Juggling blood sugar and blood pressure

Type 2
1

This might get a little long, will try to keep it somewhat brief, but I need to know if others have gone through this and what they did. I posted about this a few months ago and got little response, but feel the need to try again.

I had been on metformin and on diltiazem and hyzaar for blood pressure, but my insurance co. made me switch from hyzaar to a cheaper med, avapro. I started noticing my blood sugars rising, so contacted my doc and switched to a similar cheaper one, diovan. Same thing. So we spent an entire year trying to figure out how to control my bp (which, after unexplained increasing weight, had been my first symptom of insulin resistance, though no one could tell me that 20 years ago when it began). Can’t take ACE inhibitors because I get that cough. Beta blockers make me depressed and emotionally a total mess. So we tried to control it with hydrochlorothiazide, the old standard, or a larger dose of diltiazem but that doesn’t do it. I had even said ok, I’ll pay for my own hyzaar, since that had worked fine, and the doc gave me a bunch of samples to start with, but now they also raise my blood sugar. I began adding glyburide to the blood sugar meds as they stayed higher than I felt good about. I finally just asked for a break–I was reeling with all the unacceptable side effects and needed to feel in balance for a while.

The last couple times I’ve seen the doc for illnesses etc my bp has been unnacceptably high, and the substitute doc (why is my doc never there when I’m sick?) wanted to put me on yet another med, one he said is similar to the diltiazem but stronger. But I’m afraid of side effects, and asked to wait till my physical and my own doc. (Seems like, lately, any med I’m put on either messes with blood sugar, sexual response, or causes weight gain, which, duh, is the last thing I need). Coming up to my physical in about a week, I thought, ok, I’ll try the diovan again, which I still had some of, just to buy some time till I can get to an endo. After all, I’m low-carbing now and my sugars are much more controlled, maybe the diovan won’t affect them this time. Well…

My blood sugars are again through the roof, and I ache all over. So today I am quitting the diovan again. I can’t see keeping my blood pressure down while allowing my blood sugars to spiral out of control. What good will that do me? I will just have to try whatever few bp choices there are out there (doc warns me there are a few but they are a bit scary because if you miss a day the bp goes through the roof immediately, a giant rebound effect). And I am really scared of side effects lately since I’ve begun having so much trouble with them, even with the hyzaar that used to work so well.

I just need some support with this struggle–I understand it’s not a common one to have unacceptable responses to so many classes of bp drugs, but just some support for what I’m going through, and if anyone has any thoughts or similar experiences. Thanks.

2

I didn’t know insurance companies could dictate what meds you take. I guess I am a little niavete, but I thought if you were prescribed the meds, and you have prescription coverage, they had to cover it. Have you talked to your doc about this policy? Have you contacted the insurance company and talked to a manager or supervisor?

3

Yes, apparently they can, and it makes me angry. The doctor said she even wrote to them telling them my issue (though I’m not sure she actually did) and it was not possible. Doctors are no longer in charge.

4

Please, I would like to hear from somebody. I am feeling really alone in this.

5

I have had issues with diuretics (e.g. hydrochlorothiazides), ACE inhibitors, and calcium-channel blockers. Beta blockers lower my pulse rate too far and may be responsible for some peripheral circulation problems I have. I’m currently on Cozaar, which is an angiontensin-renin II blocker. Hyzaar may be in the same class of medication.

I don’t notice any blood glucose reaction to the Cozaar.

One other thing is that when I was diagnosed, I was put on a very low sodium diet. There are several sources which suggest this is very helpful not just for people dealing with hypertension, but also for those dealing with high cholesterol and with diabetes. I also take a fish oil supplement, which is supposed to be helpful with, well, the big metabolic syndrome risks. And I try not to consume refined grains, high fructose corn syrup, or trans fats.

6

Hi. I have HBP, well PreHBP, and I am on a calcium channel blocker and an ACE. I do love the calcium channel blocker.

But what has helped me is loosing weight, quiting smoking, and working out an hour a day. but I have to take the calcium channel blocker for raynauds syndrome.

I am new to hypertension and diabetes, but wanted to give you a ((hug)).

7

Thanks Imana, Judith, Yanna. My sugars are now going down again after a couple days off the diovan. But my blood pressure is up again. I see the doc next week, and I have an appointment (for May!) with an endo, and one with a CDE next month, although I fully expect her to just spout the ADA line, which I have learned through my reading and own experiences to reject. So I suspect my primary doc will prescribe one of the new scary bp meds next week. For me, although blood pressure is important, it seems to me like keeping my sugars low is most important, as that will, I understand, in the long run be more important for my heart and also be better on my blood pressure ultimately. Last summer the doc opined that the important thing was to control my blood pressure (we are talking, to the very low levels now recommended for diabetics) and then control the rise in blood sugar that causes. But that would mean new and scary meds for blood sugar, as I am already on max of metformin and small dose of glyburide (and worried about its burning out my pancreas, don’t want to increase that) and low-carbing. So we shall see. What a roller-coaster!

8

Yes, hyzaar is cozaar plus hydrochlorothiazide. I guess blood sugar rise is rare, but it is a possible symptom, I have found out. Oddly, I have never had problems with the thiazides raising blood sugar. I do take fish oil. Don’t know much about low sodium diet, but I eat little salt and few processed foods.

9

Yes Judith, I’d appreciate the book recommendations. And yes, I also read yesterday that “white coat hypertension” is bad for us. Geez. I will just take it a step at a time I guess. All I can do is the best I can do.

10

How much fish oil are you taking? I used to take 4,000 units at night, and I recently cut back to 2 1,000 pills. I have heard the same thing…read Dr. Sear’s Zone stuff…but wondering what everyone else with diabetes, high cholesterol, high BP does?

11

What do you consider “very low levels recommended for diabetics”? Last I heard, standard of care was still 130/80 for people with diabetes, though “prehypertension” is set excessively low, 115/75, for the general population. I’ve also heard the reason for the 115/75 is to sell more blood pressure drugs.

12

Yes, I think it’s something like 115/75 for diabetics. At least that’s what my doc says. My lower number is, in fact, near that level, which I have always understood is the most important number, but the upper number is high, and I also understand that the gap between upper and lower is also to be avoided. You could be right about the reason for lowering the recommendated rates, I would not be at all surprised.

13

I am a T1,so diff circumstances…but if the other diabetic meds are causing probelms–why not investigatge changing to insulin and one of the safer bp meds? Just a thought.

Lower BP helps protect your kidneys as well as your heart-both important to the D world.

14

Oh, someone like me! Diabetic and hypertensive. I went with what our office doctor said, metformin and amlodipine. As she said, try controlling your weight and you diet, exercise (which, I still have a hard time doing, will issues), and it should help. If I am hearing her right, whatever can help your diabetes will automatically help your blood pressure, save the medication of course.

15

Cut the carbs! Lowering your carbohydrate intake will almost always drop your blood pressure dramatically while improving your blood sugar at the same time.

HCTZ is known to raise blood sugar.

Another thing that may or may not apply, but which I have run into with Diovan is that when I am taking too much Diovan my blood pressure, paradoxically, can go up. I have had some month long nightmares with this until I figured it out. It seems to be because my body fights against lowered blood pressure if I am taking too much by secreting hormones that raise it high. But until I figured this non-intuitive thing out, my doctor kept raising my Diovan dose and my blood pressure kept going up. At 180/110 I was not a happy girl.

Another thing that raised my blood pressure when I was younger was some supposedly bioidentical female hormone called Tri-Est. One pill and my bp was stratospheric. Same thing with Birth Control Pills which I was given in pre-menopause. Turns out I can’t tolerate progestins. It took about two months after I was taken off the BCPs (which I only took 2 weeks) for me to get back to normal. Regular estrogen does not cause me any problems and in fact lowers my bp.

Anyway, if you can do an Atkins type diet for a few weeks–which the ADA has endorsed in their practice guidelines as safe for at least a year, you may be pleasantly surprised at what happens to your BP.

For me, if i eat 60 g a day or less of carbs I don’t need any blood pressure meds. More than that, and I do. This has been true for a couple years.

I also found Byetta raised my BP dramatically, so I had to stop taking it.

16

Thanks Jenny. I started a low-carb way of eating a couple months ago, although with the holidays and some depression type feelings around that time I did not keep to it well till this week again. I am now doing it again, ADA be damned. I know it makes a big difference in my bg, and if it will help my bp as well that is intuitive and makes sense. We will see how it goes.

17

Hi, Ellie. It’s soooooo frustrating having to figure out how to juggle multiple meds for blood sugar and blood pressure. The stress seems to make both numbers go up!

Getting bp in control is REALLY important to help prevent and minimize complications. I hope you’re able to find something that works. As PWDs, we put so much emphasis on blood sugars. But bp control is just as important when it comes to vascular complications (kidneys, eyes, heart).

I sympathize with your struggle to find a bp meds combo that works.

In the meantime, have you and your doc discussed exercise (I hate that word and I hate doing it, but have realized it’s such a help with both bp and blood sugars)? 30 minutes a day of walking can give you some impressive results. When you’re feeling sore and achy, it’s tough to get moving, but even the littlest effort helps use up excess glucose and lower bp. I’m trying to stick to my 30 minutes a day, too. We should cheer each other on!

Also, it’s good to hear you’re already careful about sodium intake. The ADA and AHA recommendation for a person with diabetes who has a bp reading of over 130/90 is 1,500 mg a day from all sources. That is a tough target, but any decrease in sodium/salt can help. The number one lifestyle change docs recommend is to quit smoking, if you do.

I hope you hear from others in the same situation who may have ideas about meds. The suggestion about insulin is a good one. At some point in the slow down of the pancreas plus building insulin resistance, insulin is necessary.

18

Thanks for the suggestions Kelly. I have exercised with a goal of 30 minutes a day for the past at lesat 35 years, although many weeks I don’t do it every single day. It’s part of my lifestyle. The sodium number is helpful, something to aim for. As to insulin, I am not in a rush to try that as I clearly have a lot of insulin still running around in my body, since the metformin is still doing its job, and the bit of glyburide is able to prod out enough insulin to keep my bgs ok as long as I don’t take the particular meds I’ve had problems with. I want to wait to take insulin until it’s clear I’m no longer making my own insulin, all I don’t need is even more excess of insulin in my body running around unable to get into the cells and so laying down more fat.

19

Sounds like you’re doing all the recommend lifestyle things! That makes it even more frustrating, then, that the bp meds are giving you so many troubles. No fair!

20

Kelly, thanks. I appreciate the advice, but I also appreciate the affirmation. :slight_smile: None of this is fair. My daughter is disabled with fibromyalgia but has a wonderful spirit of acceptance about it (most of the time). I am trying to learn from her, that life is what it is. I can do the best I can to take care of myself but life isn’t fair, and we have to take it as it comes. I do keep learning more things on this site and the other links it has sent me to, and that sure helps, along with the support of others for whom life is no fair!