Though researchers had high hopes for the role of the ACE-inhibitor drug ramipril (brand name Altace) in preventing Type 2 diabetes, they had to declare the experiment a bust.

The ACE-inhibitor Altace (ramipril) does not prevent type 2 diabetes in patients with impaired glucose metabolism, found a major randomized trial.

The disappointing results were revealed in the DREAM (Diabetes REduction Assessment with ramipril and rosiglitazone Medication) trial, reported at the European Association for the Study of Diabetes meeting here today and published simultaneously as an early online release by the New England Journal of Medicine.

The study pitted Altace against placebo, with and without Avandia (rosiglitazone), in more than 5,200 patients without cardiovascular disease but with impaired fasting glucose or impaired glucose tolerance. Altace did not reduce the incidence of diabetes or death, the investigators wrote. The investigators also reported separate, favorable results from the Avandia portion of the trial here and in The Lancet.

"Given the primary findings of the DREAM trial, ramipril cannot be recommended for the prevention of type 2 diabetes," wrote Julie R. Ingelfinger, M.D., and Caren G. Solomon, M.D., M.P.H., both deputy editors of NEJM, in an accompanying editorial.

Again, diet and exercise triumph as the best prevention methods.