Findings from the MAPEC trial in Spain were recently published in Diabetologica. Hermida and colleagues had previously reported their finding that antihypertensives taken at bedtime significantly reduced the number of cardiovascular and cerebrovascular events in patients whose BP did not drop at night as expected (“nondippers”).

The current study followed 2012 hypertensive patients and 644 normotensive patients for an average of 5.9 years. The 190 patients who developed type 2 diabetes were more likely to be “nondippers” (which required ambulatory BP evaluation).

A second study looked at the same 2012 hypertensive patients, the timing of their antihypertensive medications (morning vs night) and the risk of developing type 2 diabetes. “Nondipping” occurred less often in patients who took their BP medication at night and the risk of developing diabetes was lower in those patients who took their antihypertensives at night time.

There was significantly less risk of developing diabetes with evening vs morning dosing of ACE inhibitors and beta blockers (mostly nebivolol), but not with calcium channel blockers, alpha blockers or diuretics.