The DREAM (Diabetes Reduction Assessment With Ramipril and Rosiglitazone Medication) Trial

Inclusion Criteria: * impaired glucose tolerance (FPG \< 7 mmol/L or 126 mg/dL AND 2 hr PG \>= 7.8 mmol/L and \< 11.1 mmol/L (140 mg/dL and \< 200 mg/dL)or, * isolated impaired fasting glucose (FPG \>= 6.1 mmol/L and \< 7 mmol/L (FPG \>= 95 mg/dL and \< 126 mg/dL) AND 2 hr PG \< 7.8 mmol/L (140 mg/dL). Exclusion Criteria: * current use of an ACE-inhibitor (ACE-I) or thiazolidinedione(TZD) * known hypersensitivity to ACE-I * prior use of anti-diabetic medications (with the exception of during pregnancy) * use of systemic glucocorticoids or niacin * congestive heart failure or EF \< 40% * existing cardiovascular disease (previous MI, stroke, angina, uncontrolled hypertension) * diabetes * renal or hepatic disease * major illness * use of another experimental drug * pregnant or unwilling to use reliable contraception * major psychiatric disorder * diseases that affect glucose tolerance * unwillingness to be randomized or sign informed consent * known uncontrolled substance abuse * inability to communicate with research staff