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A randomised controlled trial for the evaluation of risk for type 2 diabetes in hypertensive patients receiving thiazide diuretics: Diuretics In the Management of Essential hypertension (DIME) study Ueda S, et al. BMJ Open 2014;4 Thiazide diuretics are one of the first choice antihypertensives but not optimally utilised because of concerns regarding their adverse effects on glucose metabolism. The Diuretics In the Management of Essential hypertension (DIME) study was designed, for the first time, to assess the risk for type 2 diabetes mellitus in patients with essential hypertension during antihypertensive treatment with low-dose thiazide diuretics compared to those not treated with diuretics. Objectives Multicentre, randomised, controlled. started in 2004 and finished in 2012. Setting: Hypertension clinics at 106 sites in Japan,including general practitioners’ offices and teaching hospitals. 1130 patients were allocated. median follow-up of 4.4 years. Participants: Non-diabetic patients with essential hypertension. Design aged 30–79 years at randomisation, either untreated hypertension with systolic blood pressure of 150 mm Hg or more, diastolic blood pressure of 90 mm Hg or more, or both; or treated hypertension with systolic blood pressure of 140 mm Hg or more, diastolic blood pressure 90 mm Hg or more, or both. Patients were excluded if they had type 2 diabetes, gout, systolic blood pressure of 200 mm Hg or more, diastolic blood pressure of 120 mm Hg or more, hypokalaemia (3.5 mmol/L),erectile dysfunction, renal dysfunction (serum creatinine levels of 2.0 mg/dL or more), history of stroke or myocardial infarction within 3 months, history of revascularisation of coronary arteries within 6 months, heart failure or left ventricular dysfunction (ejection fraction 40%),history of serious adverse reaction to thiazide diuretics,or history of malignant tumour within 5 years. Patients who were pregnant, breastfee
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