[How to use anti-hypertensive medication in management of diabetic patients]

Hypertension is often accompanied with type-2 diabetes mellitus. Based on insulin resistance and/or resultant hyperinsulinemia, diabetes mellitus, hypertension, lipid disorders and atherosclerotic vascular diseases are often seen in the same individuals. Lifestyle modification to reduce insulin resistance is very important to manage diabetic patients with hypertension. When the doctors use anti-hypertensive medication, we have to take care not to worsen glucose or lipid profiles. Taking recent guidelines from US, Japan and Europe into considerations, blood pressure of diabetic patients should be controlled below 130-135/80 mmHg. ACE inhibitors, angiotensin II receptor antagonists are commonly recommended as first-line medicine to choose. However, Ca-channel blockers, alpha 1-blockers, beta-blockers and diuretics are often needed to achieve the goal: preventing organ damage which would be the most important issue for diabetic patients.