I'm hoping someone can offer some advice on this for me.
I'm 25 and have been type 1 since I was 21. I've seen a few endos, internists, general practitioners and educators since then (some better than others). I recently moved and changed my PCP. He wants to start me on a low dose of Ramipril to protect my kidneys. I've never even heard of the drug before, and none of my doctors have ever suggested it.
I'm wondering if this is something I should consider, or if I should change my PCP again.
My A1C was below 6 last time I was checked. My blood sugar rarely ever sees a number above 150. I pay close attention to what I eat and exercise 90 minutes a day 5x a week (a mix of weight training, cardio and core strengthening). None of my test results were outside of normal range.
Also, those of you who are on the drug, what do you think of it?
I want to state up front that I am NOT a doctor and I recommend going to a physician to get advice.
Ramipril is an ACE inhibitor used generally to treat high blood pressure. Some studies suggested that high blood pressure is more damaging to the kidneys then just about anything else.
So you need to know what your blood pressure is. Is it high? If not I do wonder what help this drug will be. While I have never taken Ramipril I did take a similar drug for high blood pressure. It wasn't until my kidneys failed that I heard from my kidney guy of the effects of high blood pressure on my kidneys. In fact, since I went on dialysis none of my doctors even seem to be the least bit concerned about my blood pressure.
Go figure.
Best cause of action is to get educated and write down your questions and concerned and go back to the doctor.
Is your blood pressure high ? If not why bother your BG is better than the average american. I lived happily with ramipril for 10 years then the coughing period in the morning went over 1 hour so no more for me.
I was told by my GP that I should be on Ramipril(Altace) years ago because I was a long term Diabetic. My Endo disagreed since my tests results were good including my blood pressure.
I did go on the Ramipril for a while. Soon after, I couldn't eat more than half a meal daily, so of course I ended up losing weight. My Hubby was also very concerned that I was dizzy often and close to fainting a few times.
So I stopped taking it and found that it was the Ramipril causing my symptoms.
If a Diabetic has high blood pressure then they can decide to take these type of meds.
I am on Ramipril 1.25mg to protect my kidneys. I didn't want to go on this drug as I have had bad side effects with blood pressure pills in the past, but have to say I have had no side effects from this particular drug. I believe it is considered more a protective measure for diabetics than actually needed for high blood pressure.
it is the first time that i hear the existence of that drug. As the others suggested this is only if you have high blood pressure. My personal opinion is that since you are so well blood sugar controlled why to mix it with a drug that interferes with lowering blood sugar? I have diabetes for 39 years and my kidneys are fine, even though i do not have such a good diabetes control. Do you have kidneys problem?
Diabetes can be the cause of a lot of implications. If it were to take a tablet for any possible implication would be drug addicted all day. I prefer exercise. Personally i feel better if a take less medicines and doing more exercise
there's lots of studies out there showing the benefits of ace inhibitors for protecting the kidneys of type 1 diabetics. I think I've been taking them for maybe 30 years or more with no adverse effects and still have relatively decent kidney function.
Sorry, I meant to add that my blood pressure, like some others, usually fluctuates between 94/60 - 122/80. I've been on infusions for many years that can dangerously increase or decrease my blood pressure. That is another reason why my Endo disagreed with using Ramipril and similar meds.
You seem very fit, active, healthy and great numbers. Most of the comments on here are from type 2's who usually are put on ACE inhibitors as they have other metabolic issues, a metabolic syndrome (type 2), rather than an autoimmune disease, as is type 1 (what we have). Unless your blood pressure is high, I'd say no. Did you ask your new doctor why? Did/do you have protein in your urine? I too am a very fit, active type 1 and discussed this with my endo and endo prior, no endo - doc has ever advised or mentioned an ACE inhibitor to me, in fact just the opposite (no need for one), as I have great BP and cholesterol, vitals etc...I wouldn't take it if I were you unless you have high BP. Good job with your numbers and A1C's..:)
My doctor gives seminars and mentions the side effect of dry coughing typical of ACE inhibitors. He also says the body will try to increase the blood pressure to a level it needs to get the blood flow going properly. He said notice what type of shower you can have if the water dribbles out. So, he said, since these drugs, plus pharmaceutical diuretics which are also often used to lower BP, cause the body to release water from the kidneys so forcefully that the kidneys lose their ability to selectively retain the nutrients like magnesium that is needed in the body to relax arteries, so it is counterproductive. It is better to take magnesium. My GP uses nutrients in his therapies, but said that in the 1970's U. of Toronto medical school there was only one optional 3 hour course and he did take it. So imagine all the other doctors who know even less. He continues his education constantly. That's why I like him. He's been my GP for 13 years and I have an endo for 27 years and I've been T1 for 32 years with excellent kidney function and a perfectly functioning liver, all because I started to research and use supplements in 1986. I'm 56 with having had perfect blood pressure my whole life.
Whoever you live with would also be disturbed by the side effect of the dry cough because they would have to listen to it and people often feel miserable when their loved ones sound sick. I would say, go the rout of researching on the Internet. I can recommend books you could find at the library.
Vitamin E of a natural form also brings down BP plus acts as a wonderful antioxidant. It costs me 5c per capsule and I use up to 4 per day. Plus magnesium....to relax arteries.... here is a good tip: if you put epsom salts in warm water and soak you feet the body will absorb just the right amount of magnesium from the epsom salts that it wants. So after you exercise, if you like to watch TV or read, then just soak your feet. Epsom salts can be bought in even 2 kilo bags for about $10 as lots of people use it for spa treatments at home. It's good that it is also great for your health. It will help in many ways as magnesium is used in over 300 body processes.
I did end up with a high potaasium level ...2 blood tests at the Lab . After 30 years living with d , no complications I choose to discontinue taking Ramipril. I believe there are other BP meds available .I was not taking any of the items as mentioned in the next sentence " The use of ACE inhibitors with potassium supplements, salt substitutes or diuretics (for example, spironolactone [Aldactone] that increase potassium in the blood may lead to excessive potassium levels. Potassium levels should be monitored whenever ACE inhibitors are used in combination with these drugs " . I think we need to keep in mind one's own history and that of close relatives .
My endo see's no need for me being on any ace inhibitor on cholesterol medications just because...my bp is excellent and so are my cholesterol and kidney function. I've been type 1 for close to 30 years.
I want to thank everybody for their input. I probably should have stated in the beginning that no, I do not have high blood pressure. I am going to discuss this with my GP when I see him again in 3 months. I will also have another round of blood and urine analysis to confirm all of my levels. If he is still insistent upon the Ramipril, perhaps I should find another GP. I couldn't help but notice he was visited by 2 drug reps while I was in the waiting room. It just doesn't seem wise to take medication I do not need.
My 20 year old son was prescribed the lowest dose 5mg for the same reason to protect his kidney's. His random urine tests more often than not show that he spills protein into his urine. This issue never shows up on a 12 hour collection, just the small pee in the cup random tests that are done with bloodwork for his endo to review. His pediactric endo had always requested a 12 hour collection when the random protein in urine results were high and always put it down to him being very athletic, as hard workouts can cause protein to spill over into one's urine. His adult endo did not like the random results. She did not order 12 hour collections. She explained this to us using the following analogy. She likened the surface of the kidney to a thin rubber coating on a ball and that protein in the urine is protein that normally flows over the rubber coating. In my sons situations, the rubber surface is being pitted as protein in pushed through the surface, and through the kidney and then expelled from the body via one's urine. Whether exercise induced or not, she does not care, as she does not like to see any undue pressure on the kidneys. Some blood pressure testing at clinic visits are above normal and my son was monitored on more than two occassions with a 24 hour blood pressure system, which confirmed that he does not have high blood pressure even though he does experience elevated blood pressure in situations that cause him a little stress. So last endo visit after three months of 5mg of rampiril, they upped the dose to 10mg of rampiril and while I know his blood pressure from monitoring at home is now, not just good, but on the low side, I'll be interested in the albumin creatinine results when he has his labwork done next week.
To Steve, you're right about that. My GP says he could eat out everyday with drug reps. Since you are luckily young and were only diagnosed in 2010, I want to say again that as soon as my endo told me in 1986 that T1s once diagnosed will be completely dependent within 5 years, it struck me so much as I was at that point at 5 years and far from dependent yet, so I redoubled my efforts at learning about supplements and it has done me a great deal of good. I cured a serious case of neuropathy 10 years ago. My liver is in top working order and my kidneys have been fine all along. I read books written by doctors and other professionals. Here is a title of a book well worth reading "What Your Doctor Doesn't Know About Nutritional Medicine May Be Killing You" by Ray D Strand M.D. (2007)
My doctor suggested a medication for kidney protection. I at first said no because I've had no problems with kidneys and take enough meds. He was fine with that. Then I thought about it and asked if there were any side effects and he said no and that it was a small dose. The medication I'm taking is Benazrapril. I guess at this point in my life I'm willing to take one side effect-less pill to make sure I don't have kidney problems; what's the harm? But if I'd said no and my doctor pushed or insisted I probably would have been very unhappy with my choice of doctor.
If you have high (or even borderline high) BP, I would take it. You seem healthy by what you are saying. Personally, I am against taking drugs unless you have to. It's expensive and can lead to side effects and other things. Even relatively benign drugs can carry some risk.
Ramipril and Benazepril are both ACE inhibitors that treat high blood pressure. They are also used to treat congestive heart failure, diabetic neuropathy and to help protect kidneys from harm due to diabetes.
I think my son was prescribed Ramipril over one of the other ACE inhibitors as it is available in a very small dose. I thought he was initially prescribed 5mg and bumped to 10mg, but it was actually 2.5mg and bumped to 5mg.
Being only 20 years of age, his pharmacist asked me why it was being prescribed and when I told her that it was being prescribed to protect his kidneys as he does show protein in many of his randome urine samples, she told me that Ramipril was a good choice then for that purpose. She said that she'd have definitely chosen Ramipril first over another ACE inhibitor for him.
