Diabetes and high blood pressure

Diabetes and high blood pressure raise your risk of having a stroke or heart attack, and having both together raises your risk much more than having either one alone.

Type 2 diabetes is becoming more common in the UK, but like high blood pressure it often has no symptoms, so people don’t know they have it and aren’t getting the support they need to prevent problems later on.

The good news is there are simple checks you can have to find out if you have diabetes, pre-diabetes or high blood pressure, and then there are steps you can take to prevent them or keep them under control.

What is diabetes?

Diabetes is where your blood sugar levels are too high because your body isn’t making or has become resistant to the hormone insulin, – which controls blood sugar levels. Without treatment, the high levels of sugar in your blood can damage your blood vessels and nerves, leading to heart disease, stroke, and problems with your kidneys, eyes and feet.

There are different types of diabetes:

Type 1 diabetes
This is where your body doesn’t produce any insulin. It usually develops in childhood or young adulthood and is caused by a problem with the immune system. Type 1 diabetes can’t be prevented, but it can be managed with insulin injections. 

Type 2 diabetes
This is when your body stops making enough insulin or stops responding to it and it is often linked to being overweight. This is the most common type of diabetes – around nine out of 10 people with diabetes have type 2 diabetes. 

Pre-diabetes
This is the stage that comes before type 2 diabetes. It’s where your blood sugar levels are above the normal range because you are starting to become resistant to insulin, but the sugar levels are not high enough for you to be diagnosed with diabetes. Pre-diabetes can be reversed with a healthy lifestyle, so it doesn’t develop into diabetes.

What causes type 2 diabetes and pre-diabetes?

Pre-diabetes and type 2 diabetes are linked to being overweight and leading an unhealthy lifestyle, with a lack of physical activity and an unhealthy diet.  Most people with type 2 diabetes are overweight.  Carrying your weight around your middle in particular can lead to other health problems as well as diabetes.

A number of things can mean you’re more likely to develop type 2 diabetes, known as risk factors.

• Age. Type 2 diabetes becomes more common with age, starting from around the age of 40. This could be because people tend to gain weight and exercise less as they get older. In recent years however, more and more younger people are developing type 2 diabetes.
• Being of African, African-Caribbean and south Asian descent.  Diabetes is more common in these ethnic groups.
• A family history of diabetes.  If a parent, brother or sister has diabetes you may be more likely to develop it.
• High blood pressure. You may be more at risk of diabetes if you have or have had high blood pressure.

Why is type 2 diabetes a problem?

Diabetes often doesn’t have any obvious symptoms to begin with, but it can cause problems later on. The large amounts of sugar in the blood can damage your blood vessels. Fatty deposits can be laid down in the damaged areas so your arteries become clogged and narrow, a process known as atherosclerosis. This means you’re much more likely to have a heart attack, heart disease, a stroke or problems with circulation in the legs, such as PAD, and at worst can require amputation.

High blood sugar can also damage the tiny blood vessels in your nerves, kidneys and eyes, leading to erectile dysfunction, kidney failure, sight loss.  Diabetes can also lead to problems during pregnancy and pregnant women with diabetes will need careful monitoring.

How are high blood pressure and diabetes linked?

High blood pressure and diabetes don’t cause one another, but people with type 2 diabetes tend to have other health problems at the same time, including high blood pressure and high blood cholesterol. These can all individually damage the blood vessels, leading to heart disease, stroke, kidney disease and other problems, but having them all together raises the risk even more.

If you are diagnosed with diabetes your GP will want to manage all these health problems to prevent a heart attack or stroke. 

How can you lower your risk of type 2 diabetes?

It’s possible to lower your risk of type 2 diabetes by making healthy changes to your lifestyle.  The changes you can make to lower your blood pressure will also lower your risk of diabetes. In particular, keeping to a healthy weight, stopping smoking, eating a healthy diet, drinking less alcohol and getting active.

Pre-diabetes can be reversed with a healthy lifestyle, and getting diagnosed early means you can get the treatment and support you need to prevent type 2 diabetes from developing.

There are simple checks you can have to find out if you have diabetes or may be at risk:

• Get an NHS Health Check – these are free and available to adults aged 40-74 in England. Find out what’s available near you.  
• Find out if you're at risk of type 2 diabetes – this simple questionnaire calculates your risk of diabetes.
• Use this BMI calculator to find out if you’re a healthy weight.

Looking after your health if you have diabetes

There are a number of ways you and your doctor can look after your health, protect your blood vessels and prevent serious illness if you have diabetes.

Controlling your blood pressure
Your doctor will want to make sure your blood pressure is very well controlled – to below 140/90mmHg, or sometimes below 130/80mmHg. You may need to take medications to lower your blood pressure enough, as well as making healthy changes to your lifestyle

Healthy lifestyle
A healthy diet, losing weight and being active will help to keep your blood sugar and blood pressure under control. Go for a blood pressure-friendly diet which is low in salt, sugar and saturated fat, and high in fruit and vegetables.

Medications for diabetes
If you have type 1 diabetes, you will always need to have insulin injections to control your blood sugar levels. If you have type 2 diabetes, you may eventually need medications, usually as tablets, to control your blood sugar levels as the diabetes progresses.

Read more
Diabetes UK have lots of information on diabetes, the lifestyle changes you can make, and living with diabetes. They also have a helpline and online forum where you can ask questions and share experiences.

NHS Choices have information on diabetes and its treatments.

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