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For most people, recommendations are to reduce blood pressure to less than or equal to somewhere between 140/90 mmHg and 160/100 mmHg. [2] In general, for people with elevated blood pressure, attempting to achieve lower levels of blood pressure than the recommended 140/90 mmHg will create more harm than benefits, [3] in particular for older people. [4]
This is because they have been associated with increased risk of new-onset diabetes and as such are recommended for use in patients over 65, for whom the risk of new-onset diabetes is outweighed by the benefits of controlling systolic blood pressure. [8] Another theory is that they are off-patent and thus rarely promoted by the drug industry. [9]
Secondly, high blood pressure is a silent disease and thus it is vital for all diabetics to regularly check their blood pressure or have it checked at a doctor's office on a regular basis. The American Diabetes Association recommends that all diabetics get their blood pressure measured by a health care professional at least 2-5 times a year. [94]
Sodium nitroprusside (SNP), sold under the brand name Nitropress among others, is a medication used to lower blood pressure. [3] This may be done if the blood pressure is very high and resulting in symptoms, in certain types of heart failure, and during surgery to decrease bleeding. [3]
Initial assessment upon diagnosis of hypertension should include a complete history and physical examination. The World Health Organization suggests the following initial tests: serum electrolytes, serum creatinine, lipid panel, HbA1c or fasting glucose, urine dipstick and electrocardiogram (ECG/EKG). [9]
The main goal of diabetes management is to keep blood glucose (BG) levels as normal as possible. [1] If diabetes is not well controlled, further challenges to health may occur. [1] People with diabetes can measure blood sugar by various methods, such as with a BG meter or a continuous glucose monitor, which monitors over several days. [2]
Although it must be used with caution in patients with impaired liver or kidney function, Metformin, a biguanide, has become the most commonly used agent for type 2 diabetes in children and teenagers. Among common diabetic drugs, Metformin is the only widely used oral drug that does not cause weight gain. [9]
For high blood pressure it is usually a first-line treatment. It is also used to prevent kidney problems in people with diabetes mellitus. [7] Lisinopril is taken orally (swallowed by mouth). [7] Full effect may take up to four weeks to occur. [7] Common side effects include headache, dizziness, feeling tired, cough, nausea, and rash. [7]
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