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Management of Diabetes in Hypertension

Management of Diabetes in Hypertension

Nearly 60% of people with Type 2 diabetes have hypertension, and people with both hypertension and diabetes face a high risk of cardiovascular and kidney disease. Patients with diabetes should have blood pressure levels less than 130/80 mmHg and low-density lipoprotein cholesterol levels < 100 mg/dL (2.60 mmol/L). If left uncontrolled, diabetes and hypertension are a dangerous combination.

Initial treatment goals for diabetes-related hypertension include:

Weight loss

There is a general association in people with diabetes between weight reduction and a reduction in blood pressure, but there is great variability in the response. Reduction in blood pressure can occur with a modest amount of weight loss.

Evidence demonstrates that structured, intensive lifestyle programs involving participant education, individualized counseling, reduced dietary fat and energy intake, regular physical activity, and frequent participant contact are necessary to produce long-term weight loss of as much as 5-7% of starting weight fat is probably the most important nutrient to be restricted. Spontaneous food consumption and total energy intake are increased when the diet is high in fat and decreased when the diet is low in fat. Exercise by itself has only a modest effect on weight loss. However, exercise(30-45 minutes for most days ) is to be encouraged because it improves insulin sensitivity, acutely lowers blood glucose, and is important in long-term maintenance of weight loss. Weight loss with behavioral therapy alone also has been modest, and behavioral approaches may be most useful as an adjunct to other weight loss strategies. However, optimal strategies for preventing and treating obesity long-term have yet to be defined.

The available data suggest that weight loss medications may be useful in the treatment of overweight persons with type 2 diabetes. However, their effect is modest. Moreover, the available data suggest that these medications only work as long as they are taken and should be used in conjunction with lifestyle strategies. These drugs should be used only in people with BMI >27.0 kg/m2.

Although gastric reduction surgery can be an effective weight loss treatment for severe obesity (including severe obesity in persons with type 2 diabetes), this surgery should only be considered for patients with a BMI 35 kg/m2. There are no data comparing medical and surgical approaches to weight loss, and thus the relative benefits and risks of surgical approaches are uncertain. Therefore, gastric reduction surgery should be considered unproven in treating diabetes.

Smoking Cessation

Cigarettes provide the delivery system for nicotine, an addictive substance related to various pharmacological, biochemical, and psychological processes that interact to support a compulsive pattern of drug use.

The prevention and treatment of smoking should be a high priority for diabetes care providers. View all of the daily reasons to quit smoking.

Dietary Modifications

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Cut back on salt:


Alcohol Intake:

Potassium, Calcium intake:

Water Intake:

The ‘watch points’, particularly important for diabetics, are : saturated/animal fats, sugary, low-fiber foods and alcohol.

Monitor your blood sugar level

Blood glucose monitoring refers to home monitoring of blood glucose levels. This test uses a portable glucose monitor. Monitoring is done by the individual or a caregiver on a regular basis. Blood glucose monitoring is used for women who have diabetes. This includes individuals with type 1 diabetes, type 2 diabetes, and pregnant women with gestational diabetes.

The test is performed by pricking the finger with a sterile lancet, or pointed instrument, to get a drop of blood. This drop of blood is placed on the glass plate of a home glucose monitor. The monitor will give a reading of the blood glucose level. Some home monitors keep a computerized record of these readings. According to the National Institutes of Health, or NIH, Blood glucose level before meals should be 80 to 130 mg/dL and Blood glucose level at bedtime should be 100 to 150 mg/dL.

All tests should be done in clean and healthy environment. Keep complete and accurate records of your daily routine and your blood glucose levels. These records will help you with pattern management, which is a way to get more of your blood glucose values into your target range.


Diabetes sufferers should monitor their blood pressure carefully. The chances of heart disease, strokes or kidney disease are increased significantly for diabetics with hypertension. Dietary controls are often used in the treatment of both diseases. Prompt intervention is required to control high blood pressure in these circumstances, often by both medication and by the elimination of possible contributors to high blood pressure. Women with diabetes should keep their blood pressure below 130/85.

To sum up, Women with diabetes and high blood pressure should see their doctors regularly and follow these steps: eat foods to control blood sugar and salt intake, get 30 to 45 minutes of physical activity most days, quit smoking and limit alcohol intake, lose weight if needed, and take medications as prescribed by the physician. You can improve your health dramatically if you keep your blood sugar and your blood pressure under control.


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