Suggest Ways To Manage Blood Pressure In Type 2 Diabetes Patient
atacand 32mg morning, aspiring 100mg morning, dithizide 25mg morning, zanidip 10mg night, metforming 850mg night, gliclazide 80mg morning.
he says after reducing his dosage of betaloc.. his bp that is normally round 135-140/60-65 is now 140-148/70 .. he has been adviced to sit before standing in the morning from bed and not to stand for too long but is he doing the right thing by reducing his betaloc or should he continur on 50mg twice a day but take it morning and night instead? or is it possible to increase zanidip to 20mg and reduce betaloc to 25mg twice a day?
Blood pressure
Detailed Answer:
Sorry to learn about your dad's bothersome symptoms.
It is not possible to manage an individual's blood pressure (BP) at an online forum such as this one.
He will need close follow up during the medication readjustment phase. He will need to see his doctor frequently during this time with twice daily BP readings.
But I will advise a couple things:
1 Betaloc should not be stopped abruptly or it can cause problems. I know he is reducing the dose and not stopping it entirely but even then this should all be done under professional medical guidance
2 He should check his blood glucoses levels with a meter at the time of his symptoms . It could be well be due to hypoglycemia ie low sugar reaction.
When I see someone like your dad in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
12 hour Fasting Lipid profile
Urine albumin to Creatinine Ratio (early sign of diabetes affecting the kidney)
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
Follow up
Detailed Answer:
I understand the glucoses are well controlled but it is important to note exactly how much it is at the time of symptoms.
Suddenly stopping betaloc can lead to rebound increase in BP. I see he is not suddenly stopping it but still a physicians guidance is required even while tapering.
Second follow up
Detailed Answer:
No. On the contrary, heart rate increases in these two situations