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Endocrinology


Answer 6
  1. Captopril administration. Angiotensin-converting enzyme (ACE) inhibitors, such as captopril, are considered the treatment of choice for hypertension in patients with diabetes mellitus. Although this patient’s high creatinine level is a cause for concern, it should not be considered a contraindication of captopril treatment. ACE inhibitors are the only category of medications proven, in several studies, to be protective for the kidneys of patients with diabetes. If renal function worsens and the ACE inhibitor needs to be discontinued, control of high blood pressure is most important, and any other category of medications can then be used. In the United Kingdom Prospective Diabetes Study, even beta-blockers were considered to be an acceptable treatment for hypertension.

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