Abstract
Angiotensin receptor blockers (ARBs) play an important role in regulation of blood pressure.Telmisartan(Tel.) and Irbesartan(Irb.) are structurally quite different than older ARBs (Valsartan,Losartan) and could function as selective peroxisome prolifarator activated receptor gamma( PPAR gamma) agonist to increase insulin sensitivity .They could be very useful in treatment of coexisting type II diabetes and hypertensive.
In animal model of insulin resistance (10% fructose for 5 weeks),treatment with either Tel. (5 mg/Kg/day)or Irb. (50 mg/Kg/day)during last 2 weeks of induction of insulin resistance improved serum levels of glucose, Triglycerides(TG) total cholesterol (TC),high density lipoprotein (HDLc),low density lipoprotein (LDLc) and hypertension. Tel. but not Irb .has significant effect on increased body weight. The improvement of insulin sensitivity by Tel. and Irb. may be through multiple mechanisms : including strong binding affinity and slow dissociation to angiotensin receptor( AR), acting as partial agonist on PPAR gamma receptor which may affect glucose and lipid metabolism, attenuate serum adiponectin which was recognized as marker of PPAR activation .The later may have potential effect on adipocyte differentiation, increase NO generation which result in increase in skeletal blood flow, decrease in sympathetic activity, enhancing insulin signaling and increase sensitivity of peripheral cell to insulin.