Establishing target systolic and diastolic blood pressure in diabetic patients with hypertension: what do we need to consider?

2021 ◽  
Author(s):  
Brian Thompson ◽  
John W McEvoy
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Diabetic Patients

scholarly journals SGLT2 inhibitors and lower limb complications: an updated meta‐analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chu Lin ◽  
Xingyun Zhu ◽  
Xiaoling Cai ◽  
Wenjia Yang ◽  
Fang Lv ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Lower Limb ◽  
Blood Pressure Reduction ◽  
Random Effect Model ◽  
Diabetic Patients ◽  
Controlled Trials ◽  
Pressure Reduction ◽  
Effect Model ◽  
Meta Regression

Abstract Background To exam the associations between the use of sodium glucose co-transporter 2 inhibitor (SGLT2i) and the risk of lower limb complications, and to analyze the associated factors. Methods Pubmed, Medline, Embase, the Cochrane Center Register of Controlled Trials for Studies and Clinicaltrial.gov were searched from the inception to November 2020. Randomized controlled trials of SGLT2i conducted in population containing diabetic patients with reports of amputation, peripheral arterial disease (PAD) and diabetic foot (DF) events were included. Random-effect model, fixed-effect model and meta-regression analysis were accordingly used. Result The numbers of SGLT2i users versus non-SGLT2i users in the analyses of amputation, PAD and DF were 40,925/33,414, 36,446/28,685 and 31,907/25,570 respectively. Compared with non-SGLT2i users, the risks of amputation and PAD were slightly increased in patients with canagliflozin treatment (amputation: OR = 1.60, 95% CI 1.04 to 2.46; PAD: OR = 1.53, 95 % CI 1.14 to 2.05). Meta-regression analyses indicated that greater weight reduction in SGLT2i users was significantly associated with the increased risks of amputation (β = − 0.461, 95% CI − 0.726 to − 0.197), PAD (β = − 0.359, 95% CI − 0.545 to − 0.172) and DF (β = − 0.476, 95% CI − 0.836 to − 0.116). Lower baseline diastolic blood pressure (β = − 0.528, 95% CI − 0.852 to − 0.205), more systolic blood pressure reduction (β = − 0.207, 95% CI − 0.390 to − 0.023) and more diastolic blood pressure reduction (β = − 0.312, 95% CI − 0.610 to − 0.015) were significantly associated with the increased risks of amputation, PAD and DF respectively in patients with SGLT2i treatment. Conclusions The risks of amputation and PAD were slightly increased in patients with canagliflozin treatment. Reductions in body weight and blood pressure were associated with lower limb complications in patients with SGLT2i treatment.

Temperature Biofeedback Training to Improve Peripheral Blood Flow in the Upper Extremities of Diabetic Patients

1984 ◽  
Vol 51 (5) ◽  
pp. 219-224 ◽  
Author(s):  
Elizabeth Dean
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Diastolic Blood Pressure ◽  
Peripheral Blood ◽  
Diabetic Group ◽  
Biofeedback Training ◽  
Control Group ◽  
Diabetic Patients ◽  
Peripheral Blood Flow ◽  
Temperature Biofeedback

Ten control and ten diabetic subjects were first given a baseline session of no temperature biofeedback, and then were exposed to four 40-minute temperature biofeedback sessions over consecutive days. As the result of feedback training, peripheral skin temperatures increased on the training (right) hands of both groups, and this occurred to a greater extent in the diabetic group. Concomitant temperature increases occurred also in the left hands of both groups. Neither group produced any significant changes in heart rate, respiration rate, or systolic blood pressure with the exception of a significant decrease in diastolic blood pressure for the diabetic group. No difference in diastolic blood pressure was observed, however, when the diabetics were compared with the control group. The results would suggest further evaluation of temperature biofeedback training is warranted in a diabetic population as a potential means of increasing peripheral blood flow in the extremities.

Modification of Cardiovascular Risk Factors during Antihypertensive Treatment: A Multicentre Trial with Quinapril

1993 ◽  
Vol 21 (1) ◽  
pp. 15-25 ◽  
Author(s):  
E Manzato ◽  
A Capurso ◽  
G Crepaldi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Enzyme Inhibitor ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Intent To Treat

A large multicentre study involving 6003 [3044 males, 2959 females; mean (± SD) age 59 ± 11 years] mild-to-severe hypertensive patients was carried out to evaluate the effects of the angiotension converting enzyme inhibitor quinapril on blood pressure and on metabolic cardiovascular risk factors during 3 − 6 months' treatment (mean follow-up 90.4 days). The study population included 551 elderly [mean (± SD) age 71.9 ± 9.3 years] patients, 1314 subjects with diabetes mellitus and 154 non-diabetic patients with hyperlipaemia; 4% of patients were lost to follow-up. Diastolic blood pressure decreased from 102 to 87 mmHg (intent-to-treat analysis) and 62% of patients were normalized (diastolic blood pressure below 90 mmHg) at the last evaluable visit. Overall, serum lipids were favourably affected during quinapril treatment; when corrected for changes in body weight, a significant improvement in total, low- and high-density lipoprotein cholesterol, and triglycerides was detected. Quinapril treatment in elderly patients was efficacious and well tolerated, and quinapril appears to be an effective antihypertensive drug devoid of untoward effects on metabolic risk factors for cardiovascular disease.

The effects of a Melissa officinalis L. based product on metabolic parameters in patients with type 2 diabetes mellitus: A randomized double-blinded controlled clinical trial

2019 ◽  
Vol 16 (3) ◽  
Author(s):  
Neda Nayebi ◽  
Alireza Esteghamati ◽  
Alipasha Meysamie ◽  
Nahid Khalili ◽  
Mohammad Kamalinejad ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Diastolic Blood Pressure ◽  
Common Finding ◽  
Controlled Study ◽  
P Value ◽  
Diabetic Patients ◽  
Melissa Officinalis ◽  
Double Blinded

Abstract Background Diabetic patients are at increased risk for coronary artery disease. Since phytotherapy has been greatly common, finding safe and effective treatments is of importance. This study aimed to evaluate the effects of a Melissa officinalis L. based product (MO) in patients with type 2 diabetes. Methods A randomized double-blinded controlled study was conducted with 37 dyslipidemic diabetic patients, assigned to either MO or placebo (P) groups receiving two 500 mg capsules daily for 3 months. Finally, 32 cases completed the study and were included in the analysis; MO (n=16) and P (n=16). Results Safe and significant effects in terms of decreasing the serum level of triglyceride (TG) in all patients after 2 months (p-value=0.02) and in patients with higher baseline serum levels of TG (TG≥200 mg/dl) after 3 months (p-value=0.04) were shown in the MO group. However, no metabolic significant changes were seen compared to the control group. Significant decrease in both systolic and diastolic blood pressure from baseline values were also found in patients with higher systolic blood pressure (SBP≥130 mmHg) (p-value=0.02) and those with higher diastolic blood pressure (DBP≥85 mmHg) (p-value=0.02) in the MO group. Conclusion This study showed that MO might be safe and beneficial in decreasing the serum TG level in dyslipidemic diabetic patients. Although, larger long-term studies are required.

scholarly journals Characteristics of Masked Hypertension in Diabetes Mellitus Patientstype 2

2021 ◽  
pp. 176-184
Author(s):  
Vu Thanh Binh ◽  
Nguyen Le Thuy ◽  
Le Minh Hieu
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Diastolic Blood Pressure ◽  
University Hospital ◽  
Diabetic Patients ◽  
Masked Hypertension ◽  
Blood Pressure Monitor ◽  
Pressure Monitor ◽  
Hypertensive Patients

Monitoring blood pressure with a continuous blood pressure monitor to carry around to detect masked hypertension (MH) in type 2 diabetes patients who are on outpatient treatment at Thai Binh Medical University Hospital, Thai Binh, Vietnam. Objective: Analysis of MH characteristics in type 2 diabetic patients. Research Methods: Cross-sectional descriptive study, sample size of 186 patients with type 2 diabetes with MH determined by blood pressure monitor 24 hours. Analysis of 24-hour blood pressure results in MH patients. Results: 186 patients with hypertension / type 2 diabetes, including 77 men and 109 more, the average age is 62.2 ± 9.3 years old, there are 98.9% of hypertensive patients with grade I, only 1.1% of hypertensive patients degree II; MH at night accounted for the highest rate of 43.0%, of which the average systolic blood pressure was 123.8 ± 9.8 mmHg, and diastolic blood pressure was 75.2 ± 6.1 mmHg; On average, the highest increase is around 9 am and 19 pm, slightly down around 13pm and down at the deepest around 2-3am. There is a synchronous variation between systolic and diastolic blood pressure. Conclusion: Blood pressure should be monitored continuously for 24 hours in all patients with type 2 diabetes to detect and promptly treat MH.

scholarly journals Demographic, medical and visual aspects of Dia- betic Retinopathy (DR) and Diabetic Macular Edema (DME) in South African diabetic patients*

2009 ◽  
Vol 68 (2) ◽  
Author(s):  
Anusha Y. Sukha ◽  
Alan Rubin
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
South African ◽  
Vision Loss ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Central Visual Field ◽  
Interaction Domain ◽  
Cross Sectional ◽  
The Impact

Objective: To investigate some of the demographic, medical, and visual aspects of diabetic retinopathy (DR) and diabetic macula edema (DME) in diabetics attending an urban clinic in Johannesburg, Gauteng.Design: In this cross-sectional study, 202 diabetic patients were recruited. Demographic variables included age, gender, race, age of diagnosis, duration of diabetes mellitus (DM), and social habits. Medical variables included systemic conditions present, blood pressures, body mass indices (BMI), lipid profiles, glycerated haemoglobin (HbA1c), and other biochemical data. Visual variables included distance, pinhole and near visual acuities, contrast visual acuities (CVA), refractive status, colour vision, central visual field evaluation with the Amsler grid, intraocular pressures (IOP), fundus photography and administration of the Impact of Visual Impairment (IVI) questionnaire. All variables were compared between diabetic subjects with and with-out DR and DME in both right and left eyes.Results: Overall prevalence of DR was 22.8% and DME 12.5%. In DR subjects, significant results indicated that Whites were more likely to present with DR (p = 0.002). Subjects with DR had a higher mean duration of DM (p = 0.002) and a higher mean diastolic blood pressure (p = 0.035). Autorefraction suggested that more myopia and less astigmatism might be associated with DR. A higher mean CVA at the 2.5% level in DR was significant in both the right eyes (p = 0.042) and left eyes (p = 0.035). These subjects also reported a higher mean IVI score in the consumer and social interaction domain (p = 0.032). Similarly, DME subjects displayed a higher mean duration of DM (p = 0.042) and a higher mean diastolic blood pressure (p = 0.048). A higher mean CVA was associated at both the 10% level: right eyes (p = 0.021); and left eyes (p = 0.046), and at the 2.5% level: right eyes (p = 0.033) and left eyes (p = 0.045). A higher mean IVI score in leisure and work (p = 0.026), consumer and social interactions (p = 0.01) and emotional re-action to vision loss (p = 0.018) was reported in subjects with DME.Conclusion: This study has identified possible demographic, medical and visual risk factors of DR and DME in South African diabetic patients.  

scholarly journals Study of Adiponectin Level in Diabetic Adolescent Girls in Relation to Glycemic Control and Complication of Diabetes

2015 ◽  
Vol 3 (4) ◽  
pp. 613-618 ◽  
Author(s):  
Soha M. Abd El Dayem ◽  
Hayam K. Nazif ◽  
Mona Abd EI-Kader ◽  
Maha El-Tawil
Keyword(s):  
Blood Pressure ◽  
Glycemic Control ◽  
Total Cholesterol ◽  
Diastolic Blood Pressure ◽  
Disease Duration ◽  
Adiponectin Level ◽  
Glycosylated Hemoglobin ◽  
Female Adolescent ◽  
Diabetic Patients

AIM: To study the relation between adiponectin level with glycemic control and complication of diabetes.PATIENTS AND METHODS: The study included 40 female adolescent type 1 diabetic patients and 40 healthy volunteers of the same age and sex. Blood sample was taken for assessment of glycosylated hemoglobin, lipid profile and adiponectine. Urine sample was taken for assessment of albumin/ creatinine ratio.RESULTS: Diabetic patients had a significantly higher diastolic blood pressure, triglyceride, total cholesterol, LDL and adiponectin than controls. Patients with diabetes complication had a significant lower BMI and HDL. On the other hand, they had higher disease duration, total cholesterol, HbA1, albumin/creatinine ratio and adiponectin. Patients with microalbuminuria had a lower BMI, higher disease duration, diastolic blood pressure and adiponectin. Patients with diabetic retinopathy had higher disease duration, insulin dose, HbA1, microalbuminuria and adiponectin. Adiponectin in diabetic patients had a significant negative correlation with BMI and positive correlation with systolic blood pressure and microlabuminuria.CONCLUSION: Serum adiponectin level is high in adolescent type 1 diabetic girls. It can be used as a predictor of diabetes complications rather than a sensitive biochemical marker for glycemic control.

scholarly journals Fasting Blood Glucose Level Progression And Its Associated Factors Among Diabetic Patients Attending Treatment In North Shewa Hospitals, Oromia, Ethiopia

2021 ◽  
Author(s):  
Yordanos Berihun Yohannes ◽  
Berhanu Teshome Woldeamanuel ◽  
Buzuneh Ayano
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Diastolic Blood Pressure ◽  
Glucose Level ◽  
Associated Factors ◽  
Fasting Blood Glucose ◽  
Secondary Data ◽  
Diabetic Patients ◽  
Fasting Blood Glucose Level

Abstract Background: Diabetes describes a group of metabolic disorders characterized and identified by hyperglycemia without treatment. It includes defects in insulin secretion, insulin action, or both, and disturbances of carbohydrate, fat, and protein metabolism. The study aimed to assess fasting blood glucose level progression and its associated factors among diabetic patients attending insulin and metformin follow-up in fiche and Chancho hospitals.Methods: A retrospective study was conducted to obtain secondary data among diabetic patients attending treatment from September 2016 to August 2018 in the hospital. The linear- mixed effects model for longitudinal data was employed to measure the changes in fasting blood glucose level.Result: The result of the study revealed that age, body mass index, systolic blood pressure, diastolic blood pressure, marital status, regime, and education level were significantly associated factors for the progression of fasting blood glucose levels among diabetic patients. Conclusion: The study recommended that the progression of blood glucose level was higher among diabetic patients, and the health professionals, health sectors, and government should be paid an intervention on patients who had high systolic and diastolic blood pressure, who had high BMI, and older age patients.

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