What is the evidence for the use of ACE-Is and ARBs in patients with diabetes and albuminuria? 
The available data are consistent, suggesting the effects of both classes of agents are likely to be similar. For cardiovascular protection in patients with diabetes, the evidence largely points to ACE-Is. A 2004 meta-analysis concluded that there was insufficient evidence on the relative effects of ACE-Is versus ARBs on survival. However, extrapolations within and between drug classes must be made with care: within-class effects on hard outcomes may differ substantially and may depend on the dose, making extrapolation to other drug classes problematic. We were unable to find trials directly comparing ACE-Is and ARBs in patients with diabetes and albuminuria.