Pressure in diabetes mellitus: the mechanism and causes of the development of pathology

Diabetes and blood pressure are closely related. Increased pressure in diabetes is the most common symptom. Due to fluctuations in glucose levels, the blood of patients acquires some viscosity, this causes fluctuations in blood pressure. All diabetics are recommended to regularly monitor blood pressure levels.

Increased pressure in diabetes

Metabolic disorders accompanied by chronic hyperglycemia are called diabetes mellitus. The pressure in this case, as a rule, exceeds the normal values. Due to the lack of insulin, the work of the circulatory system deteriorates, which leads to the emergence of other diseases. For example, hypertension develops.

Hypertension and diabetes mellitus are combined with each other and increase the mutual negative impact on human organs and systems. More than half of patients with diabetic disease of the second type have a history of increased pressure. First of all, the cardiovascular system suffers: the vessels of the brain, kidneys, retina. They lose elasticity and flexibility, which leads to an increase in pressure and the resulting complications.

Not less dangerously low pressure in diabetes. Such phenomena are more characteristic of women. Hypotension is more difficult to diagnose, since there are no signs at the initial stage. General disruption of well-being people do not give attention. This leads to a gradual disruption of the blood supply to the organs and the death of tissues.

Why hypertension develops

Even minor hypertension with diabetes mellitus adversely affects the body. Such patients are more susceptible to vascular atherosclerosis, myocardial infarction, and the development of stroke. In the initial period, the pressure in type 2 diabetes remains unnoticed due to the absence of symptoms. With the combination of two pathologies - diabetes and high blood pressure - you should pay attention to the factors that can aggravate hypertension:

  • atherosclerotic vascular changes,
  • endocrine disorders (thyroid, adrenal glands),
  • disorders of the nervous system, stressful situations,
  • increased exercise
  • age-related changes of the body,
  • nutritional errors,
  • overweight,
  • respiratory failure, sleep apnea,
  • lack of trace elements, vitamins,
  • the influence of harmful chemicals
  • genetic predisposition
  • harmful stereotypes.

Some factors can be considered both as the reasons for which there is high pressure in diabetes mellitus, and as the consequences of hypertension. Hypertension often appears before diabetes occurs. Blood pressure rises if abruptly abolish antihypertensive drugs. Therefore, to exclude such phenomena, drugs for pressure should be canceled in stages. Pressure in case of diabetes mellitus type 2 has a peculiarity to rise in the evening, which is taken into account in the diagnosis.

Main features

Hypertension in type 2 diabetics mostly occurs without specific symptoms. And such manifestations as an emerging headache, dizziness, vision loss are characteristic of many diseases. Type 2 diabetes is sensitive to salt. Sometimes, to get rid of high pressure, it is enough for a person to limit the amount of sodium chloride in dishes.

With insulin deficiency, hyperkalemia can develop - an increase in the content of potassium in the blood, in the intracellular or extracellular space.

It is common for a person to experience pressure fluctuations throughout the day - a decrease in performance at night and in the morning to 20%. Diabetic blood pressure at night may be higher than during the day. This happens because of the increase in blood glucose, the so-called diabetic neuropathy develops. The vessels lack the ability to respond to stress, time to narrow and expand. Patients are often forced to measure pressure during the day. It is important to determine the required quantity and hours with great accuracy when it is better to use pills for increased pressure.

Diabetes is characterized by orthostatic hypotension - this is a sharp drop in blood pressure due to a change in the position of the human body. If the patient gets up after lying down on his back, with reduced pressure, circles appear before his eyes, dizziness, fainting is possible. In addition, people complain of shortness of breath, lethargy and weakness, excessive sweating, cold limbs. Such people are dependent on changes in weather and atmospheric pressure.

Complications

Complications with a combination of diabetes and hypertension increase the risk of disability and death in 80% of patients. Such complications are mainly caused by disorders in the vascular system. To reduce the risk of developing pathology, the task of the attending physician is not only to stabilize the metabolism, but also to constantly monitor pressure.

Among the complications, diabetic kidney damage is more common. This is the pathology of the vessels supplying these organs. Diffuse or nodular atherosclerotic changes appear, leading to severe renal failure. And also hyperkalemia is a symptom of renal pathology. This further aggravates the condition of the entire vascular system and leads to impaired cardiac conduction.

In diabetes, hyperkalemia causes disturbances in the work of the neuromuscular apparatus, the peripheral circulatory system. Muscle weakness, paresthesia, flaccid paralysis of the arms and legs, diabetic foot, gangrene.

A dangerous complication is the damage not only of small peripheral vessels, but also of vessels of the brain and heart.

The risk of atherosclerosis, coronary heart disease, heart failure increases, more often a heart attack and stroke develops 3 times. Damage to the brain and retinal vessels leads to visual impairment and absolute blindness. More fully about the pathological changes in the body and the combination of two diseases can be found on the website Diabetes hypertension py.

Therapeutic aid

Treatment of hypertension in type 2 diabetes mellitus is carried out in parallel with therapy with drugs that lower sugar levels. The patient should understand that the struggle with two serious diseases at once is a long and difficult process, and often a lifelong one. Ways to get rid of diseases of hypertension, diabetes is banal simple. The main task is to change lifestyle:

  • body weight correction
  • rejection of bad habits,
  • feasible regular exercise,
  • healthy balanced diet.

Of course, you have to use drugs for pressure. The appointment must be made by a doctor, taking into account many factors. Sometimes, to achieve the effect, it is necessary to change the pressure medication several times, selecting the right agent and the right dose. Treatment of hypertension in diabetes mellitus begins with ACE inhibitors (angiotensin-converting enzyme), as well as prescribe any medication from the group of beta-blockers.

With type 2 diabetes, treatment is often complicated. It should be carried out with caution. Many pressure reducing medications contain sucrose in their composition, which can affect glucose levels. Diuretics are also used to reduce blood pressure, and some antihypertensive drugs already contain them. If hyperkalemia is found in a patient, diuretic drugs are used to reduce potassium accumulation. Hyperkalemia is characteristic of patients with renal insufficiency who take potassium-sparing diuretic.

If previously hypertension, aggravated by diabetes, was treated only with the help of antihypertensives, now diet therapy is one of the main effects. To stabilize blood sugar it is necessary to limit the consumption of foods with easily digestible carbohydrates. Fatty, fried, smoked and spicy foods should be excluded from the diet. In addition, the use of such food can cause gastritis.

Another development of hypertension due to the fact that people are gradually increasing the amount of salt in food. It should be remembered that some products already have hidden salt in their composition, so diabetics are forbidden to add food to the salt. A diet for hypertension should fill the body with micronutrients and vitamins. In the sufficient quantity in the menu there are vegetables and fruits, fish, vegetable oil. It is desirable to eat five times a day, the portions should be small.

Nutrition for hypotension should be strictly controlled by a nutritionist. On the one hand, hypotonic needs high-calorie, nourishing food, and on the other hand, such products can increase blood glucose levels in diabetic.

Pathogenesis, causes of pathology

In type 1 diabetes, the kidney is impaired due to microangiopathy (affection of small vessels) of the glomeruli. As a result, the protein is excreted in the urine. This condition is called proteinuria and is accompanied by an increase in blood pressure.

High pressure causes gradual dying off of the glomeruli. In the future, there is renal failure. In 10% of cases, hypertension is in no way associated with type 1 diabetes, but is a concomitant disease. In these patients, renal function is preserved.

In patients with type 2 diabetes, hypertension begins before diabetes or accompanies the disease. Kidney damage causes the development of pathology only in 15-20% of patients. In 30-35% of cases, the pressure rises before a breakdown in metabolism has occurred.

Pathology begins with the development of insulin resistance (lowering the sensitivity of tissues to the action of insulin). To compensate for this condition, insulin rises, causing an increase in blood pressure.

  1. The sympathetic nervous system is activated,
  2. The normal process of excretion of sodium, liquid,
  3. Inside the cells accumulates sodium, calcium,
  4. Walls of vessels thicken, their elasticity decreases.

Adverse factors that increase the likelihood of hypertension in type 1 and type 2 diabetes are the following:

  • Elderly age,
  • Deficiency of trace elements in the body,
  • Chronic intoxication,
  • Frequent stress
  • Atherosclerosis,
  • Obesity,
  • Other endocrine system pathologies.

Possible complications

High blood pressure in diabetes increases the likelihood of dangerous complications several times:

  • Renal failure - 25 times,
  • Non-healing ulcers, gangrene - 20 times,
  • Heart attack - 5 times,
  • Stroke - 4 times
  • A sharp deterioration in the function of vision - 15 times.

For many diabetics, high blood pressure is complicated by orthostatic hypotension. Pathology is characterized by a sharp drop in blood pressure when lifting from a prone position. It is manifested by darkening of the eyes, dizziness, fainting. The reason for the disturbed vascular tone is diabetic neuropathy.

Symptomatology

In many patients, hypertension does not manifest itself, in other patients, an increase in pressure is accompanied by:

  1. Dizziness
  2. Headaches,
  3. Impaired vision
  4. Weakness
  5. Increased fatigue.


There are 3 degrees of hypertension in diabetes, which are characterized by the following indicators:

  1. Soft The upper pressure is 140-159, the lower - 90-99 mm Hg. Art.,
  2. Moderate. Upper BP - 160-179, lower - 100-109 mm Hg. Art.,
  3. Heavy. The pressure exceeds 180/110 mm Hg. Art.

In order to avoid the rapid progression of vascular disorders and subsequent complications, patients with diabetes should try to keep the pressure at 130/85 mm Hg. Art. This will extend the life of 15-20 years.

With increased pressure, you need to consult a specialist, self-medication is unacceptable.. Therapeutic methods include:

  • Drug treatment. Use drugs that lower blood pressure. The most frequently prescribed diuretics, ACE inhibitors, which reduce the risk of kidney damage.
  • Diet. The body of the patient with diabetes is sensitive to sodium, therefore, with increased blood pressure, you need to reduce the salt in the diet. Often this measure has a good effect.
  • Weight loss. This will improve the overall condition.
  • Compliance with the daily regimen, maintaining a healthy lifestyle. Motor activity, sports have a positive effect on the blood vessels, reduce the concentration of glucose in the blood. Tablets for hypertension

Drugs and doses are selected so that the pressure decreases gradually. The optimal period to reach the norm is about 8 weeks from the start of taking the drugs. Too rapid decrease in blood pressure causes deterioration of blood circulation, the functions of organs and systems are disturbed.

Altered carbohydrate metabolism in diabetics makes selection of drugs difficult. Medicines are prescribed taking into account the state of the patient and the severity of the pathology.

To lower blood pressure in type 1 and type 2 diabetes, drugs of the following groups are commonly used:

  • Diuretics (Furosemide, Diacarb),
  • ACE inhibitors (Captopril, Enalapril),
  • Beta blockers (Nebilet, Tradat, Dilatrend),
  • Alpha adrenergic blockers (doxazosin, prazosin, terazosin),
  • Calcium antagonists (Diltiazem, Verapamil),
  • Agonists (stimulants) of the imidazoline receptor (Albarel, Physiotens).

Let us consider in more detail each group of drugs.

There are 4 diuretic groups:

  • Thiazide,
  • Thiazide-like,
  • Loopback
  • Potassium-sparing.

Thiazide-like diuretics, which do not affect glucose concentration, have a good effect. In cases of diabetes of the 1st and 2nd type, thiazide diuretics are used in an amount not exceeding 12.5 mg. Both groups of diuretics prevent the appearance of complications in the kidneys, myocardium, but such drugs cannot be used in case of renal failure.

Loop diuretics are rarely used, because the body loses potassium as a result. However, they are indicated for renal failure, in which case potassium supplements are also prescribed.

Treatment of hypertension in diabetes mellitus

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Under the arterial hypertension understand the increase in pressure above 140/90 mm. Such a state greatly increases the risk of heart attack, stroke, kidney failure, etc. In diabetes, the threshold of hypertension is reduced: a systolic pressure of 130 and a diastolic of 85 millimeters indicate the need for therapeutic measures.

ACE inhibitors

They block the enzyme that is involved in the synthesis of active angiotensin, which causes an increase in blood pressure. Medications prevent the development of complications in the kidneys, heart. Sugar concentration does not increase during the period of administration.

The drugs have a mild hypotensive effect, persistent lowering of blood pressure is achieved after 2 weeks. In type 1 and type 2 diabetes, such drugs are contraindicated if hyperkalemia and renal artery stenosis are detected. In some patients, they cause a cough. It should be borne in mind that if hypertension is severe, ACE inhibitors will not have a therapeutic effect.

Beta blockers

There are 2 groups:

  1. Selective. They act only on the receptors of the cardiovascular system,
  2. Nonselective. Affect all body tissues.

Nonselective beta blockers are contraindicated for diabetics because they increase sugar.Selectives are prescribed if diabetes and elevated blood pressure are combined with other pathologies:

  1. Ischemia,
  2. Heart attack
  3. Heart failure.


Such drugs are often used simultaneously with diuretics. Blockers are not used to treat high blood pressure in patients with asthma.

Calcium Antagonists

The processes of calcium intake into cells are slowed down, which leads to the expansion of blood vessels and a decrease in blood pressure. There are 2 groups:

  1. Dihydropyridine. Increase heart rate, reduce the likelihood of a heart attack.
  2. Non-dihydropyridine. Reduce heart rate, suitable for the treatment of hypertension, appeared on the background of nephropathy. Help avoid kidney damage in diabetes.

And those and others can be used simultaneously with diuretic, ACE inhibitors. Do not use them for heart failure, unstable angina.

Agonists (stimulators) of imidazoline receptors

Medications weaken the function of the sympathetic nervous system, resulting in reduced heart rate, blood pressure decreases. Long reception improves work of cardiovascular system.

Contraindications for appointment:

    Bradycardia, Alpha-blockers

They block postsynaptic alpha-adrenoreceptors, providing a steady decrease in pressure without increasing the heart rate. In diabetes, these drugs reduce the concentration of sugar, increase insulin sensitivity.

Diet therapy

For hypertension that has developed on the background of type 1 or type 2 diabetes, pay special attention to nutrition. Low-carb diet effectively lowers sugar, helps to normalize blood pressure.

Observe the following rules:

  1. The diet should contain vitamins, trace elements in sufficient quantities,
  2. Reduce salt intake. Daily rate - no more than 1 tea. lt
  3. Give up food rich in sodium,
  4. Eat more often - at least 5 p. / Day, in small portions,
  5. Do not eat before bedtime. The last meal should be no later than 2 hours before bedtime,
  6. Use low-fat foods, give preference to complex carbohydrates,
  7. Eat potassium rich foods. Macroelement dilates the walls of blood vessels and helps reduce pressure.

Include vegetables, fruits allowed for diabetics in the daily menu. Other approved products:

  • Wholemeal Bread,
  • Lean meat, fish,
  • Fat-free dairy, fermented milk products,
  • Vegetable broths,
  • Seafood,
  • Dried fruits,
  • Eggs
  • Vegetable oils.

To improve the taste of dishes, use seasonings, aromatic herbs, lemon juice.

  • Wheat flour products,
  • Smoked products
  • Fatty fish, meat,
  • Saturated broths,
  • Pickles,
  • Marinades,
  • Caffeinated beverages,
  • Alcoholic drinks.

Being overweight greatly increases the likelihood of hypertension in diabetics. To lose weight, it is recommended to reduce the daily caloric intake, increase physical activity.

Lifestyle change

Maintaining a healthy lifestyle contributes to lowering pressure in type 1 and type 2 diabetes. Required:

  1. Full rest,
  2. Avoiding alcohol or minimizing the use of alcohol
  3. The exclusion of smoking. Nicotine increases the likelihood of complications on the cardiovascular system,
  4. Avoiding stressful situations.

Important regular physical activity (charging, walking at an active pace, etc.). Massage has a good effect. Normalization of pressure with the help of drugs, diet, increase motor activity helps to alleviate the course of hypertension in diabetes and significantly improves well-being.

Why does diabetes increase blood pressure?

The causes of arterial hypertension in diabetes mellitus are different and depend on the type of the disease. Thus, in the insulin-dependent form of the disease, arterial hypertension in most cases develops due to diabetic kidney disease. In a small number of patients, primary arterial hypertension is observed, or isolated systolic hypertension.

If the patient has insulin-independent diabetes, then hypertension is formed in some cases much earlier than other metabolic diseases. In such patients, a frequent cause of the disease is essential arterial hypertension. This means that the doctor can not determine the cause of its occurrence. Rare enough causes of hypertension in patients are:

  • pheochromocytoma (a disease characterized by increased production of catecholamines, which causes tachycardia, pain in the heart and arterial hypertension),
  • Itsenko-Cushing syndrome (a disease caused by increased production of adrenal cortex hormones)
  • hyper aldosteronism (increased production of adrenal hormone aldosterone), characterized by a negative effect on the heart,
  • another rare autoimmune disease.

Contribute to the disease also:

  • magnesium deficiency in the body
  • prolonged stress
  • intoxication with heavy metal salts,
  • atherosclerosis and the constriction of the large artery caused by it.

Features of hypertension in insulin-dependent diabetes

This form of the disease is often accompanied by kidney damage. It develops in a third of patients and has the following stages:

  • microalbuminuria (albumin appears in the urine),
  • proteinuria (appearance in the urine of large protein molecules),
  • chronic renal failure.

At the same time, the more protein excreted with urine, the higher the pressure. This is due to the fact that diseased kidneys cope worse with sodium excretion. This increases the fluid content in the body and as a result - increases blood pressure. With increasing glucose levels, the fluid in the blood becomes even larger. This forms a vicious circle.

It consists in the fact that the body is trying to cope with poor kidney function, while increasing the pressure in the renal glomeruli. They gradually die off. So is the progression of renal failure. The main task of the patient with insulin-dependent diabetes mellitus is to normalize the glucose level and thereby delay the onset of the terminal stage of chronic renal failure to infinity.

Signs of hypertension in non-insulin dependent diabetes

Even before the patient shows signs of this disease, the process of insulin resistance begins. The resistance of tissues to this hormone gradually decreases. The body is trying to overcome the low sensitivity of the tissues of the body to insulin that produces more insulin than necessary. And this, in turn, contributes to increased pressure.

Thus, the main factor in the development of hypertension in diabetes mellitus is an indicator of insulin. However, further hypertension occurs due to the progression of atherosclerosis and deterioration of the kidneys. The lumen of the vessels gradually narrows, causing them to pass less and less blood.

Hyperinsulinism (that is, high insulin in the blood) is bad for kidney function. They are worse than removing the fluid from the body. And an increased amount of fluid in the body leads to the development of edema and hypertension.

How does hypertension manifest itself in diabetes?

It is known that blood pressure is subject to daily rhythm. At night it goes down. In the morning it is lower by 10–20 percent than during the day. In diabetes, such a daily rhythm is disturbed, and it turns out to be high all day. Moreover, at night it is even higher than during the day.

This violation is associated with the development of one of the dangerous complications of diabetes mellitus - diabetic neuropathy. Its essence is that high sugar adversely affects the functioning of the autonomic nervous system. In this case, the vessels lose the opportunity to taper and expand, depending on the load.

Determines the type of hypertension daily monitoring. This procedure will show when you need to take drugs against hypertension. At the same time, the patient must significantly reduce salt intake.

Medications for hypertension in diabetes

Preparations against hypertension should be taken in order to reduce it to 130/80 mm recommended in case of sugar disease. Treatment with a diet gives good blood pressure values: the pills are well tolerated and give the most satisfactory result.

This indicator is a kind of guideline in the treatment of hypertension. If the drugs do not reduce the pressure in the first weeks of treatment due to side effects, you can slightly reduce the dosage. But after about a month, intensive treatment should be resumed and medication should be taken in the indicated dosage.

A phased reduction in high blood pressure helps to avoid the symptoms of hypotension. Indeed, in patients with diabetes, arterial hypertension is complicated by orthostatic hypotension. This means that with a sharp change in the position of the body, a sharp drop in the indices of the tonometer is observed. This condition is accompanied by fainting and dizziness. His treatment is symptomatic.

Sometimes it is difficult to choose pills for hypertension with diabetes. This is due to the fact that changes in the metabolism of carbohydrates leave their mark on the effect of all drugs, including antihypertensives. Choosing treatment and drugs for the patient, the doctor should be guided by many important nuances. Properly selected pills meet specific requirements.

  1. These drugs sufficiently relieve the symptoms of arterial hypertension in diabetes mellitus and have small side effects.
  2. Such drugs do not impair the necessary control of blood sugar and do not increase cholesterol levels.
  3. Tablets protect the kidneys and the heart from the harmful effects of high blood sugar.

What groups of drugs used

Currently, doctors recommend their patients with diabetes to take pharmaceuticals of such groups.

  1. Diuretics, or diuretics. These drugs reduce well the increased pressure in arterial hypertension. The body gets rid of excess water and salts. Drugs in this group are used for heart failure, as they reduce the load on the heart and blood vessels. Diuretic drugs are well struggling with edema. The doctor will help you choose the most appropriate medication.
  2. Beta blockers. These drugs effectively affect the sympathetic nervous system. They are effectively used to treat the disease as primary means. Modern beta blockers have a minimal number of side effects.
  3. ACE inhibitors. Such drugs act on the production of an enzyme responsible for hypertension in a person.
  4. Angiotensin II Receptor Blockers. These drugs support the heart in high sugar conditions. They also effectively protect the liver, kidneys and brain from possible complications.
  5. Calcium antagonists. These drugs inhibit the ingress of ions of this metal in the heart cells. Thus, it is possible to achieve optimal readings of the tonometer and avoid complications of the cardiovascular system.
  6. Vasodilating agents relax well the walls of blood vessels and thus lower blood pressure. However, at present such drugs take an insignificant place in the treatment of hypertension, since they have serious side effects and have an addictive effect.

The role of diet in the treatment of hypertension

Consumption of perhaps less carbohydrates in hypertension and diabetes mellitus is a real and achievable step in maintaining health. This treatment will reduce the need for insulin and at the same time bring the performance of the cardiovascular system to normal.

Treatment with a low carb diet kills several problems at once:

  • lowers insulin and blood sugar
  • prevents the development of various complications,
  • protects the kidneys from the toxic effects of glucose,
  • significantly slows down the development of atherosclerosis.

Low-carb treatment is ideal when the kidneys do not yet secrete proteins. If they start working normally, the blood counts for diabetes return to normal. However, when proteinuria such a diet should be applied with caution.

You can eat enough sugar-reducing foods. It:

  • meat products,
  • eggs,
  • seafood,
  • green vegetables, and mushrooms,
  • cheeses and butter.

In fact, with a combination of hypertension and diabetes, there is no alternative to a low-carb diet. This treatment is used regardless of the type of diabetes. Sugar is reduced to normal levels in just a few days. You will have to constantly monitor your diet in order not to risk and not increase your glucose levels. Low-carb meals are hearty, tasty and healthy.

Simultaneously, with this diet, the tonometer indicators normalize. It is a guarantee of excellent well-being and the absence of life-threatening complications.

Pressure in diabetes mellitus: the mechanism and causes of the development of pathology

High blood pressure in diabetes is a common problem faced by patients. According to statistics, hypertension is detected in 60% of diabetics. Pathology greatly worsens health, aggravates the course of the underlying disease. Against the background of high blood pressure increases the risk of severe complications (stroke, heart attack), the outcome of which is fatal.

For patients with diabetes type 1, 2, pressure is considered normal, not exceeding the indices of 130/85 mm Hg. Art. The appearance of hypertension is usually caused by severe damage to the blood vessels against the background of elevated glucose levels. Consider how to lower blood pressure in diabetes.

Hypertension Pills

Drugs and doses are selected so that the pressure decreases gradually. The optimal period to reach the norm is about 8 weeks from the start of taking the drugs. Too rapid decrease in blood pressure causes deterioration of blood circulation, the functions of organs and systems are disturbed.

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Altered carbohydrate metabolism in diabetics makes selection of drugs difficult. Medicines are prescribed taking into account the state of the patient and the severity of the pathology.

To lower blood pressure in type 1 and type 2 diabetes, drugs of the following groups are commonly used:

  • Diuretics (Furosemide, Diacarb),
  • ACE inhibitors (Captopril, Enalapril),
  • Beta blockers (Nebilet, Tradat, Dilatrend),
  • Alpha adrenergic blockers (doxazosin, prazosin, terazosin),
  • Calcium antagonists (Diltiazem, Verapamil),
  • Agonists (stimulants) of the imidazoline receptor (Albarel, Physiotens).

Let us consider in more detail each group of drugs.

There are 4 diuretic groups:

  • Thiazide,
  • Thiazide-like,
  • Loopback
  • Potassium-sparing.

Thiazide-like diuretics, which do not affect glucose concentration, have a good effect. In cases of diabetes of the 1st and 2nd type, thiazide diuretics are used in an amount not exceeding 12.5 mg. Both groups of diuretics prevent the appearance of complications in the kidneys, myocardium, but such drugs cannot be used in case of renal failure.

Loop diuretics are rarely used, because the body loses potassium as a result. However, they are indicated for renal failure, in which case potassium supplements are also prescribed.

Treatment of hypertension in type 2 diabetes mellitus: a list of pills

  • Stabilizes sugar levels for long
  • Restores insulin production by the pancreas

At present, a pharmacist at any pharmacy can offer various pills for blood pressure for type 2 diabetes, the list of which is quite long.

"Sweet disease" with ineffective treatment leads to many complications, one of the most dangerous is hypertension. It is characterized by a significant rise in blood pressure (BP).

Diabetes mellitus and pressure in the complex increases the likelihood of stroke, ischemia, uremia, lower extremity gangrene, or loss of vision. Therefore, it is important to know how to deal with high blood pressure in diabetes, in order to prevent the development of undesirable pathologies.

Causes of hypertension

I wonder what pressure in diabetes is acceptable? After all, in healthy people it should be 120/80.

Pressure in diabetes should not exceed the threshold value of 130/85. If this indicator is exceeded, an expert should be urgently requested.

What are the causes of high blood pressure in diabetics? Well, they are quite a lot. The increase in pressure in type 1 diabetes in 80% of cases is due to renal pathology.

In the second type of the disease, hypertension, that is, a persistent increase in blood pressure, often occurs before the disturbance of the metabolic process.

Depending on what type of hypertension, it has a different nature of occurrence. The following are the main types and causes of the development of pathology:

  1. Essential, so-called hypertensive disease, occurring in 90-95% of cases with high blood pressure.
  2. Isolated systolic, resulting from a decrease in the elasticity of the vascular walls, as well as neurohormonal dysfunction.
  3. Renal (nephrogenic), the main reasons for which are associated with the functioning of the paired organ. These include diabetic nephropathy, polycystic, pyelonephritis, and glomerulonephritis
  4. Endocrine, developing extremely rarely. However, the main causes of the disease are Cushing's syndrome, pheochromocytoma, and primary hyper aldosteronism.

The development of hypertension in type 2 diabetes can be caused by other causes. For example, in women who took hormonal contraceptives, the risk of hypertensive disease increases significantly. It also increases the chances of a diabetic patient in addition to get hypertension, if he is older, he has problems with overweight or has considerable "experience" of smoking.

Sometimes the occurrence of hypertension in diabetes mellitus can be triggered by a lack of magnesium, intoxication with certain substances, narrowing of a large artery, as well as chronic stressful situations.

The causes of the disease, as we see, are many. Therefore, in case of diabetes, it is important to adhere to the basic rules of its successful treatment, including special nutrition, sports, medication (Metformin, etc.) and regular glycemic check.

Features of the course of hypertension

In type 1 diabetes, an increase in pressure is often caused by renal dysfunction. It goes through several stages - microalbuminuria, proteinuria and chronic insufficiency.

Many studies show that of all patients with type 1 diabetes, only 10% do not have kidney disease. Since the kidneys cannot fully excrete sodium, hypertension develops in diabetes. Over time, the concentration of sodium in the blood may increase, and with it accumulate and fluid. Excess circulating blood leads to the fact that blood pressure increases.

Diabetic nephropathy and hypertension is a vicious circle. Impaired kidney function is compensated by an increase in blood pressure. The latter raises intraglacial pressure, which leads to the gradual destruction of filter elements.

Hypertension and diabetes mellitus type 2 interact before the appearance of its serious signs. It all starts with the process of losing the reaction of tissue structures to a glucose-lowering hormone. To compensate for insulin resistance, insulin begins to accumulate in the blood, increasing blood pressure in diabetes. This phenomenon over time leads to a narrowing of the lumen of the vessels due to the adverse effects of atherosclerosis.

Abnormal obesity (accumulation of fat in the waist) is a feature of the abnormal process in insulin-independent diabetes mellitus. With the breakdown of fat substances are released, even more increasing the pressure. Over time, renal failure develops, but it can be prevented if treatment is taken seriously.

Increased insulin concentration (hyperinsulinism) entails high blood pressure in type 2 diabetes. Hyperinsulinism can raise it because:

  • Sodium and fluid are not fully excreted by the kidneys,
  • the sympathetic nervous system is activated,
  • intracellular accumulation of calcium and sodium begins,
  • decreases the elasticity of blood vessels.

To prevent hypertension, it is necessary to hold back high and low blood sugar.

Indicators are 5.5 mmol / l, you need to strive for it.

Treatment with ACE inhibitors and ARBs

Having learned the information, how blood pressure rises in diabetes mellitus, you can go to the question of how to reduce it and which pills for hypertension are allowed to use.

To begin with, let's dwell on the ACE inhibitors in more detail, because this is an essential group of drugs that can lower blood pressure.

It should be immediately noted that the medicine will have to be canceled if a patient has diabetic stenosis of a single kidney or bilateral stenosis.

Treatment of hypertension in type 2 diabetes mellitus with ACE inhibitors is canceled when the patient has:

  1. Creatinine increases by more than 30% after 7 days of treatment with this drug.
  2. Hyperkalemia was detected, in which the level of potassium is not less than 6 mmol / l.
  3. The period of carrying a child or breastfeeding.

In the pharmacy you can buy Captopril, Capoten, Perindopril, etc. Thus, high pressure in diabetes can be prevented using ACE inhibitors. But before taking them, it is necessary to consult a doctor.

In type 2 diabetes, treatment includes taking angiotensin receptor blockers (ARBs) or sartans to reduce pressure. It should be noted that ARBs in no way affect the metabolic processes, increasing the diabetic susceptibility of tissue structures to the production of the hormone with elevated blood sugar.

Such drugs from high pressure in diabetes mellitus are transferred quite easily by many patients. Therefore, you can choose the following drugs for hypertension - Valsartan, Azilsartan, Candesartan, etc.

Compared with ACE inhibitors, sartans have far fewer negative reactions, and the therapeutic effect can be observed already after two weeks.

Studies have proven that such a medicine for hypertension really lowers the secretion of urine proteins.

Use of diuretics and calcium antagonists

What drugs for pressure can be used when sodium retention occurs in the human body? For this, taking diuretics or diuretics is enough.

There are many factors to consider when choosing a pressure pill for diabetes.

So, in case of kidney dysfunction from pressure, it is better to drink “loop” diuretics.

In case of diabetes of the second type, doctors do not recommend using diuretics of the following types:

  • osmotic (mannitol), because they can cause a hypersolar coma,
  • thiazide (Xipamide, Hypothiazide), because drugs with elevated sugar cause hypertension,
  • carbonic anhydrase inhibitors (Diacarb) - drugs that do not show the proper hypotensive effect, their use is not sufficiently effective.

The most effective pills for diabetes are “loopback” diuretics. In the pharmacy, you can buy Bufenox or Furosemide. The prices of pressure reducing drugs can vary considerably if ordered online.

Here is one of the positive reviews from Anna (55 years old): “I have been suffering from type 2 diabetes for 8 years. Recent years have begun to worry about the pressure. She was treated with Diacarb, but the drug practically did not help. But then she drank Bufenox and began to feel great. I don’t know if another remedy can relieve the pressure so quickly and effectively, but I am very pleased with this drug. ”

Dosages are determined personally by the attending specialist. When choosing drugs to reduce pressure, the following factors should be considered:

  1. When taking Nifedipine (short-acting), the likelihood of cardiovascular mortality may increase.
  2. Calcium antagonists are prescribed to prevent stroke and heart attack in diabetes mellitus.
  3. Felodipine (prolonged action) is safe, but not as effective as ACE inhibitors. For good pressure reduction must be combined with other means.
  4. Negidropeliny (Diltiazem and Verapamil) is preferable for diabetes, they have a favorable effect on the functioning of the kidneys.

Calcium antagonists are effective pills for high blood pressure, although with prolonged use they can inhibit insulin production.

If you stop taking medications for hypertension in diabetes, the pancreas function will gradually recover.

Use of alpha and beta blockers

Alpha-blockers such as Terazosin or Prazosin, unlike beta-blockers in diabetes, improve carbohydrate and lipid metabolism, as well as increase the susceptibility of tissue structures to the glucose-lowering hormone.

Despite all the benefits, these drugs for pressure in diabetes can cause some side effects - swelling, persistent tachycardia and orthostatic hypotension (low blood pressure). Pills in any case do not drink with heart failure.

When using beta-blockers and diabetes, and heart disease can be kept under control. Choosing which pills to drink, one needs to take into account the selectivity, hydrophilicity, vasodilating effect and lipophilicity of drugs for hypertension in diabetes mellitus.

In case of diabetes, you can drink selective beta-blockers, as they improve the functioning of the cardiovascular system and, unlike non-selective ones, do not inhibit insulin production.

Also, with considerable pressure and diabetes, many doctors advise taking vasodilators, since they favorably affect the metabolism of carbohydrates and fats, increasing sensitivity to glucose-lowering hormone. However, these pressure pills can only be taken under the strict supervision of a doctor, as they have a long list of contraindications.

Taking lipophilic and water-soluble beta-blockers is generally undesirable, as they affect the liver and psycho-emotional state.

Against the background of drug therapy, treatment of hypertension with folk remedies is also possible. The most popular products of alternative medicine are red pine cones, flax seeds and garlic. There are different ways of preparing them - tinctures, decoctions, etc. You can treat with folk recipes for diabetes, you should not first consult with a specialist.

No less dangerous is the low pressure in diabetes mellitus (hypotension), since low blood circulation leads to tissue death. In any case, it is necessary to monitor the pressure in diabetes mellitus type 2.

Diabetes and high blood pressure are two interrelated concepts. Therefore, to prevent the development of severe consequences, it is necessary to take pills for diabetes from pressure, as well as to observe proper nutrition, to engage in active rest and to use folk remedies after consultation with the doctor.

What pills for hypertension diabetics can tell an expert in the video in this article.

  • Stabilizes sugar levels for long
  • Restores insulin production by the pancreas

Watch the video: Type 2 Diabetes. Nucleus Health (February 2020).