Posts Tagged ‘blood pressure’

10 Things You Should Know If You Have Diabetes

Wednesday, August 5th, 2009

Diabetes currently affects more than 280 million people worldwide, including 6% of the United States’ entire population, and is estimated to double by the year 2030. Diabetes is a serious condition, but by choosing healthy foods, being physically active, and monitoring blood sugar levels, you can greatly reduce your risk of developing the complications associated with diabetes.  Here are some helpful tips for living well with this disease:

1. Take a walk

Walking regularly can help make your body more sensitive to insulin, increase weight loss, and give you better control of your blood sugar levels. Not only is it easy on your muscles and joints, but it rarely causes low blood sugar. Other modes of exercise, such as cycling, swimming, jogging, aerobics, and weight lifting can also be included in your exercise plan.

2. Take good care of your feet

Tending to your feet is essential in maintaining an active, healthy lifestyle. Your feet are vulnerable to poor circulation and diabetic nerve damage, making it easier for you to sustain injuries that do not heal and get infected. Be sure to wear well-fitting, comfortable shoes and socks, and be sure to check your feet at the end of each day to look for cuts, blisters, or other skin irritations.

3. Know high blood sugar symptoms

The symptoms of hyperglycemia differ for everyone, but, generally, if your blood sugar is high, you will:

  • Have to urinate more frequently
  • Feel extremely tired or will lack energy
  • Feel hungrier or thirstier than usual
  • Have blurry or distorted vision

Regulating your blood glucose levels is critical to living healthy.  Hyperglycemia puts you at risk for heart problems, infections, stroke, vision impairment, amputation, kidney disease, and sexual problems.

4. Lose weight

Being overweight makes blood sugar control especially difficult since this causes resistance to insulin. Excess weight may also raise your blood pressure, making you more prone to kidney disease or stroke.

5. Always carry healthy snacks

Carrying healthy snacks can help you avoid unhealthy alternatives, such as junk food or fast food, and can significantly reduce the chance of developing hypoglycemia. Choose wholesome snacks with 15 grams of carbohydrates or less per serving, particularly whole grain foods, fruits, and vegetables.

6. Understand that sugar-free foods are not calorie- and carb-free

While a food labeled “sugar-free” must have less than 0.5 grams of sugar per serving, it could still contain calories and carbohydrates. Sugar-free pudding, for example, contains 0 grams of sugar per serving, but still has 70 calories and 6 grams of carbohydrates.

7. Limit alcohol

Alcohol will interfere with your body’s ability to produce blood sugar. While a minimal amount will generally not cause low blood sugar, too much can result in low blood sugar, or hypoglycemia.

8. Get an annual eye exam

Diabetes is the leading cause of blindness in the United States; however, many eye problems are treatable if detected early. People with diabetes are also prone to developing cataracts or double vision. An annual eye exam by a doctor who specializes in diabetic eye disease is the best way to detect eye problems in the early stages when they are most easily treated.

9. Be especially cautious about blood sugar during pregnancy

Babies born to diabetic mothers have greater risks for birth defects and stillbirth. However, many problems can be averted if you maintain near normal blood sugar before and during pregnancy. It is most critical to control your blood sugar during the first 12 weeks of pregnancy when the baby’s organs are forming in order to reduce these risks.

10. Employ a good healthcare team

Having a competent and compassionate healthcare team is the best strategy to manage diabetes.  Your family physician, a diabetes education nurse, and a nutritionist are all core members of your team and can help you live healthy with diabetes.

Type 2 Diabetes and Hypertension

Wednesday, August 5th, 2009

Hypertension is extremely common in people with type 2 diabetes, affecting approximately 20-60% of all patients, depending on age, ethnicity, and body weight. The causes of this type of high-blood pressure are unknown, but are likely to be a complex combination of genetic, environmental, and other factors.  A number of genetic factors or interactions between genes play a major role in essential hypertension and many experts believe that specific chromosomes house the genes responsible for blood pressure regulation.

Whereas kidney damage is generally the cause of high blood pressure in type 1 diabetes, obesity and insulin resistance are the factors associated with hypertension in type 2 diabetes.  Obesity is common in both type 2 diabetes and hypertension and clinical testing indicates that obesity is the one common element linking insulin, type 2 diabetes, and high blood pressure. However, studies have found a stronger association between hypertension and insulin resistance in thin patients as well as overweight people with type 2 diabetes.

The development of hypertension in patients with diabetes is particularly harmful, as it is responsible for up to 75% of diabetic cardiovascular complications, including coronary artery disease, peripheral vascular disease, and stroke. Hypertension is also thought to play a significant role in the development of retinopathy (eye damage), nephropathy (kidney disease), and possibly neuropathy (nerve damage).

The gas nitric oxide also plays a predominant role in hypertension.  It can be produced in the body, affecting the smooth muscle cells that line blood vessels by keeping them relaxed and flexible. It may also help prevent blood clotting. Low levels of nitric oxide have been observed in people with high blood pressure (particularly in African Americans) and may be a significant factor in essential hypertension.

Clinical testing and research has explored the benefits of lowering blood pressure in individuals with diabetes, such as a reduction in cardiovascular disease, stroke, or nephropathy events. In older individuals with type 2 diabetes, females in particular, the incidence of heart failure is rapidly increasing, and hypertension is often the primary cause.  Additionally, aside from diabetes, hypertension is the leading cause of end-stage renal disease (ESRD).  Coexisting hypertension and diabetes is a common clinical scenario that can ignite a vicious cycle of rising blood pressure, increasing renal damage, and increased cardiovascular morbidity.  Treatment of hypertension often requires multiple drugs to effectively minimize and prevent complications of diabetes. In patients with type 2 diabetes mellitus, the impact of blood pressure control on micro vascular and macro vascular health may be equal to or even greater than that of strict glycemic control.

Those who have type 2 diabetes must also be aware of secondary hypertension, which has recognizable causes that are usually treatable or reversible.  There are a number of medical conditions that can cause secondary high blood pressure.  The most common of which is kidney disease, although it occurs more often in older diabetics.  Sleep apnea, a disorder in which breathing briefly ceases repeatedly during sleep, is also highly associated with hypertension. A weak but still higher than normal association with high blood pressure has even been observed in those who snore or have mild sleep apnea. The link between sleep apnea and hypertension is thought to be largely due to obesity, but major studies are finding a higher rate of hypertension in people with sleep apnea regardless of their weight. Treating sleep apnea with a device known as nasal continuous positive airway pressure (CPAP) may have modest benefits on blood pressure as well.  Additionally, some medical conditions may contribute to temporary hypertension such as cirrhosis, pregnancy, and Cushing’s disease.

To help temporarily aid blood-pressure, people with type 2 diabetes can attain certain prescription and over-the-counter medication.  This includes cough medicines that contain pseudo ephedrine, oral contraceptives, corticosteroids, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen.  Other causes of secondary hypertension in type 2 diabetics include stress and vigorous exercise, as well as caffeine, cigarettes, and alcohol, all of which could increase the risk of stroke if not limited.