How should we treat patients with primary aldosteronism to prevent new-onset diabetes mellitus?

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Previous clinical reports have revealed that primary aldosteronism is a possible cause of glucose intolerance and might be a cause of diabetes mellitus [1–3]. However, a long-term, large-scale observation study examining the onset of diabetes mellitus among patients with primary aldosteronism has not been conducted, and data related to treatment options, including surgical and pharmacological interventions, are particularly lacking. Previous basic studies have demonstrated that aldosterone not only controls blood pressure and electrolyte balance, but also is involved in glucose metabolism [4]. Although these basic studies clarified the molecular mechanism of glucose metabolism at high aldosterone levels, clinical trials to elucidate the involvement of new onset of diabetes mellitus (NODM) are lacking and the effects of therapeutic options to prevent NODM in patients with primary aldosteronism remain controversial.

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