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Diabetic With Low Blood Pressure

Low Blood Pressure

Low Blood Pressure

Blood pressure varies from one person to another. A drop as little as 20 mmHg, can cause problems for some people. There are different types and causes of low blood pressure. Severe hypotension can be caused by sudden loss of blood (shock), severe infection, heart attack, or severe allergic reaction (anaphylaxis). Orthostatic hypotension is caused by a sudden change in body position. This occurs most often when you shift from lying down to standing. This type of low blood pressure usually lasts only a few seconds or minutes. If this type of low blood pressure occurs after eating, it is called postprandial orthostatic hypotension. This type most often affects older adults, those with high blood pressure, and people with Parkinson disease. Neurally mediated hypotension (NMH) most often affects young adults and children. It can occur when a person has been standing for a long time. Children usually outgrow this type of hypotension. Certain medicines and substances can lead to low blood pressure, including: Alcohol Anti-anxiety medicines Certain antidepressants Diuretics Heart medicines, including those used to treat high blood pressure and coronary heart disease Medicines used for surgery Painkillers Other causes of low blood pressure include: Continue reading >>

When Blood Pressure Is Too Low

When Blood Pressure Is Too Low

Talk around blood pressure typically centers on what to do if blood pressure is too high. We know that high blood pressure is more common in people with diabetes than people without diabetes. We also know that uncontrolled high blood pressure is a risk factor for stroke, heart disease, and kidney disease. The American Diabetes Association recommends a blood pressure goal of less than 140/80 for most people with diabetes. But what if your blood pressure is too low? Is it cause for concern? And what do you do about it? Low blood pressure defined Low blood pressure is also known as “hypotension.” You might be thinking that low blood pressure is a good thing, especially if yours tends to run on the high side. But the reality is that low blood pressure can be a serious condition for some people. For people without diabetes, the American Heart Association recommends a blood pressure of less than 120 over 80 (written as 120/80). Low blood pressure is generally defined as a blood pressure of less than 90/60. If your blood pressure tends to hover in that area without any symptoms, then there’s likely no cause for concern. But if symptoms occur, that’s a signal that something is amiss. Symptoms of low blood pressure Low blood pressure may be a sign that there’s an underlying medical condition, especially if your blood pressure drops suddenly or if you have the following symptoms: • Dizziness or lightheadedness • Fainting • Fast or irregular heartbeat • Feeling weak • Feeling confused • Lack of concentration • Blurred vision • Cold, clammy skin • Nausea • Rapid, shallow breathing • Depression • Dehydration That’s quite a list. Some of the above symptoms can occur if you have, say, the flu, a stomach bug, or have been outside for a long time in h Continue reading >>

Blood Pressure And Diabetes

Blood Pressure And Diabetes

This page is best viewed printed out. If you are a patient you can take this to your practice nurse so it can be used for ideas. Why do you need a blood pressure of 130/80? Complications from diabetes develop much more quickly if blood pressure is high. This is illustrated in the graph opposite, from the UKPDS £23 million study. Lifestyle has a major impact on blood pressure, but medication is generally needed. Each 1 mmHg of blood pressure rise causes a 1.2% increase in the number of problems. In practice for instance, if you have diabetic maculopathy, a serious form of retinopathy, you need a very low blood pressure to stop (or slow down) your sight getting worse. Unfortunately some people become ill if their blood pressure is too low (dizzy, occaional falls), so like everything else in diabetes, the blood pressure is a balance. The balance is between keeping well and avoiding diabetic problems, versus the side effects of the tablets, too low a blood pressure and becoming dizzy, and too many trips to the doctor. Worldwide, blood pressure is undertreated see . Long term control is needed (NEJM 2008). also. Candersartan reduced retinopathy progression by 18-34% (BMJ 10) DIRECT . White coat hypertension does contribute to retinopathy and does need treatment 2008. Some ethnic groups such as Afro-Carribeans seem to retain more salt, and this causes much higher blood pressures. Each 1mm of blood pressure increases risk 5% (NEJM 2009). Treatment is important even in the very elderly BMJ12 BMJ12. <120 is harmful 2012. BP 130 (2012). General 2012. Take control of your blood pressure If you have high blood pressure, take control. Buy a machine (in Birmingham, Lloyds Chemists sell good machines for ~£15). If your blood pressure is high and you are trying to lower it, check the Continue reading >>

How Low Is Too Low? Blood Pressure Goals For Diabetic Patients

How Low Is Too Low? Blood Pressure Goals For Diabetic Patients

Research indicates setting more aggressive blood pressure goals for diabetic patients may cause harm. As guidelines are updated, the recommendations for treating blood pressure also change. As of today, the American Diabetes Association (ADA) recommends treating hypertension in diabetic patients if their blood pressure is above 140/90. In January 2016, a new systematic review was published in the BMJ that looked into the studies that re-evaluated this recommendation. The authors looked at 49 randomized controlled trials (RCTs), which included 73,738 participants, of whom most had diabetes mellitus. CENTRAL, Medline, Embase, and BIOSIS databases were used for a search. In the analyzed studies, most diabetes patients were followed for at least 12 months with the mean of 3.7 years. The authors’ final review and meta-analyses were stratified by entry and systolic blood pressure (SBP) goals. The results of a review clearly state that we should not treat patients’ blood pressure if it is less than 140. Authors analyzed risks for multiple negative health events for which all diabetes patients are especially in danger of death as compared to the rest of our population and their risk of death. All cause mortality was reduced if SBP was 140-150 mmHg before treatment (relative risk 0.87, 95% confidence interval 0.78-0.98) or above 150 mmHg (relative risk 0.89, 95% confidence interval 0.80-0.99) and 130-140 mmHg after treatment (relative risk 0.86, 95% confidence interval 0.79-0.93). If the starting SBP was less than 140 mmHg and it was treated with medications, it increased patients’ risk for mortality (relative risk 1.05, 95% confidence interval 0.95-1.16). Also, if patients achieved SBP less than 130, it increased their odds for mortality (relative risk 1.10, 95% confidenc Continue reading >>

10 Warning Signs Of Low Blood Sugar

10 Warning Signs Of Low Blood Sugar

Hypoglycemia, or low blood sugar, is common among people with diabetes and can occur even when you're carefully managing the condition. "Hypoglycemia happens when the amount of blood glucose (sugar in the blood) drops to a level that's too low to sustain normal functioning," says Erin Palinski-Wade, RD, CDE, author of 2 Day Diabetes Diet. "In most people, this is defined as a blood-sugar level below 70 milligrams per deciliter." A review published in June 2015 in the journal PLoS One found that among people with type 2 diabetes, this is a far too common occurrence. Individuals with the condition had an average of 19 mild episodes of hypoglycemia per year, and nearly one severe episode per year on average. Low blood sugar was particularly common among those taking insulin. This decrease in blood sugar levels can cause both short-term complications, like confusion and dizziness, as well as more serious, long-term complications. Left untreated, it can lead to a coma and even death. To prevent hypoglycemia and its dangerous side effects, it's crucial to monitor your glucose levels and treat low blood sugar as soon as you become aware of it. Pay attention to these telltale signs of dipping blood sugar levels to make sure yours stays under control: 1. Ravenous Hunger If you've already eaten but still aren't satisfied, or if you suddenly, inexplicably feel as if you're starving, your body is signaling that it needs more glucose. Work with your healthcare team to determine the exact amount of sugar your body needs. A good starting point is the American Diabetes Association's recommendation to eat between 15 and 20 grams (g) of sugar or carbohydrates with each snack, and between 40 and 65 g at each meal. Some good options include 2 tablespoons of raisins, 4 ounces of fruit juice Continue reading >>

Blood Pressure And Diabetes: How Low Should You Go?

Blood Pressure And Diabetes: How Low Should You Go?

July 6, 2010 -- Tight control of high blood pressure, recommended for those with diabetes by national guidelines, gives no better results than moderate control, according to a new study. ''The guidelines suggest you want diabetics to have [systolic pressure] under 130," says researcher Rhonda M. Cooper-DeHoff, PharmD, associate professor of pharmacy and medicine at the University of Florida, Gainesville. But in her study, those who kept their systolic pressures moderately controlled -- at 130 to 139 -- did as well as those who controlled it more tightly. Systolic pressure is the upper of the two blood pressure numbers, representing the maximum pressure exerted when the heart contracts. She compared ranges of blood pressure control on the effect on death, heart attack, and stroke during the follow-up. "There was no difference comparing those with tight control or usual control," she tells WebMD, "which is contrary to what the guidelines would suggest." ''The message is: we need to get diabetic patients' systolic blood pressure to less than 140, particularly when they have heart disease, but working to get it to less than 130 does not appear to add any additional benefit with regard to the risk of death, stroke, or heart attack," Cooper-DeHoff says. The study is published in the Journal of the American Medical Association. For this study, Cooper-DeHoff and colleagues looked at a subgroup of 6,400 participants of a large study, called INVEST (International Verapamil SR-Trandolapril Study). It included more than 22,000 participants from 14 countries who were at least 50 years old and had high blood pressure and coronary artery disease. Study participants enrolled in the study from 1997 to 2000 and were followed through March 2003, with follow-up for U.S. participants extend Continue reading >>

Type 1 Diabetes Faq

Type 1 Diabetes Faq

What is type 1 diabetes? Type 1 diabetes is all about insulin—a lack of the hormone insulin. If you have type 1 diabetes, then your body doesn’t produce enough insulin to handle the glucose in your body. Glucose is a sugar that your body uses for instant energy, but in order for your body to use it properly, you have to have insulin. What are the symptoms of type 1 diabetes? Type 1 diabetes develops gradually, but the symptoms may seem to come on suddenly. It can take years for the body to deplete its insulin, but as soon as there’s no more insulin in the body, blood glucose levels rise quickly. Symptoms can then rapidly develop, including: Extreme weakness and/or tiredness Extreme thirst—dehydration Increased urination Abdominal pain Nausea and/or vomiting Blurry vision Wounds that don’t heal well Irritability or quick mood changes Changes to (or loss of) menstruation There are also signs of type 1 diabetes. Signs are different from symptoms in that they can be measured objectively; symptoms are experienced and reported by the patient. Signs of type 1 diabetes include: Weight loss—despite eating more Rapid heart rate Reduced blood pressure (falling below 90/60) Low body temperature (below 97º F) What causes type 1 diabetes? It isn’t entirely clear what triggers the development of type 1 diabetes. Researchers do know that genes play a role; there is an inherited susceptibility. However, something must set off the immune system, causing it to turn against itself and leading to the development of type 1 diabetes. To get more details on this, please read our article on the causes of type 1 diabetes. What are the risk factors for type 1 diabetes? There are several risk factors that may make it more likely that you’ll develop type 1 diabetes—if you have th Continue reading >>

6 Best Tips To Lower Blood Pressure When You Have Diabetes

6 Best Tips To Lower Blood Pressure When You Have Diabetes

If you have diabetes , youve probably already startedcounting carbs and exercising more to keep your blood sugar stable. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy But you may be neglecting another, often silent problem that can go hand-in-hand with diabetes: high blood pressure. Also known as hypertension , the condition occurs in as many as two-thirds of people with diabetes. If you have both conditions and either is out of control, your risk of blood vessel damage increases, heightening the likelihood of complications like heart attack, stroke or kidney failure. If both conditions are unmanaged, the risk is even greater. Here are sixsuggestions to help keep your blood pressure in check. RELATED: Have Diabetes? Why You Need to Know Your Blood Pressure Numbers Exercise is an important part of any healthy lifestyle. It strengthens the heart and makes it pump more efficiently, so it is particularly critical if you have hypertension. To improve cardiovascular health and maintain your weight, try to get 150 minutes each week of aerobic activity. You want to spread this over at least three days, with no more than two consecutive days without exercise. This can include walking, cycling and swimming. If you find yourself struggling to figure out which foods in the grocery aisles have too much sodium, heres a good tip to follow: Food in its natural state is best. Skip over processed foods and opt for fresh fruits and vegetables, whole grains and lean meats. RELATED: 3 Natural Ways to Control Your High Blood Pressure If you are planning to start a low-sodium diet (no more than 1,500 mg per day), the first step is to get rid of the salt shaker. I Continue reading >>

Low Blood Pressure Increases Diabetes Mortality Risk

Low Blood Pressure Increases Diabetes Mortality Risk

Tight blood pressure control fails to confer a survival benefit in patients newly diagnosed with Type 2 diabetes, and may even increase mortality risk when low blood pressure levels are achieved, UK investigators have discovered. Writing in the British Medical Journal, the team says: "Although no causality can be implied for these relations, our results suggest that 'the lower the better' approach might not apply to blood pressure control beyond a critical level in high risk patients. "Since there is currently no robust evidence available for lowering the blood pressure below 130/80 mmHg in people with diabetes, it might be advisable to maintain blood pressure between 130-139/80-85 mmHg, supported by other therapeutic and lifestyle interventions to improve cardiovascular outcomes in patients with diabetes." Examining data on 126,092 adults from the United Kingdom General Practice Research Database who were diagnosed with Type 2 diabetes between 1990 and 2005, Matthew Harris, from Imperial College London, and colleagues found that 9.8% had a prior diagnosis of cardiovascular disease. Over a median follow-up period of 3.5 years, 25,495 (20.2%) patients died, at an event rate of 48.3 per 1000 patient years. Mortality was 28.6% in patients with cardiovascular disease and 19.3% in those without. Cox proportional hazards model analysis, controlling for age at diagnosis, gender, practice level clustering, deprivation score, body mass index, smoking, glycated hemoglobin, cholesterol levels, and blood pressure, revealed that tight blood pressure control, defined as systolic blood pressure (SBP) below 130 mmHg and diastolic blood pressure (DBP) below 80 mmHg, did not lower the risk for all-cause mortality, except in patients without cardiovascular disease who had DBP levels of 75 Continue reading >>

Low Blood Pressure (hypotension)

Low Blood Pressure (hypotension)

Print Overview Low blood pressure might seem desirable, and for some people, it causes no problems. However, for many people, abnormally low blood pressure (hypotension) can cause dizziness and fainting. In severe cases, low blood pressure can be life-threatening. A blood pressure reading lower than 90 millimeters of mercury (mm Hg) for the top number (systolic) or 60 mm Hg for the bottom number (diastolic) is generally considered low blood pressure. The causes of low blood pressure can range from dehydration to serious medical or surgical disorders. It's important to find out what's causing your low blood pressure so that it can be treated. Symptoms For some people, low blood pressure signals an underlying problem, especially when it drops suddenly or is accompanied by signs and symptoms such as: Dizziness or lightheadedness Fainting (syncope) Blurred vision Nausea Fatigue Lack of concentration Shock Extreme hypotension can result in this life-threatening condition. Signs and symptoms include: Confusion, especially in older people Cold, clammy, pale skin Rapid, shallow breathing Weak and rapid pulse When to see a doctor If you have indications of shock, seek emergency medical help. If you have consistently low blood pressure readings but feel fine, your doctor is likely just to monitor you during routine exams. Even occasional dizziness or lightheadedness may be a relatively minor problem — the result of mild dehydration from too much time in the sun or a hot tub, for example. Still, it's important to see your doctor if you have signs or symptoms of hypotension because they can point to more-serious problems. It can be helpful to keep a record of your symptoms, when they occur and what you're doing at the time. Causes Blood pressure is a measurement of the pressure i Continue reading >>

Low Blood Pressure - When Blood Pressure Is Too Low

Low Blood Pressure - When Blood Pressure Is Too Low

Within certain limits, the lower your blood pressure reading is, the better. There is also no specific number at which day-to-day blood pressure is considered too low, as long as none of the symptoms of trouble are present. Symptoms of low blood pressure Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as: Dizziness or lightheadedness Nausea Dehydration and unusual thirst Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration (a loss of as little as 1 percent to 2 percent of body weight) can cause weakness, dizziness and fatigue. Lack of concentration Blurred vision Cold, clammy, pale skin Rapid, shallow breathing Fatigue Depression Underlying causes of low blood pressure Low blood pressure can occur with: Prolonged bed rest Pregnancy During the first 24 weeks of pregnancy, it’s common for blood pressure to drop. Decreases in blood volume A decrease in blood volume can also cause blood pressure to drop. A significant loss of blood from major trauma, dehydration or severe internal bleeding reduces blood volume, leading to a severe drop in blood pressure. Certain medications A number of drugs can cause low blood pressure, including diuretics and other drugs that treat hypertension; heart medications such as beta blockers; drugs for Parkinson’s disease; tricyclic antidepressants; erectile dysfunction drugs, particularly in combination with nitroglycerine; narcotics and alcohol. Other prescription and over-the-counter dru Continue reading >>

All About Hypoglycemia (low Blood Sugar)

All About Hypoglycemia (low Blood Sugar)

Hypoglycemia refers to an abnormally low level of sugar, or glucose, in the blood. Hypoglycemia is not a disease in itself, it is a sign of a health problem. The brain uses a lot of energy and needs glucose to function. Because the brain cannot store or manufacture glucose, it needs a continuous supply. Signs of low blood sugar include hunger, trembling, heart racing, nausea, and sweating. Hypoglycemia is commonly linked with diabetes, but many other conditions can also cause low blood sugar. This article will discuss the causes, diagnosis, and treatment of hypoglycemia, and the difference between hypoglycemia and hyperglycemia. We will also look at how to prevent it. Here are some key points about hypoglycemia. More detail is in the main article. Hypoglycemia is not a disease but a symptom of another condition. Early symptoms include hunger, sweating, and trembling. A common cause is diabetes. Alcohol abuse and kidney disorders can also lower blood sugar levels. What is hypoglycemia? Hypoglycemia is a condition where there is not enough glucose, or sugar, in the blood. Levels of blood sugar are below 4 mmol/L (72mg/dL). Adults and children with mild hypoglycemia may experience the following early symptoms: hunger tremor or trembling sweating irritability a pale face heart palpitations accelerated heart rate tingling lips dizziness weakness Severe hypoglycemia is sometimes called diabetic shock. It may involve: concentration problems confusion irrational and disorderly behavior, similar to intoxication inability to eat or drink Complications If a person does not take action when symptoms of hypoclycemia appear, it can lead to: A person who regularly experiences hypoglycemia may become unaware that it is happening. They will not notice the warning signs, and this can lea Continue reading >>

Low Blood Pressure (hypotension)

Low Blood Pressure (hypotension)

A A A Low blood pressure is a difficult clinical finding for a healthcare professional to address. While high blood pressure is known as the "silent killer," because it is associated with few acute symptoms, hypotension (hypo=low + tension=pressure) may be normal for a patient if it is without symptoms, but can be of great importance if it is associated with abnormal body function. Sometimes low is good, a goal to be achieved in keeping blood pressure under control. Sometimes low is bad because there is not enough pressure to provide blood flow to the organs of the body. Blood pressure readings have two parts and are expressed as a ratio: "Normal" blood pressure, for example is 120/80 (120 over 80) and measures the pressure within the arteries of the body. Systolic pressure, the upper number, measures the pressure within the arteries when the heart is contracting (systole) to pump blood to the body. Diastole pressure, the lower number, measures resting pressures within the arteries, when the heart is at rest. You can think of the heart and the blood vessels (arteries and veins) as a system to pump blood, just like the oil pump in your car. Oil is pumped through rigid tubes. Pressure remains relatively constant throughout the pumping cycle unless the pump fails or there is an oil leak. Then oil pressure will fall. The body is similar, except that the tubes have pliable walls, meaning that the space within the arteries can get bigger or smaller. If the space gets bigger, there is effectively less fluid, and pressure falls. If the space gets smaller, pressure goes up. Arteries have layers of muscles within their walls that can contract and narrow the artery, making less space inside the vessels. Alternatively, the muscles can relax and dilate the artery, making more room. Continue reading >>

Hypoglycemia-induced Blood Pressure Elevation In Patients With Diabetes

Hypoglycemia-induced Blood Pressure Elevation In Patients With Diabetes

Blood pressure elevation secondary to hypoglycemia has been demonstrated in human experimentation through the activation of the sympathoadrenal system.1 Though hypoglycemia is a fact of life for patients with both type 1 and type 2 diabetes mellitus,2 blood pressure (BP) variations after hypoglycemic events has not been clarified. Our aim was to determine the relationship between glucose level and BP swings in patients with diabetes under everyday conditions. We performed 24-hour home monitoring of subcutaneous glucose level using a continuous glucose monitoring system (Medtronic, Minneapolis, Minnesota) and simultaneous ambulatory BP measurement (Diasys Integra II; NOVACOR, Rueil-Malmaison, France) in 22 patients with type 1 (n = 4) or type 2 (n = 18) diabetes (mean duration, 18 years). Of the 22 patients, 14 (64%; 10 with type 2 diabetes) were receiving long-term insulin therapy and 18 (82%) were taking hypotensive drugs. The Medtronic MiniMed continuous glucose monitoring system has been shown to be clinically accurate for the recording of hypoglycemic episodes in daily life conditions.3,4 Subcutaneous interstitial glucose values were recorded every 5 minutes, providing approximately 288 readings per day. Hypoglycemia was defined by a blood glucose value lower than 60 mg/dL (to convert to millimoles per liter, multiply by 0.0555). Blood pressure was measured every 15 minutes during daytime (7 AM–11 PM) and 30 minutes during nighttime (11 PM–7 AM). The last BP and heart rate measurements before blood glucose level fell under 60 mg/dL were taken as reference values to assess the variability of cardiovascular parameters after the hypoglycemic episode and during the 1-hour period before, which was taken as the control period. Statistical analyses were performed using Continue reading >>

When Is Blood Pressure Too Low

When Is Blood Pressure Too Low

According to the Centers for Disease Control and Prevention (CDC), 75 million adults in the U.S. have high blood pressure. That amounts to one in every three adults. And according to the American Diabetes Association, two out of three people who have diabetes also have high blood pressure. So, understandably, a lot of attention is focused on helping people lower their blood pressure to a safe level. But what if you have blood pressure that’s too low? What does it mean? And what should you do? Low blood pressure, defined We’ve all had our blood pressure checked at the doctor’s office numerous times. The nurse or medical assistant wraps a cuff around your upper arm, pumps it up, and, as it is deflating, listens with a stethoscope. What he or she is listening for is, first, the sound when blood starts flowing as the cuff is released — that’s the systolic, or top number — and then the last sound that’s heard before blood flow returns to normal — that’s the diastolic, or bottom number. An “ideal” blood pressure reading is under 120/80 mmHg. For most people who have diabetes, the goal is less than 140/90 mmHg. All well and good, but what about low blood pressure? Low blood pressure is also called “hypotension.” Hypotension, according to the National, Heart, Lung, and Blood Institute, is “abnormally low blood pressure,” and, in general, is a blood pressure that is below 90/60 mm Hg. Why is low blood pressure a concern? With all the concern around high blood pressure, or hypertension, it almost seems like the lower your blood pressure, the better. After all, high blood pressure isn’t called the “silent killer” for nothing. It’s a leading risk factor for heart attack and stroke, and can also cause kidney disease, blindness, and dementia. Low Continue reading >>

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