Blood Pressure In Diabetic Patients Research Articles

Relationship Between Hyperuricemia and Hypertension in Diabetic Patients Undergoing Hemodialysis

Background: Diabetes is a prevalent chronic disease and is considered a risk factor for other chronic diseases. Various studies have pointed out the relationship between uric acid and type 2 diabetes. Objectives: This study aimed to investigate the relationship between hyperuricemia and hypertension in diabetic patients undergoing hemodialysis. Methods: The descriptive-analytical cross-sectional study was conducted on dialysis patients referred to the Comprehensive Center for the Treatment of Special Diseases in Birjand in 2022. Data were collected through a checklist, which included information such as age, sex, duration of hemodialysis, duration of diabetes, history of underlying diseases, blood pressure, and serum uric acid level. The data were analyzed using SPSS 26 software and chi-square, Fisher's exact, Mann-Whitney tests with a significance level of 0.05. Results: Hypertension was present in 61 (85.9%) of patients. The average uric acid level was 5.9 ± 1.12, and hyperuricemia was observed in 11 (15.5%) of patients. Although the rate of hyperuricemia was higher in patients with high blood pressure [10 (16.4%) vs. 1 (10%)], no significant relationship between hyperuricemia and high blood pressure was observed (P = 0.605). Additionally, no significant relationship was observed between the average uric acid level and demographic factors (age, sex, duration of dialysis, and average blood sugar) (P > 0.05). Conclusions: According to the present study's results, the rate of hyperuricemia in dialysis patients with high blood pressure is higher than in patients without high blood pressure. However, due to the non-significance of this relationship, there is a need to conduct studies with a larger sample size to truly understand its relationship with high blood pressure in diabetic patients undergoing hemodialysis.

HbA1C, proliferative and non-proliferative retinopathy in diabetic patients

BackgroundRetinopathy is one of the most common microvascular complications caused by diabetes, which occurs due to changes in blood capillaries. One of the most important factors to determine the progression of retinopathy is measuring HbA1C. This study aimed to investigate the relationship between glycosylated hemoglobin levels, blood pressure (systolic and diastolic), and triglycerides with DRP in the population of diabetic patients. MethodsThis descriptive and analytical study was conducted on 80 diabetic patients referred to Hafiz Sabzevar Diabetes Clinic in 1400. Based on fundoscopic examination, patients were divided into three general categories: patients without retinopathy, patients with proliferative diabetic retinopathy, and patients with non-proliferative retinopathy. Patient information was collected through a demographic questionnaire (including age, sex, insulin or oral drug use, and fasting blood sugar level) and a researcher-made checklist (including HbA1C, systolic blood pressure, diastolic blood pressure and triglycerides). Data were analyzed with spss 28. Descriptive statistical tests, ANOVA and Bonferroni's post hoc test were used for analysis. ResultsThe results of the study showed that there is a significant difference in HbA1C, SBP and DBP levels between the three groups (P = 0.000). Post Hoc (Bonferroni) test was used to accurately determine this significant difference. The data showed that both retinopathy groups (NPDR and PDR) had higher levels of HbA1C and blood pressure (SBP and DBP) compared to the non-retinopathy group and this difference was statistically significant (P = 0.000). However, there was no significant difference between the three groups in terms of triglyceride levels (P = 0.96). ConclusionHigh levels of glycosylated hemoglobin, systolic and diastolic blood pressure play an important role in the occurrence of diabetic retinopathy. Therefore, it is recommended to carefully control blood sugar and blood pressure of diabetic patients in order to prevent the occurrence of retinopathy.

Effects of brisk walking on fasting blood glucose and blood pressure in diabetic patients

Background: Aerobic exercises have been administered as an adjunct treatment for health conditions; however, the effects of brisk walking on Type 2 diabetes mellitus (T2DM) patients living with hypertension in Ghana are yet to be explored.Aim: To determine the effects of brisk walking on fasting blood glucose and blood pressure of patients with T2DM living with hypertension in Ghana.Setting: The National Diabetes Management and Research centre at Korle-Bu Teaching Hospital.Methods: Males and females above 18 years with T2DM and hypertension were included. Fasting blood glucose, anthropometric measurements and distance walked were measured at baseline and after 8 weeks of intervention. The intervention consisted of brisk walking three times a week for 8 weeks.Results: Sixty participants completed the intervention. There was a statistically significant reduction of fasting blood glucose (baseline: 8.79 mmol/L (3.55), after intervention: 7.62 mmol/L (2.73) with p = 0.02) and blood pressure levels: (systolic blood pressure baseline: 141.12 mmHg (2.91) after intervention 120.75 mmHg (1.21) with p = 0.00); diastolic blood pressure (baseline: 80.78 mmHg (1.66), after intervention mmHg 69.38 (1.05) with p = 0.00) between baseline and post-intervention.Conclusion: Eight weeks of brisk walking reduced the levels of fasting blood glucose and blood pressure in patients with T2DM and hypertension.Contribution: This study will enlighten healthcare workers about the integration of brisk walking as a possible adjunct to control blood glucose and blood pressure levels in patients with T2DM and hypertension.

The effect of a low versus high sodium diet on blood pressure in diabetic patients: A systematic review and meta-analysis of clinical trials.

There have been numerous clinical trials that have investigated the effect of sodium intake on blood pressure in diabetic patients. The purpose of this systematic review and meta-analysis was to evaluate the clinical trial studies performed on the effect of low sodium diet (LSD) versus high sodium diet (HSD) on blood pressure in diabetic patients. PubMed, Scopus, and Web of Science were systematically searched from database inception to July 10, 2021. Both type 1 and 2 diabetes was considered. Overall, there were 15 studies included in this meta-analysis. The weighted (WMD) mean difference with 95% confidence interval (CI) was calculated using a random-effects model. Risk of bias in the studies was assessed based on the Cochrane collaboration tool and the quality of all the studies was considered as good. Overall, LSD significantly reduced SBP (systolic blood pressure) (WMD: -3.79 mmHg, 95% CI: -6.02, -1.56) and DBP (diastolic blood pressure) (WMD: -1.62 mmHg, 95% CI: -2.84, -0.40), in comparison with HSD, in diabetics. However, LSD had no significant effect on MAP (mean arterial pressure) in comparison with HSD (WMD: -1.81, 95%CI: -5.49, 1.87). Although subgroup analysis could not attenuate heterogeneity in SBP, subgroup analysis in DBP based on duration (≤1week: WMD: -2.35, 95%CI: -3.69, -1.00, I 2 = 48.9%, p=0.081, >1week: WMD: -1.04, 95% CI: -2.83, 0.76, I 2 = 74.7%, p=0.003) and study design (cross-over: WMD: -1.94, 95% CI: -2.71, -1.17, I 2 = 32.1%, p=0.183, parallel: WMD: -2.17, 95% CI: -6.48, 2.13, I 2 = 82.4%, p=0.001) successfully detected sources of heterogeneity. LSD significantly reduced SBP and DBP, however, had no effect on MAP, in comparison with HSD.

Abstract 11180: Assessing the Impact of the Covid-19 Pandemic Shelter in Place on Glycemic Control and Blood Pressure in Diabetic Patients

Introduction: The impact of the COVID-19 pandemic state and county orders for home isolation and social distancing on glycemic control in diabetics is yet to be understood. We aimed to evaluate the impact of California’s 2019 shelter-in-place (SiP) order (mandated from March to June 2020) on glycemic control, blood pressure, and body mass index in the Kaiser Permanente Northern California (KPNC) diabetic population. Methods: This is a retrospective cohort study of Kaiser Permanente Northern California members, age ≥ 18 years old with a diagnosis of type 1 or type 2 diabetes prior to 2019. We evaluated the change in glycated hemoglobin (HbA1c), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), use of oral hypoglycemic agent (OHA), and use of insulin for diabetics, stratified by pre-SiP HbA1c level (<7, 7-8, 8-9, 9-10, and >10%) prior to and following the SiP order. Results: A total of 168,621 diabetics were included. Prior to the SiP, the mean HbA1c was 7.45 (1.48)%, with a mean BMI of 31.81 (7.29), SBP 133.04 (13.84), DBP 70.79 (9.97), 72.06% OHA users and 28.64% insulin users. Following SiP, the mean HbA1c was 7.49 (1.57)%, BMI 31.51 (7.39), SBP 134.12 (15.68) and DBP 71.30 (10.52), and 72.41% OHA users and 29.25% insulin users. A marginal decrease in BMI, was seen across all groups. Increases in HbA1c, SBP, DBP were highest in the HbA1c<7% and 7-8% groups (p<0.0001, Table 1). Conclusions: Marginal increases in HbA1c, SBP and DBP were seen in this diabetic cohort following the California 2020 SiP order. Increased use of OHA and insulin were seen following SiP, with insulin initiation in the highest HbA1c groups. The study helps to identify diabetics in our Northern California cohort that require more intensive management in the post-pandemic era. Further studies will help characterize long-term impacts on risk factors and incident cardiovascular disease.

Effect of sodium-glucose co-transporter inhibitors on blood pressure values. A new class of diuretic drugs?

New sodium-glucose co-transporter (SGLT 2) inhibitors are already widely used in patients with diabetes mellitus and in patients with heart failure. From the beginning of their use, it has been noticed that they slightly but statistically significantly lower both systolic blood pressure (SBP) and diastolic blood pressure (DBP). The antidiabetic activity of these drugs is based on the inhibition of the reabsorption of glucose and partially sodium in the renal tubules, which leads to an increase in the amount of urine excreted. Most likely, increased diuresis is responsible for the drop in blood pressure (BP). So far, numerous meta-analyses confirming the reduction of BP in diabetic patients have already been published, for both office BP and home BP, twenty-four hour BP and ambulatory central blood pressure. The action of SGLT 2 inhibitors, after a single administration, extends over 24 hours and there are already the first successful attempts to use them in hypertension in the course of diabetes mellitus with obstructive sleep apnea. The action of SGLT 2 inhibitors is pleiotropic and, apart from the diuretic effect, they slightly reduce the patient’s weight, reduce the activity of the sympathetic nervous system, restore the normal function of the endothelium, increase uric acid excretion, and reduce blood vessel stiffness. All these factors are responsible for the drop in BP. These favorable properties of SGLT 2 inhibitors indicate that these drugs will be increasingly used, probably not only in diabetes.

Hypertension and Type 2 Diabetes-The Novel Treatment Possibilities.

Elevated blood pressure and hyperglycaemia frequently coexist and are both components of metabolic syndrome. Enhanced cardiovascular risk is strongly associated with diabetes and the occurrence of hypertension. Both hypertension and type 2 diabetes, if treated inappropriately, lead to serious complications, increasing the mortality of patients and generating much higher costs of health systems. This is why it is of great importance to find the missing link between hypertension and diabetes development and to simultaneously search for drugs influencing these two disorders or even drugs aimed at their pathological bases. Standard antihypertensive therapy mainly focuses on blood pressure reduction, while novel drugs also possess a wide range of pleiotropic modes of actions, such as cardio- and nephroprotective properties or body weight reduction. These properties are especially desirable in a situation when type 2 diabetes coexists with hypertension. This review describes the connections between diabetes and hypertension development and briefly summarises the current knowledge regarding attempts to define targets for the treatment of high blood pressure in diabetic patients. It also describes the standard hypotensive drugs preferred in patients with type 2 diabetes, as well as novel drugs, such as finerenone, esaxerenone, sodium–glucose co-transporter-2 inhibitors, glucagon-like peptide-1 analogues and sacubitril/valsartan.

Free vitamin D is independently associated with systolic blood pressure in diabetic patients with impaired kidney function.

Vitamin D contributes to blood pressure (BP) regulation. We compared the association of BP in diabetic patients with either total vitamin D - the standard way of analyzing the vitamin D status - or free vitamin D, because only free vitamin D passes the cell membrane and interacts with the nuclear vitamin D receptor (VDR). An analytical cross-sectional study was conducted with 178 diabetic patients with impaired kidney function. Free and total vitamin D concentrations were measured in all patients. Multiple linear regression analysis considering patient age, sex, body mass index, height, smoking and drinking situation, the use of antihypertensive drugs, cholecalciferol treatment, C-reactive protein and estimated glomerular filtration rate as confounding factors were conducted to compare the association of free and total vitamin D with systolic and diastolic blood pressure (SBP and DBP). Multiple linear regression analysis revealed that neither SBP nor DBP was correlated with total vitamin D (SBP, 95% CI -0.405 ~ 0.159, p = 0.390; DBP, 95% CI -0.131 ~ 0.142, p = 0.933) (Table 2). However, the concentration of free vitamin D was independently associated with SBP (95% CI -2.691 ~ -0.210; p = 0.022) (Table 3), but not with DBP (95% CI -0.934 ~ 0.285; p = 0.293). In conclusion, free - but not total - vitamin D serum concentrations in patients with diabetes and impaired kidney function are inversely correlated with SBP. This study suggests that free vitamin D measurements might be more clinically relevant - as compared to measurements of total vitamin D - to adjust vitamin D therapy in diabetic patients with impaired kidney function.

Hypertensive Phenotypes and Pattern of Ambulatory Blood Pressure in Patients of Diabetes Mellitus of Kashmir Valley.

Background:Patients of diabetes mellitus (DM) with hypertension (HTN) have a fourfold increased risk of cardiovascular disease (CVD) as compared to normotensive nondiabetic controls. However, many patients of DM who are normotensive or have controlled blood pressure on office BP measurement (OBPM) may assume that they do not have increased risk of CVD but may be having HTN or uncontrolled blood pressure on ambulatory blood pressure monitoring (ABPM).Study Design Objective:A cross-sectional observational study to compare OBPM with ABPM and thus predict various hypertensive phenotypes like masked hypertension (MH) and white coat hypertension and pattern of blood pressure in diabetic patients of our population.Materials and Methods:Two hundred patients of DM with or without HTN were included in this study. The cases were subjected to detailed history, clinical examination, OBPM, and ABPM.Results:Out of 200 patients of DM, 32 were normotensives, 46 were hypertensives controlled on antihypertensive treatment, 22 were hypertensives not on anti-hypertensive treatment, and 100 were hypertensives uncontrolled on anti-hypertensive treatment. Among 32 normotensive diabetics, 17 (53%) patients had MH on ABPM. Out of these 32 normotensive patients, 7 (21.8%) had isolated nocturnal hypertension, 3 (9.3%) had isolated day-time HTN (IDH) and 7 (21.8%) had day-time and nocturnal HTN (DNH). Patients with MH had higher BMI, an observation that was statistically significant. Non-dipping pattern was found in 53% of patients of masked HTN. Out of 46 hypertensive diabetics with controlled OBPM on antihypertensive treatment, 26 (56.5%) had masked effect or masked uncontrolled hypertension on ABPM. Out of 22 diabetics with treatment naïve HTN, 7 (32%) were found to have white coat hypertension on ABPM. Fifteen (15%) patients out of 100 hypertensive diabetics with uncontrolled OBPM despite on anti-hypertensive were found to have white coat effect on ABPM. Patients with white coat effect had higher body mass index an observation that was statistically significant (p = 0.039). Non-dipping pattern was significantly associated with longer duration of diabetes (≥ 120 months), retinopathy and neuropathy.Conclusion:To rely exclusively on OBPM to diagnose HTN and monitor blood pressure may underestimate the CVD risk especially in diabetics. ABPM is a tool that may not only help clinicians in starting anti-HTN treatment perspicuously, but also may help in avoiding unnecessary anti-hypertensive treatment and/or withdrawing anti-hypertensive treatment as indicated and thus avoiding credulity.

The effect of Borago officinalis on the signaling pathway of the NLRP3 inflammasome complex, TLR4 and some inflammatory cytokines in type II diabetic patients with acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a life-threatening condition in which the lungs become severely inflamed, causing the alveoli to constrict or fill with fluid, which prevents the lungs from functioning properly. This disease becomes more dangerous when it occurs in patients with diabetes. Because of the clinical condition of these patients, it is not possible to treat them with usual medicines. One of the best options for treating these people is to use herbs. Borage (Borago officinalis) is a medicinal herb that, in addition to its anti-inflammatory properties, is also able to control blood sugar. Therefore, in the current study, the effect of borage oil was considered on the signaling pathway of the NLRP3 inflammasome complex, TLR4, and serum levels of inflammatory cytokines (IL-1? and IL-18) in type II diabetic patients with ARDS. For this purpose, 25 diabetic type II patients with ARDS were divided into three groups by ARDS Berlin Definition. Then, after providing the demographic and clinical characteristics of the patients, they were treated with 30 mg/day borage oil for seven days. The expression of NLRP3 and TLR4 genes (by Real-time PCR technique) and serum levels of IL-1? and IL-18 (by ELISA test) were evaluated before and after treatment with borage oil through blood samples taken from patients. The results showed that serum levels of inflammatory cytokines (IL-1? and IL-18), NLRP3 gene, and TLR4 gene were significantly decreased in diabetic type II patients with mild ARDS by treating with borage oil. IL-1? serum level and TLR4 were significantly decreased in diabetic type II patients with moderate ARDS. But there was not any significant decrease or increase in IL-1?, IL-18, NLRP3 gene, and TLR4 gene in diabetic type II patients with severe ARDS after 7 days of treatment with borage oil. According to the obtained results, borage oil can act as a double-edged blade. Thus, in the early and middle stages of ARDS, borage oil can be effective in reducing the inflammasome pathway of inflammation and also reduce blood sugar levels in these diabetic patients. But in the severe stage of ARDS, it not only does not help to treat the ARDS; it also increases systolic and diastolic blood pressure in diabetic patients.

The effect of cocoa/dark chocolate consumption on lipid profile, glycemia, and blood pressure in diabetic patients: A meta-analysis of observational studies.

Due to the increasing rate of cardiovascular disease and related risk factors in the worldin recent decades, the present meta-analysis was performed to investigate the effects ofcocoa/chocolate consumption on lipid profile, glycemia, and blood pressure control in diabetic patients. A systematic search of the databases PubMed, Scopus, Web of Science, and Cochran Library was performed up to July 2020. All randomized controlled trials (RCTs) using cocoa/dark chocolate in diabetic patients were included in the study. The search results were limited to English-language publications. Eight RCTs, including 433 participants, were selected for this meta-analysis. Pooled analysis indicated a significant reduction in low-density lipoprotein cholesterol LDL-c levels (WMD: -15.49 mg/dl; 95% CI: -24.56, -6.42, p= .001) and fasting blood sugar (FBS) concentrations (WMD: -6.88 mg/dl; 95% CI: -13.28, -0.48, p= .03) following cocoa/dark chocolate consumption. The analysis of papers included in current study indicates that the consumption of cocoa/dark chocolate reduced the serum fasting blood glucose (FBS) and LDL cholesterol concentrations. However, further high quality trials are essential for confirming the clinical efficacy of cocoa/dark chocolate consumption on complete metabolic profile.

Climate Changes’ Effect on Blood Pressure in Diabetic Patients

There has been noted a correlation between atmospheric temperature and some chemical, hematological and homeostatic variables on blood presure. Blood pressures’ variation was determined in diabetic patients with no high blood pressure issues living in a region with hot summers of 90–100º F (BP Hot) and cold winters with snow (BP cold). Chihuahua city has such weather conditions. 221 patients were included, 44 were women (20%) and 177 men (80%). The timeline was from May 2016 to January 2019 were all the cardiovascular events were noted. Group I had 89 patients (40.2%), having Diabetes Mellitus for more than 20 years. Average age of the group is 70 years old (60 - 84 years old). The increase in systolic blood pressure (BP) was of 27.5 mmHg (15–30 mmHg) and of the diastolic BP of 10 mmHg. As extra data it was noted that pulse increased 10 beats per minute (bpm). As a clinical presentation, 35 patients (39.3%) patients were found to be in NYHA class I, 27 (30.3%) in class II, and 27 (30.3%) in class III. Dyslipidemia was present in 70 (78.6%) of them, hypertensive cardiomyopathy (per ECG or Echocardiogram) in 37 (41.5%). From this group, 27 (30.3%) were admitted in the ER for uncontrolled blood presure with no symptoms, 45 (50.5%) admitted for high BP with symptoms (headaches, dizzines, epistaxis or conjuctival hemorrhage), 9 (10.1%) were admitted due to heart insuficiency and 4 (4.4%) sudden cardiac death. Group II included 132 patients (59.8%) with less than 20 years with DM and an average age of 64 years old (53–71 years of age). The increase in systolic BP was of 8.5 mmHg (less than 10 mmHg) and diastolic BP of 5.8 mmHg. Heart rate varied by 3.3 bpm (less than 5). Clinical presentacion of NYHA class I were 89 (67.4%) patients, 30 (22.7%) in class II, and 13 (9.8%) in class III. 92 (69.6%) patients presented dyslipidemia, and 30 (22.7%) hypertensive cardiomyopathy. Out of this group, 30 (22.7%) patients were admitted due to high BP without symptoms and 17 (12.8%) were admitted with high BP and symptoms. It is concluded that patients that have been diabetic for a longer time, with greater cardiovascular problems and older in age have a diminished reaction to the body’s control mechanisms and react more to the cold weather.

Evaluation of blood pressure lowering effects of cocoa flavanols in diabetes mellitus: A systematic review and meta-analysis

• Weak evidence for small benefits of cocoa flavanols on blood pressure in diabetes. • Very few papers evaluating effect of cocoa flavanols on blood pressure in diabetes. • Studies show high heterogeneity and low quality in diabetic population. • Too few papers to evaluate other vascular benefits of cocoa flavanols in diabetes. • Call for more research with optimal design for this promising nutraceutical. In healthy people, cocoa-derived flavanols (CF) improve blood pressure (BP). This meta-analysis investigates whether CF also affect BP in diabetic patients. PubMed, Web of Science, and Embase were consulted to retrieve eligible randomized controlled trials. A random-effects model and the Grades of Recommendation, Assessment, Development and Evaluation (GRADE)-approach were used for analyses and quality of evidence respectively. Of 267 citations, 11 trials were identified, studying either type 2 diabetic populations only (subgroup A) or type 2 diabetic patients plus non-diabetic subjects with increased cardiovascular risk (subgroup B1) or type 1 plus type 2 diabetic patients (subgroup B2). Mid/long-term CF consumption decreased BP slightly, however, only reaching statistical significance for diastolic BP in subgroup B1 (-1.89 mmHg, 95% CI: −3.24, −0.54, I 2 = 55%). Considerable heterogeneity between studies and low quality of evidence caused poor quality evidence of minimal effects of CF ingestion on BP in diabetic patients.

Treatment of high blood pressure in diabetic patients and risk of undernutrition in a population in extreme Western Algeria

Introduction: Assessing the risk of undernutrition in hypertensive diabetics is essential. It makes it possible to detect undernutrition for better care. The objective of our study is to describe the factors influencing this undernutrition.
 Methods: A descriptive study was conducted on a sample of 366 diabetics with hypertension and 326 with normo-glycemic hypertension aged 50 years and over. Patients were enrolled at the University Hospital in Tlemcen from January to June 2018. The data collection was carried out using a questionnaire: The MNA (The Mini Nutritional Assessment).
 Results: The study made it possible to establish the profile of subjects at high risk of undernutrition. In our sample, age was not correlated with risk of malnutrition in diabetic hypertensives and normo-glycemic hypertensives respectively (p = 0.304 and p = 0.444). The linear regression model uses gender as an age-independent factor that affects the risk of undernutrition (p = 0.001). BMI was one of the most relevant variables for predicting the occurrence of undernutrition (p = 0.000). Thus, diabetic hypertensive patients in our study who were treated with an Angiotensin II receptor blockers , an angiotensin converting enzyme inhibition or an ARB/diuretic combination were more at risk of undernutrition (p = 0.009, p = 0.026 and p = 0.013).
 Conclusion: Particular attention should be paid to diabetic hypertensive subject. The treatment of hypertension in diabetics aggravates this malnutrition. Thus, a nutritional status assessment should be established in any diabetic hypertensive patient allowing appropriate therapeutic management to avoid all complications associated with undernutrition.

Effects of traditional fermented food (Ash-Kardeh) consumption on blood glucose, blood pressure, and lipid profile in type 2 diabetes: a study protocol for a randomized clinical trial.

Many therapeutic methods are recommended for the management of Type 2 diabetes. Ash-Kardeh contains several components such as flavonoids, antioxidants, and dietary fiber which can affect lipid profile and blood pressure in diabetic patients. However, no study has examined the effects of Ash-Kardeh consumption on blood glucose, blood pressure, and lipid profile in type 2 diabetic patients; therefore, the aim of this study will be to examine the effects of Ash-Kardeh consumption on blood glucose, blood pressure, and lipid profile in type 2 diabetic patients. This study is a randomized, no-blinded, controlled clinical trial in which 44 type 2 diabetic patients will be randomly allocated to intervention and control groups. Individuals in both the intervention and control groups will receive (the usual treatment of diabetic patients) for 6weeks, while those in the intervention group will receive (250g of traditional fermented food daily in addition to the usual treatment) at the same time. Assessment of anthropometric measures, blood pressure, and biochemical parameters including serum concentrations of fasting blood sugar, high-density lipoproteins-cholesterol, low-density lipoproteins-cholesterol, total cholesterol, and triglyceride will be performed at the study baseline and end of the trial.

Effect of Lifestyle Educational Intervention on Blood Pressure in Diabetic Patients with Hypertension

Effect of Lifestyle Educational Intervention on Blood Pressure in Diabetic Patients with Hypertension

Effects of dietary salt restriction on home blood pressure in diabetic patients with excessive salt intake: a pilot study.

The aim of the present study was to examine whether dietary salt restriction guidance is beneficial for dietary salt restriction and lowering of home blood pressure in patients with diabetes with excessive salt intake. We performed an intervention trial of 37 people with type 2 diabetes and excessive salt intake. National registered dietitians provided dietary salt restriction guidance to each patient at the start of the study. All participants were instructed to perform triplicate morning and evening home blood pressure measurements using home blood pressure telemonitoring system. Daily salt intake at 2 months and 6 months was significantly lower than that at baseline; the difference was 0.8 [95% confidence interval (CI): 0.2–1.4, p = 0.009] g and 0.7 (95% CI: 0.1–1.3, p = 0.009) g, respectively. Morning systolic blood pressure at 2 months and 6 months was significantly lower than that at baseline; the difference was 2.7 (95% CI: 0.2–5.1, p = 0.034) mmHg and 5.8 (95% CI: 0.5–11.1, p = 0.034) mmHg, respectively. This intervention study revealed, for the first time, that dietary salt restriction guidance provided by a national registered dietitian is beneficial for reducing daily salt intake and home blood pressure in people with diabetes with excessive salt intake.

Air pollution exposures and blood pressure variation in type-2 diabetes mellitus patients: A retrospective cohort study in China

Air pollution exposure has been associated with hypertension, but limited studies have examined the associations in diabetic patients. We aimed to examine the associations of exposure to air pollution with blood pressure in diabetic patients. We identified patients who were previously diagnosed as type-2 diabetes mellitus from hospital records from January 2013 to May 2017. We used generalized linear models to estimate adverse effects of air pollution on systolic/diastolic blood pressure in diabetic patients. A total of 40,125 patients were enrolled in this study. An IQR increase in PM2.5, PM10, NO2, SO2, and O3 exposure was associated with an increased risk of higher systolic blood pressure level (β = 0.628 for PM2.5, β = 0.758 for PM10, β = 0.766 for NO2, β = 0.516 for SO2, β = 0.482 for O3, all P value < 0.05). Significant associations were observed for some air pollutants and SBP among patients with fasting blood glucose (FBG) ≥ 7.0 mmol/L, normal weight, and younger age. Little evidence was available for the associations between particulate matter (PM) or O3 exposure and diastolic blood pressure in present study. In our study, diabetic patients were at increased risk of higher blood pressure when exposed to higher residential PM, NO2 and SO2. Individuals with lower BMI, younger age, and FBG ≥ 7.0 mmol/L were more susceptible to the adverse effects of ambient air pollution.

A10642 Effects of masked visceral fat obesity on the blood pressure in patients with diabetes

Objectives: Abdominal obesity (AO) is characterized by excessive waist circumference (≥90 cm/85 cm in the male or female) and closely related to elevated blood pressure. This study is aimed to explore the effects of visceral adipose accumulation on the blood pressure in diabetic patients with visceral fat obesity (VFO) but normal waist circumference. Methods: A total of 326 diabetic patients without history of hypertension or antihypertensive drugs were included and abdominal visceral fat area (VA) was assessed by computed tomography. VFO was defined as VA ≥ 100 cm2. All patients were divided into two categories of VFO+ or VFO- group and four subgroups: AO-VFO-, AO-VFO+ (masked VFO), AO+VFO- and AO+VFO+ group. Results: Compared with the VFO- group, systolic and diastolic blood pressure (SBP, DBP) were significantly higher in VFO+ group (P < 0.001). The SBP in masked VFO group (151 ± 18 mmHg) was significantly higher than AO-VFO- (132 ± 16 mmHg, P < 0.001) and AO+VFO-(131 ± 14 mmHg, P < 0.001), but similar to AO+VFO+ group (150 ± 15, P = 0.854). The masked VFO group also has significantly higher DBP (86 ± 13 mmHg) than AO-VFO- (80 ± 11 mmHg, P = 0.007) and AO+VFO-(79 ± 10 mmHg, P < 0.001), but lower than AO+VFO+ group (91 ± 12 mmHg, P = 0.032). Stepwise multiple linear regression analysis showed that abdominal visceral fat area and subcutaneous fat area were the independent risk factors for SBP, while age and visceral fat area were the independent risk factors for DBP. Conclusion: Abdominal visceral adipose accumulation has a marked impact on the blood pressure in diabetic patients, even in those with normal waist circumference.

Effect of diabetes mellitus on resting heart rate, postural blood pressure, Valsalva ratio, and blood pressure response to hand grip test

Background: Cardiac autonomic neuropathy is a common and serious complication in diabetic patients; the aim of the present study is to assess the effect of diabetes mellitus on heart rate (HR), postural blood pressure, Valsalva maneuver, and blood pressure response to handgrip test and its comparison with the normal individuals. Aims and Objective: The objective of the study is to detect the autonomic dysfunctions in the diabetic patients as early as possible so that later complications of the disease can be prevented and to prevent the mortality and morbidity of diabetes mellitus. Materials and Methods: Study is done involving 75 diabetic and 50 nondiabetic individuals after taking the written consent from them. Where the selection criteria of the individuals are when they do not have any other complications and recently diagnosed diabetic people. In these individuals cardiovascular reflex tests were carried out which include resting HR, effect of standing on blood pressure, Valsalva maneuver, and hand grip test. Results: Our study showed that there is a significant increase in the resting HR in diabetic persons than the normal (P < 0.01). When blood pressure in compared to resting to standing position there is a significant decrease in the diastolic blood pressure in diabetic patients than the controls. When we asked both the groups to do Valsalva maneuver through the Valsalva ratio remained in the normal range, but it is significantly reduced in diabetic patients. When we studied the hand grip test in both the groups, we found out that there is an increase in both systolic and diastolic blood pressure in controls then the diabetic persons. These tests results will suggest that in diabetic peoples there will be autonomic neuropathy. Conclusion: In conclusion, diabetic autonomic neuropathy is a serious and common complication of diabetes mellitus, these cardiac reflex tests will help us in early diagnose and proper treatment of the diabetic patients. Only one test is not sufficient, but tougher these tests will help drastically, these tests will be more economical when compared to diabetic compilation treatment.