Diabetes and Hypertension: Things you must know

What is diabetes?

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes your body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells. 

Over time, having too much glucose in your blood can cause health problems with long-term complications, involving organs like the eyes, kidneys, nerves, heart and blood vessels. Although diabetes has no cure, you can take steps to manage your diabetes and stay healthy.

The diagnostic criteria for diabetes and prediabetes are summarized Below.

Diagnostic criteria for diabetes and prediabetes

* Individuals with random plasma glucose between 140-199mg/dl are recommended to undergo OGTT

WHO - World Health Organisation; ADA-American Diabetes Association; IFG - Impaired Fasting Glucose; IGT - Impaired Glucose tolerance; FPG - Fasting Plasma Glucose; 2-h PG-2 hour post load Glucose test (oral glucose tolerance test) plasma glucose; HbA1c – Glycosylated Hemoglobin.

Diabetes symptoms

Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may sometimes not experience symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the signs and symptoms of type 1 diabetes and type 2 diabetes are:

• Increased thirst
• Frequent urination
• Extreme hunger
• Unexplained weight loss
• Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin)
• Fatigue
• Irritability
• Blurred vision
• Slow-healing sores
• Frequent infections, such as gums or skin infections and vaginal infections

Types of Diabetes

The most common types of diabetes are type 1, type 2, and gestational diabetes.

Type 1 diabetes

If you have type 1 diabetes, your b

ody does not make insulin. Your immune system attacks and destroys the cells in your pancreas that make insulin. Type 1 diabetes is usually diagnosed in children and young adults, although it can appear at any age. People with type 1 diabetes need to take insulin every day to stay alive.

Type 2 diabetes

If you have type 2 diabetes, your body does not make or use insulin well. You can develop type 2 diabetes at any age, even during childhood. However, this type of diabetes occurs most often in middle-aged and older people. It is more common in people older than 40. Type 2 is the most common type of diabetes.

Gestational diabetes

Gestational diabetes develops in some women when they are pregnant. Most of the time, this type of diabetes goes away after the baby is born. However, if you’ve had gestational diabetes, you have a greater chance of developing type 2 diabetes later in life. Sometimes diabetes diagnosed during pregnancy is actually type 2 diabetes.

Other types of diabetes

Less common types include monogenic diabetes, which is an inherited form of diabetes, and cystic fibrosis-related diabetes External link.

What is hypertension?

Hypertension is when blood pressure is too high. Blood pressure is written as two numbers. The first (systolic) number represents the pressure in blood vessels when the heart contracts or beats. The second (diastolic) number represents the pressure in the vessels when the heart rests between beats.

Hypertension is diagnosed if, when it is measured on two different days, the systolic blood pressure readings on both days are ≥140 mmHg and/or the diastolic blood pressure readings on both days are ≥90 mmHg. 

Below table shows the normal blood pressure readings

Blood Pressure Targets for Diabetics (ICMR, 2018

Types of hypertension

Primary (essential) hypertension

For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.

Secondary hypertension

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

Obstructive sleep apnea

Kidney disease

Adrenal gland tumours

Thyroid problems

Certain defects you're born with (congenital) in blood vessels

Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs

Illegal drugs, such as cocaine and amphetamines

Hypertension Symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.

When symptoms do occur, they can include early morning headaches, nosebleeds, irregular heart rhythms, vision changes, and buzzing in the ears. Severe hypertension can cause fatigue, nausea, vomiting, confusion, anxiety, chest pain, and muscle tremors.

Link between diabetes and high blood pressure

Diabetes and Hypertension are both aspects of metabolic syndrome-related to obesity and cardiovascular disease. There is a closely linked between diabetes and hypertension relationship. A study shows that hypertension is twice as frequent in patients with diabetes compared to those who do not have diabetes. Both contribute to the worsening of each other’s symptoms. Diabetes and hypertension complications are associated with an increased risk of cardiovascular disease. Tight control of blood pressure has been shown to reduce cardiovascular risk in type 2 diabetics. Hence check your blood pressure regularly in order to avoid complications of diabetes.