If you already have diabetes, tight blood sugar control is essential to avoiding hypertension. The American Diabetes Association (ADA) recommends blood sugar levels between 90 to 130 before eating, 110 to 150 before bed, and less than 180 two hours after eating. Keeping sugars well controlled minimizes potential damage to blood vessels and the kidneys, offering strong protection against the development of high blood pressure. Older patients with known heart disease should discuss specific target blood sugars with their doctor.
Dietary choices can be effective at minimizing organ damage and dysfunction that can lead to high blood pressure, especially in people with diabetes. Minimizing the intake of fats, salt, and refined sugars provides proven protection against progressive diabetes, high blood pressure, and cardiovascular disease. For personalized nutrition planning, your doctor can usually arrange meetings with a nutritionist or nutrition counselor who can help construct meal plans and provide education in making smart dietary choices. A well-balanced diet offers the additional advantage of being an effective weight management tool.
Regular physical activity conditions the cardiovascular system, improves blood vessel health, and increases the efficiency of the heart – all of which are beneficial in avoiding high blood pressure. Of special benefit to diabetics, exercise raises the muscles’ need for sugar and makes muscle tissue more sensitive to insulin. This leads to decreases in average blood sugar, which helps protect the kidneys and blood vessels from sugar-related damage. Everyone can incorporate exercise into their normal routine, and exercising does not have to be expensive or time consuming.
Being overweight is a serious stress on the cardiovascular system, and predisposes to a number of heart and blood vessel related diseases, including high blood pressure. In diabetics, weight control is an important factor in successfully managing blood sugar. As weight increases, muscles and other cells become increasingly resistant to the blood-sugar-lowing effects of insulin, causing increases in average blood sugar which can lead to kidney and blood vessel damage. Studies have shown that reducing body weight by as little as 5% improves insulin response and decreases the risk of cardiovascular disease.
Diabetics require close, long term monitoring under the care of a skilled doctor. Office visits should be a maximum of six months apart, with three month – or even one month – visits sometimes needed. By seeing you frequently, your doctor can keep better track of how treatment plans are working and make adjustments to ensure that any potential problems are avoided or promptly corrected. Blood pressure checks (every visit) and kidney function tests should be done on a regular basis (every 3-12 months). These tests help to chart the blood pressure over time and to identify any additional factors that may result in increased pressures.