
What is the seond medication you posted? The one starting with A.
Could it be Analog - a pharmaceutical term for a chemical form of
drug? If you live outside of the US, your country may put analog on
Different countries use different terminology, which is why it is
important to let us know where you live. (Country only).
I hope this clarification has been useful to you.
Again, please request another clarification, and allow me to respond,
before you rate, if you need further assistance.
Clarification of Answer by
19 Jan 2006 21:41 PST
In my last clarification I gave you lots of information on
hydrochlorothiazide, a diuretic. Note that your pamphlet states it
*may* lower glucose tolerance. This is not diabetes. Your pamphlet
goes on to say it is harful to diabetic patients. A previously latent
diabetes mellitus may become manifest at this time indicates this
druga may have triggered your dormant diabetes. The diabetes would
still be ireversible.
"Latent Autoimmune Diabetes in Adults (LADA), Slow Onset Type 1 and
Type 1.5 are all names for a type of diabetes diagnosed in adulthood.
It is caused by an immune system attack on the beta cells of the
pancreas, which are responsible for producing insulin. Patients with
LADA generally have the following characteristics: slender/physically
fit appearance, rather than overweight, little or no resistance to
insulin, do not immediately require insulin for treatment, test
positive for antibodies that attack beta cells, called GAD65
antibodies, do not respond to medications used to reduce insulin
resistance, do respond to medications that stimulate insulin
production, slow digestion of carbohydrates and decrease excess
glucose production by the liver. LADA can be misdiagnosed because
patients may initially respond well to oral therapy, similar to a Type
2 patient. Unlike Type 1 patients who require insulin immediately,
LADA patients may achieve normal glucose levels for a few years before
insulin is needed."
"This subgroup is referred to as latent autoimmune diabetes in adults
(LADA). LADA is a slow, progressive form of type 1 diabetes. Of all
the patients with diabetes, only approximately 10% of the patients
have type 1 diabetes and the remaining 90% have type 2 diabetes."
You more than likely would have developed diabetes anyway. The drug
only brought about the symptoms. Latent mean it it slow developing
LADA (latent autoimmune diabetes in adults)
"LADA, a disease characterized by immune markers typical of type 1
diabetes but that initially does not require insulin (1).
Patients with LADA have several features of both type 1 and type 2
diabetes (table 1). Like patients with type 1 diabetes, they have a
positive test for pancreatic autoantibodies, which indicates the
autoimmune nature of the disease. Among these antibodies are glutamic
acid decarboxylase antibodies, islet cell antibodies, insulin
autoantibodies, and tyrosine phosphatase antibodies (3). Like patients
with type 2 diabetes, patients with LADA do not require insulin
initially and may, to a variable degree, have insulin resistance. "
"It is logical to start screening for LADA by measuring glutamic acid
decarboxylase antibody levels. However, in cases of increased
suspicion of LADA despite a negative test for glutamic acid
decarboxylase antibodies, measurement of the other antibodies can help
establish the diagnosis. After LADA is confirmed, it is also useful to
measure levels of C peptide (a marker of pancreatic beta cell
function), which can help identify the degree of beta cell destruction
and direct management. (For example, a patient with a low C-peptide
level will not benefit from a medication that stimulates insulin
I apologize for the miscommunications, but that's the purpose of the
answer clarification process. Had you answered my own clarifications,
we may have arrived at an answer sooner.
Good luck, and I'd recommend visiting a very good endocrinologist and
being thoroughly. You never let me know if you were on insulin or
pills, or if you have already been diagnosed. In any case, sadly,m
once you have diabetes, you will have it. It can only be monitored and
treated, not cured.