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To prevent the complications associated with type 2 diabetes, therapy frequently also
includes medications for control of blood pressure, dyslipidemia and other disorders, since
patients often have more than three or four chronic conditions. Despite the benefits of
therapy, studies have indicated that recommended glycemic goals are achieved by less than
50% of patients, which may be associated with decreased adherence to therapies. treatment,
but this involves more medications than conventional treatment. To counteract the
complications associated with type 2 diabetes, therapy frequently includes medications for
the control of blood pressure and lipid metabolism. Analysis of data from 840 patients
showed that 629 (75%) had high adherence to antihypertensive monotherapy and these
patients were 45% more likely to achieve blood pressure control than those with medium or
low compliance [31]. Adherence to statin therapy to control lipids in 6,462 patients with
diabetes was also reported to be poor, with e, in a retrospective cohort study of 11,532
patients in which medication adherence was calculated as the proportion of days covered for
filled prescriptions of OHAs, antihypertensives and statins, multivariate analyses showed that
medication nonadherence was associated with higher HbA1c, blood pressure, and LDL
cholesterol levels

Garci´a-Pe´rez et al.2013. Adherence to Therapies in Patients with Type 2 Diabetes.

Diabetes Ther (2013) 4:175–194


Your 15 diabetes healthcare essentials

we call this package of care your 15 Healthcare Essentials. Having all these essential diabetes
checks helps you reduce your risk of serious diabetes complications, like losing your sight or
having dangerous problems with your feet.

Know your blood pressure

High blood pressure increases your risk of diabetes complications like heart problems, kidney
disease and serious eye damage. This is because the blood pressure puts a strain on your
blood vessels and heart, so they can’t work properly.

It’s important to know that you might still feel healthy when you have high blood pressure.
But it’s causing damage to your blood vessels that you can’t see and you need to get treated.

Your doctor or nurse must measure your blood pressure at least once a year. They’ll agree a
personal target for you. Make a note of the numbers and get to know what they mean.

You should know how to bring the levels down if you need to. You can do this by being
active, watching your weight, eating a healthy diet and with medication. Get all the facts on
how to prevent high blood pressure and how to manage it.
Penyandang diabetes dengan tekanan darah tinggi punay resiko besar terjadinya komplikasi

f it’s high (called hypertension), you’ll need treatment to bring it down. This is because it
puts a strain on your blood vessels and can damage them. This can make it harder for blood
to flow around the body and reach all the vital areas it needs to, like your heart. So you’re
more at risk of having a heart attack or stroke. There’s lots you can do yourself too – your
lifestyle has a direct impact on your blood pressure.

It also puts you more at risk of developing all types of diabetes complications, like serious
problems with your feet, your eyes and your kidneys.

It’s really important to know that you might have high blood pressure and feel fine, because
there aren’t usually any symptoms. But even if you feel healthy, high blood pressure is
damaging your blood vessels and you need to get treatment. That’s why you should never
miss a blood pressure check

Causes and risk factors of high blood pressure

For most people, there’s no single cause of high blood pressure. But we know some things
can make you more at risk. These are called risk factors, and one of these is having diabetes.

High levels of sugar in your blood can lead to something called atherosclerosis. This is when
there’s a build-up of fatty material inside your blood vessels, narrowing them. The narrower
the blood vessels, the more the pressure builds up.

The more stress your blood vessels are under, the harder it is to push blood around the
important areas of your body. This means your feet, eyes and heart are seriously at risk.

There are other risk factors you can’t do much about:

 your age
 a family history of high blood pressure
 if your ethnic background is African-Caribbean or Black African

And there are risk factors you do have control over:

 too much salt in your diet

 being overweight
 not being active
 smoking
 drinking too much alcohol
 how you cope with stress

If you make changes to your diet and lifestyle, you can reduce your risk of developing high
blood pressure. We’re not saying it’s easy, but it’s vital you understand how you can do this.
There’s lots of support to help you bring your levels down and achieve your goals.

Blood pressure safe levels and targets

Whether you have diabetes or not, your blood pressure target will be less than 140/80mmHg.
But your target level will be lower than that if you have diabetes and have complications
already. This could be eye damage, kidney damage, heart disease or a stroke.

How to lower your blood pressure

A lot of it’s down to making positive lifestyle changes. But we know it’s not always that
straightforward, and some people will need medication to help too.

 Keep to a healthy weight

 Be more active
 Reduce the salt in your diet
 Give up smoking
 Drink less alcohol
 Try different ways to cope with stress

Your healthcare team can support you with making these changes. And we’ve got advice to
help you get started too – why not start by knowing your 15 Healthcare Essentials. This is a
checklist of the diabetes care you’re entitled to and will help you take control of your

Medication for high blood pressure

Making changes to your lifestyle may not be enough and many people with diabetes also
need to take medication.

The most common types of blood pressure medicines are diuretics, ACE inhibitors, beta-
blockers, antiotensin-2 receptor blockers, calcium channel blockers. Ask your healthcare
team if want more info on these.

Your healthcare team may give you medication even if your blood pressure isn’t high and is
in the target range. This is normal but you can ask your healthcare team to explain why. It’s
usually because the medication itself can help protect you against diabetes complications –
they especially protect your kidneys.


Boon-how chew noor-hasliza hassan Mohd-sidik sherina

.2015. Determinants of medication adherence among adults with type 2 diabetes mellitus in
three Malaysian public health clinics: a cross-sectional study

Abstract: Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is
associated with improved disease control (glycated hemoglobin, blood pressure, and lipid
profile), lower rates of death and diabetes-related complications, increased quality of life, and
decreased health care resource utilization. However, there is a paucity of data on the effect of
diabetesrelated distress, depression, and health-related quality of life onMA. This study
examined factors
Treatment Adherence and Its Associated Factors in Patients with
Type 2 Diabetes: Results from the Rio de Janeiro Type 2 Diabetes Cohort
Good adherence was 93.5% for medication use, 59.3% for foot care, 56.1% for blood glucose
monitoring, 29.2% for diet, and 22.5% for exercise. Patients with general good adherence had
lower BMI, better serum lipid profile, higher values of functional capacity, emotional and
pain domains of SF-36, better occupational performance, and lower prevalence of pain or
limitation in the upper and lower limbs than patients with worse adherence. The variables
associated with good adherence were younger age, lower BMI, presence of macrovascular
complications, better occupational performance and emotional domain of SF-36, and higher
HDL cholesterol levels. The presence of pain/limitation in the upper limbs was associated
with worse adherence. Good medication adherence was associated with longer diabetes
duration, lower BMI, and lower HbA1c levels. Higher values of pain and emotional domains
of the SF-36 and lower BMI were related to better exercise and diet adherence, while the
presence of peripheral neuropathy and joint pain/limitation were associated with worse
exercise adherence. Conclusions. Emotional and physical performances are important
determinants of good diabetic treatment adherence. Good adherence has benefi cial impact on
BMI, lipid, and glycemic control.