Blood pressure and diabetes

[PurpleTrout]

Hi, I'm new here though I was diagnosed with type 2 about 20 years ago. Without going into excessive detail, doctors have always told me that I am not typical of type 2 but have never suggested looking into it. They just say it doesn't matter and that there are lots of types of diabetes. I have never been overweight, am active and eat healthily.
I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?
I would really like to get a second opinion about this and also my diagnosis of type 2 which is looking more and more wrong. I am on slow release insulin which doesn't prevent spikes or low hypo warnings on my CGM.
How can I go about this?
Sorry about multiple questions.

 

[rebrascora]

Hi and welcome.

Personally I do not think 132/68 is too high and is still at the top end of the "green" zone, which is where mine usually sits, sometimes a bit lower, sometimes a bit higher and my GP and nurse are not concerned about it.

As regards your diabetes, sorry to hear that you have not been getting the right "investigative" support with your diabetes that you feel it warrants.
How long was it after diagnosis that you needed to go onto insulin and what sort of HbA1c results do you get?
What sort of long acting dose do you take and which insulin is it ie. it's actual name.
It is possible that you were a misdiagnosed Type 1 or LADA which is a slow onset form of Type 1 in adults. Many doctors believe that Type 1 only develops in children and young adults, but there are plenty of us here on the forum who developed it in later life. I was 55. I was initially assumed to be Type 2 for the first few weeks but my levels did not respond to Type 2 oral meds and I was started on insulin and referred to the consultant at the diabetes clinic who arranged the tests for Type 1.... Antibody tests and C-peptide. The C-peptide tests how much insulin your body is able to make and mine was borderline normal/low. Most Type 2 diabetics make lots of insulin at diagnosis because their body has become resistant to it and if they are started on insulin, they often need large doses.... hence the question about your insulin dose. My GAD antibody test was also positive, so together with my sudden onset symptoms and weight loss, that all pointed to Type 1.
Unfortunately over time the antibodies which indicate that your immune system has attacked and killed your insulin producing beta cells fade and 20 years after diagnosis, you may not get a positive antibody test result if you were tested, so asking for it may not be helpful to your case. The test is not routinely done by a GP and generally the results are best interpreted by an experienced consultant, so a referral to a specialist clinic is the best option to get that test and the C-peptide test. If you can manage to get a C-pep test then it may show that you are producing very little insulin and you could argue that you need a fast acting insulin to cover your food, because your body is no longer able to do that. That should stop your levels spiking too high after meals although the timing is also important with fast acting insulin. How high do you typically go 2 hours after meals and do you follow any particular dietary regime?

 

[Leadinglights]

Hi, I'm new here though I was diagnosed with type 2 about 20 years ago. Without going into excessive detail, doctors have always told me that I am not typical of type 2 but have never suggested looking into it. They just say it doesn't matter and that there are lots of types of diabetes. I have never been overweight, am active and eat healthily.
I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?
I would really like to get a second opinion about this and also my diagnosis of type 2 which is looking more and more wrong. I am on slow release insulin which doesn't prevent spikes or low hypo warnings on my CGM.
How can I go about this?
Sorry about multiple questions.

A quick internet search and several sources suggest that what you are getting is OK so yes a second opinion might reassure you. It can depend on other factors as well as to what would be ideal for you.

 

[Robin]

The limits for OK blood pressure seem to go down every time I have a review. Last time, mine was around 130/80 at the surgery, and the nurse made me do a home check chart, taking it twice a day for a week. (That came out a lot lower!) Have you been asked to test BP at home? Because 'white coat' syndrome is so common,(my BP is always higher at the surgery) and HCPs should be aware of this, it’s meaningless to talk about needing to lower blood pressure if it was from one reading taken at the surgery.

 

[Lizajane10]

Hi, I'm new here though I was diagnosed with type 2 about 20 years ago. Without going into excessive detail, doctors have always told me that I am not typical of type 2 but have never suggested looking into it. They just say it doesn't matter and that there are lots of types of diabetes. I have never been overweight, am active and eat healthily.
I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?
I would really like to get a second opinion about this and also my diagnosis of type 2 which is looking more and more wrong. I am on slow release insulin which doesn't prevent spikes or low hypo warnings on my CGM.
How can I go about this?
Sorry about multiple questions.

My blood pressure is around 135/85 and I’ve been advised to ‘keep an eye’ on it but it won’t need treatment unless the lower figure creeps over 90. So yours sounds fine to me. I’m 56 if age makes a difference.

 

[DaveB]

Hi. BP typically increases with age and that doesn't necessarily mean you need to take pills. GPs don't always recognise that fact. Your number seem fine to me. BTW an anaesthetist at Papworth Hospital once told us that it's the lower number that really matters and your lower number is very good. I wonder how many GPs know about the lower number being more important?

 

[PurpleTrout]

The limits for OK blood pressure seem to go down every time I have a review. Last time, mine was around 130/80 at the surgery, and the nurse made me do a home check chart, taking it twice a day for a week. (That came out a lot lower!) Have you been asked to test BP at home? Because 'white coat' syndrome is so common,(my BP is always higher at the surgery) and HCPs should be aware of this, it’s meaningless to talk about needing to lower blood pressure if it was from one reading taken at the surgery.

Thanks for that, mine is also higher at the surgery, this was as a result of testing at home. The doctor I saw said that it was needed to prevent damage to my retina, he also wants me on a 10mg a day dose of statin for the same reason.

 

[PurpleTrout]

A quick internet search and several sources suggest that what you are getting is OK so yes a second opinion might reassure you. It can depend on other factors as well as to what would be ideal for you.

How do you go about getting a second opinion from somebody? I don't have lots of confidence in whoever is given the job of 'diabetes specialist'.

 

[Martin.A]

I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?

There's a range between normal and hypertension that's sometimes referred to as 'High Normal', which is where 132/68 sits. I do a weekly BP check at home and mine is regularly in that zone, on average twice as often as it's in the normal zone. It was 124/73 last check.

According to the NHS website, if BP reaches 135/85 or more it should be checked by a healthcare professional.

 

[Cheyne]

Hi, I'm new here though I was diagnosed with type 2 about 20 years ago. Without going into excessive detail, doctors have always told me that I am not typical of type 2 but have never suggested looking into it. They just say it doesn't matter and that there are lots of types of diabetes. I have never been overweight, am active and eat healthily.
I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?
I would really like to get a second opinion about this and also my diagnosis of type 2 which is looking more and more wrong. I am on slow release insulin which doesn't prevent spikes or low hypo warnings on my CGM.
How can I go about this?
Sorry about multiple questions.

Hi,
I would trade you your BP in an instant, 180/112 this morning. I'm T2 on slow acting insulin and continually have high spikes from thinking about eating and on a very low carb diet. Fortunately never had a hypo moment but always hyper for unknown reasons. I range from Bg 5 to 20 and points inbetween every day. I also wonder if I am infact T2 anymore.
Cheers

 

[PurpleTrout]

Hi and welcome.

Personally I do not think 132/68 is too high and is still at the top end of the "green" zone, which is where mine usually sits, sometimes a bit lower, sometimes a bit higher and my GP and nurse are not concerned about it.

As regards your diabetes, sorry to hear that you have not been getting the right "investigative" support with your diabetes that you feel it warrants.
How long was it after diagnosis that you needed to go onto insulin and what sort of HbA1c results do you get?
What sort of long acting dose do you take and which insulin is it ie. it's actual name.
It is possible that you were a misdiagnosed Type 1 or LADA which is a slow onset form of Type 1 in adults. Many doctors believe that Type 1 only develops in children and young adults, but there are plenty of us here on the forum who developed it in later life. I was 55. I was initially assumed to be Type 2 for the first few weeks but my levels did not respond to Type 2 oral meds and I was started on insulin and referred to the consultant at the diabetes clinic who arranged the tests for Type 1.... Antibody tests and C-peptide. The C-peptide tests how much insulin your body is able to make and mine was borderline normal/low. Most Type 2 diabetics make lots of insulin at diagnosis because their body has become resistant to it and if they are started on insulin, they often need large doses.... hence the question about your insulin dose. My GAD antibody test was also positive, so together with my sudden onset symptoms and weight loss, that all pointed to Type 1.
Unfortunately over time the antibodies which indicate that your immune system has attacked and killed your insulin producing beta cells fade and 20 years after diagnosis, you may not get a positive antibody test result if you were tested, so asking for it may not be helpful to your case. The test is not routinely done by a GP and generally the results are best interpreted by an experienced consultant, so a referral to a specialist clinic is the best option to get that test and the C-peptide test. If you can manage to get a C-pep test then it may show that you are producing very little insulin and you could argue that you need a fast acting insulin to cover your food, because your body is no longer able to do that. That should stop your levels spiking too high after meals although the timing is also important with fast acting insulin. How high do you typically go 2 hours after meals and do you follow any particular dietary regime?

Hi and thanks for the reply. I dont think its high at all and this is what has prompted the initial question(s). I dont feel that the people assigned to look after diabetic patients have generally got the time to really look into the issues. I think we are getting stock answers.
I went to my diabetic nurse with some research that I had done following a blood test which revealed very low B12 levels. The (easily available) research on the NHS web site pointed to Metformin use being a key factor in reduced B12 levels. Her initial reaction was that she would look into it, and within an hour I had a phone call telling me to stop taking my very high dose and come back. The result was that my B12 is now right back up to where it should be.
I really want a proper specialist to tell me whether my blood pressure is too high because I doubt that it is. I dont know where to go or how to go about it.
I am taking 'Humulin' 30 units in the morning and 15 at night. Blood glucose spikes after meals to about 14 and any physical activity (walk, housework etc) can set the fibre alarm off at 3.8. Going for a run though increases it although eventually it does go low again. I am still taking a small dose of metformin and sitagliptin.

 

[PurpleTrout]

Hi,
I would trade you your BP in an instant, 180/112 this morning. I'm T2 on slow acting insulin and continually have high spikes from thinking about eating and on a very low carb diet. Fortunately never had a hypo moment but always hyper for unknown reasons. I range from Bg 5 to 20 and points inbetween every day. I also wonder if I am infact T2 anymore.
Cheers

Interesting about the hyper. I am the same. Last night I went to bed with a reading of 6.8, it dropped to 3.8 and my alarm went off and while asleep it went up to 15.4. It was back at 6.9 this morning.

 

[Cheyne]

Interesting about the hyper. I am the same. Last night I went to bed with a reading of 6.8, it dropped to 3.8 and my alarm went off and while asleep it went up to 15.4. It was back at 6.9 this morning.

Hi,
It is early days for me and Autonomic polyneuropathy. It suddenly causes corrupted signals which intern change any and all of the functions the body does automatically. Being Poly it is everything including the ability to stop the heart instantly without warning. Is it interfering with my Bg and BP levels, possibly and most definitely my ability to digest food. But the readings are true and correct.
Two weeks ago I was standing in my workshop unable to move from the waist down no matter how hard I tried to convince my legs and feet to move. A whole other experience for me. Fortunately a corrected signal got through freeing me again. Felt like I was in a Si Fi movies for a moment. This is the life when BP and Diabetes are left unchecked for so long. I will never again rely on a Dr's opinion, blindly. The time to act is the first time you experience anything out of the normal. Insist on getting it sorted. I rely on NHS UK web site along with a few other renown sites for my guidance.
Cheers

 

[rebrascora]

Interesting about the hyper. I am the same. Last night I went to bed with a reading of 6.8, it dropped to 3.8 and my alarm went off and while asleep it went up to 15.4. It was back at 6.9 this morning.

Libre are prone to what we call "compression lows" where if you lie on the sensor it gradually compresses the tissue under the sensor that the filament is sampling, this gradually gets to a point where it affects the readings and it starts to give false low readings. If your Libre goes off during the night and indicates that you are hypo but you don't feel hypo or you wake up lying on that side, then it is important to double check with a finger prick before taking a hypo treatment. If you had a hypo treatment when you are not actually low, then that will cause your levels to be far too high in the morning.
It is important to understand that Libre is most reliable between 4 and 10. Above 10 it often exaggerates just how high you are, so a reading of 15.4 might actually just be 12 or 13.... still too high but ot nearly so bad. Similarly I find that generally Libre reads lower than a finger prick in range and particularly at low levels so a genuine 3.8 reading (ie not a compression low) will be nearer 4.8. For some people, Libre can be as much further adrift from their actual BG so it is important to double check it occasionally with a finger prick to get an idea of how it is performing for your body.

As regards specialist input or a second opinion I think sometimes we have to do our own research and come to our own decisions based on what we know about ourselves and our family history and our lifestyle etc. My nurse and consultant would like me to take a statin but I do not feel it is necessary. My cholesterol has been consistently middle 4s since diagnosis and I am fitter and healthier than most of my friends my age and I put a lot of effort into managing my diabetes well, so I don't feel that my diabetes makes me more at risk and in fact since diagnosis I have become healthier, because I think about everything I put in my mouth. The only reason why they want me on a statin is because I am diabetic and they like diabetics' total cholesterol to be below 4. They can advise me but it is me who ultimately decides what medication I take. I have nothing against taking a statin if my cholesterol was high, and I would review my decision if it suddenly shot up but at this level I do not feel that I need a statin.

My point is that we now have access to lots more information than previous generations and medical professionals are not always right and the NHS is seriously overstretched and in some cases collapsing, so in may respects we have to take responsibility for our own health, do our research and advocate for ourselves. Talking of which, in your situation I would be asking for a mealtime insulin to work alongside your long acting Humulin..... assuming that is Humulin I (the letter i not the number 1) so that you can dose for your meals and reduce your post meal spikes.

 

[Burylancs]

How do you go about getting a second opinion from somebody? I don't have lots of confidence in whoever is given the job of 'diabetes specialist'.

Check out NICHE Guidelines on this matter. T2 and Hypertension are bedfellows in the Metabolic Syndrome and both need Good Control.

 

[Allan_lockyer_wales]

Hi there! It sounds like you've been managing your type 2 diabetes with diligence despite some unusual aspects... A blood pressure of 132/68 is slightly elevated but not alarming. However, it's wise to seek a second opinion if you're unsure. It's better to be safe than sorry 🙂

 

[louisew]

Hi, I'm new here though I was diagnosed with type 2 about 20 years ago. Without going into excessive detail, doctors have always told me that I am not typical of type 2 but have never suggested looking into it. They just say it doesn't matter and that there are lots of types of diabetes. I have never been overweight, am active and eat healthily.
I have been told this week that my blood pressure (132/68) is too high and I need to lower it. I really don't think I do. Is this really high?
I would really like to get a second opinion about this and also my diagnosis of type 2 which is looking more and more wrong. I am on slow release insulin which doesn't prevent spikes or low hypo warnings on my CGM.
How can I go about this?
Sorry about multiple questions.

I’m also a non typical diabetic. I was put on basal insulin first which brought down my blood sugar, but even eating less than 20 carbs per meal and taking 24 units (blood sugar too low at night) , like you caused spikes. I asked to be prescribed bolus, which really helped with them. However after a scare on holiday going into a hypo on a hike, and then being too scared to take it before hikes, scuba diving etc, my blood sugars were all over the place. I did some research and asked if I could add metformin. It’s been a game changer. My basal is down form 12 units to 4, and bolus from around 10, to less than 5 and sometimes none atall. No spikes and no morning rise, and doing exercise is so much easier because i just don’t have any bolus on board, and I stay safe. i don’t have GAD antibodies, my father was a slim, healthy type 2, and TBH, I manage really well, my hbac1 dropped .3 mmol to 5.8, non diabetic range within a month of starting metformin, and probably at 5.4 now. So maybe talk to you GP or DN. I had to ask to be put on both these drugs. I had to do a food diary (20 carbs a meal) to show the spikes before I was put on bolus, and again I asked to be prescribed metformin. I’d still be struggling on basal if I hadn’t been proactive.

 

[EMcKT]

Hi and thanks for the reply. I dont think its high at all and this is what has prompted the initial question(s). I dont feel that the people assigned to look after diabetic patients have generally got the time to really look into the issues. I think we are getting stock answers.
I went to my diabetic nurse with some research that I had done following a blood test which revealed very low B12 levels. The (easily available) research on the NHS web site pointed to Metformin use being a key factor in reduced B12 levels. Her initial reaction was that she would look into it, and within an hour I had a phone call telling me to stop taking my very high dose and come back. The result was that my B12 is now right back up to where it should be.
I really want a proper specialist to tell me whether my blood pressure is too high because I doubt that it is. I dont know where to go or how to go about it.
I am taking 'Humulin' 30 units in the morning and 15 at night. Blood glucose spikes after meals to about 14 and any physical activity (walk, housework etc) can set the fibre alarm off at 3.8. Going for a run though increases it although eventually it does go low again. I am still taking a small dose of metformin and sitagliptin.

I am on Metformin as well and my B12 has gone from over 440 , well within the normal range, to 192. Oh, let's leave it another three months and test again ......the reply. Lord knows what it will be then. I need to go back and moan as I am feeling very low, aches and pains everywhere, just as I had with low Vit D which is where the malarkey started.

 

[stephenS50]

This is one thing I do every day.I use a blood pressure app to test it and no 132/68 is not that high...in fact it's pretty exceptible.

 

[nonethewiser]

This is one thing I do every day.I use a blood pressure app to test it and no 132/68 is not that high...in fact it's pretty exceptible.

How does that work then?

More importantly how accurate is this app, never knew there was such a thing.