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Medical Forum / Diseases and Disorders / Diabetes / July 2009Diabetes and hypertension
I asked some questions here last week and got some good advice, had another question or two. My MIL is visiting from India. She's elderly (late 60s) and takes insulin injections daily for her diabetes (I had asked questions about daily glucose monitoring, which she says her Indian doctor told her 'wasn't necessary', she only needed testing every 3 to 6 months). We went to a store a few days ago and she tried one of those blood pressure chairs that gives you a free reading...I know they aren't TOTALLY accurate but when I've used them they've been pretty close to my readings at my doctor's office--anyway, when it finished and gave the results, I happened to catch them before she erased them and I nearly freaked out! Her reading was 195/75 with a pulse rate of 77--yikes! When I exclaimed at how high that was, she was calm and said, that's okay, the 75 is in the normal range! :-O I've talked to my husband and he's like, "Well, they're adults and they know what they are doing and there's nothing we can do because they trust their Indian doctors" (forgot to mention she also takes hypertension meds every day, don't know the name though)...is it normal to have such high readings while on insulin? Or is that just crazy-high-she-needs-to-go-to-the-ER-right-NOW! kind of deal? Again, if anyone has experience/advice, I would greatly appreciate it! Carolyne in TX >I asked some questions here last week and got some good advice, had another >question or two. [quoted text clipped - 23 lines] > > Carolyne in TX The bottom number is the more important one I think. But that does seem a bit high. I wouldn't worry about a reading on a free machine though. They're not very accurate. >I asked some questions here last week and got some good advice, had another >question or two. [quoted text clipped - 23 lines] > > Carolyne in TX There's nothing wrong with the 75 or the 77, but the 195 is high. Of course, BP will be influenced if she was walking around for awhile. Most hospitals will provide free BP checks (often in the emergency room). Could you convince her to go with you to the hospital just to get the BP check? MaryL >> I asked some questions here last week and got some good advice, had >> another question or two. [quoted text clipped - 31 lines] > > MaryL True, we had been walking around the store for about 45 minutes or so. And nope, she wouldn't go to the hospital just to check--they are Hindu and somewhat fatalistic in their belief that whatever is meant to happen, will happen, no matter what they do! :-( Still overall she seems okay, I'm just going to keep a closer eye on her and try to catch any symptoms that might show up (I'm a stay at home mom, so that's pretty feasible for me). Thank you, Mary and Julie! >>> I asked some questions here last week and got some good advice, had >>> another question or two. [quoted text clipped - 42 lines] > > Thank you, Mary and Julie! Why not invest in a home BP machine (doesn't have to be expensive), and check her BP and pulse after she has been relaxing for awhile? Even a short walk can raise BP, sometimes a surprising amount. Good luck! MaryL Mary L. I have a wrist monitor and it is pretty accurate I check my vitals about once a week to keep an eye on the blood pressure. I think the machine was about 30 dollars and I think it is a valuable tool for home monitoring. Loretta -- I >>>> I asked some questions here last week and got some good advice, had >>>> another question or two. [quoted text clipped - 51 lines] > > MaryL *That* is an EXCELLENT idea, Mary! Didn't think of that before, but yes, it makes a LOT of sense! We can do this, and I don't think she'll be 'offended' by my 'meddling'! Thank you! :-) >> Why not invest in a home BP machine (doesn't have to be expensive), and >> check her BP and pulse after she has been relaxing for awhile? Even a [quoted text clipped - 7 lines] > it makes a LOT of sense! We can do this, and I don't think she'll be > 'offended' by my 'meddling'! Thank you! :-) Good! Please keep us updated. You could check BP for everyone in the family at the same time. That would also help avoid the idea that you are "meddling," and it's a good precaution for everyone (monitor our health). MaryL >I asked some questions here last week and got some good advice, had >another question or two. [quoted text clipped - 22 lines] >Again, if anyone has experience/advice, I would greatly appreciate it! >Carolyne in TX I am not a doctor, but: While 196/75 is indeed in the "High Blood Pressure" area, it is not in the "crazy-high-she-needs-to-go-to-the-ER" area. And while she is at higher risk than if her higher (systolic) number was under 140, in general the lower (diastolic) number is considered a more accurate indicator of risk - and yes, hers is in the "normal" area. Maybe if she got more medication her diastolic would go too low - she and her doctor have probably varied the medication and settled on this dosage and these numbers after some experimentation. Of course, the excitement of the trip could be boosting them higher than normal for her - but this will only be for a short time. So while she has "some" extra risk, she is not anywhere near "crazy" extra risk. She and her doctor know about it, she is taking medication to treat it - and meanwhile she is trying to live a normal, enjoyable life instead of worrying herself sick. Good for her. My advice would be to learn from her example. >> I asked some questions here last week and got some good advice, had >> another question or two. [quoted text clipped - 41 lines] > enjoyable life instead of worrying herself sick. Good for her. My > advice would be to learn from her example. I am concerned because last week she recieved news that her 94 y/o mother had died in India (she really hadn't been sick, although at that age, you sort of prepare yourself mentally for something to happen--still, when it does, it's quite a shocker)--I've been told and read that this kind of stress can increase diabetes and hypertension problems, so that's why I'm a bit more vigilant. Believe me, with two babies who just turned one (the day their great grandmother died) I've got plenty to do minding my own business! It's just when they visit from India (I'm in Texas) they stay for 6 months WITHOUT a doctor's care. To me that's a long time to wait for monitoring, etc. Thanks! Carolyne, what I would have done, would be have myself tested againl She is right that 75 is normal, but 195 is off the chart to me. I dont know if insulin raises hypertension as I am not on insulin. when I went to the doctor my numbers were 98/65 so as a type II,I dont see a correlation between diabetes and hypertension, but that doesnt mean there isnt. I would try to get mil to doctor. Your husband is right, they are adults and you cant make them do anything. that they dont want to do for themselves makes me think that she is very scared and wants to live in denial. I am sure she cares, but is too afraid. Some people would rather not know than face the truth. Loretta -- I > Carolyne, what I would have done, would be have myself tested againl > She is right that 75 is normal, but 195 is off the chart to me. I dont [quoted text clipped - 13 lines] > -- > I Thank you, Loretta. I think partially you are correct, there is a fear of finding something wrong so it's not discussed (they are very private people, my DH's older brother died in an accident in 1990 and because they don't discuss it, it's only been recently that they've even been able to mention his name without falling apart!)--part of it is they don't want to be a financial burden on us for doctor's fees, RX fees, etc. Plus they are Hindu and somewhat fatalistic in that they believe "if it's meant to be, who are we to try to stop God's will?" sort of thing. Thanks again for the comments! >I asked some questions here last week and got some good advice, had another >question or two. [quoted text clipped - 23 lines] > > Carolyne in TX Yeah the 195 is kinda high, I've always been told that over 200 either way is a medical emergency. 200 or over on the top is Heart attack zone, 200 or over on the bottom is stroke zone. If she's already on medication then she needs to have that checked because it isn't helping her. Also, if she had been walking around prior and didn't rest at least 5mins prior to testing then it's going to be sort of high anyhow. Adults or not, the way it sounds she needs a hefty slap upside the head to bring her back down to earth and maybe see that her doctor is a idiot and not doing her health any good. Is her doctor related to the one that treated MJ by chance? jmo pico >> I asked some questions here last week and got some good advice, had another >> question or two. [quoted text clipped - 38 lines] > > pico Good God, no! :-) He's in India, so it's not like we can ring him up easily for advice. :-) We'll make do. I'll get her a blood pressure cuff for the house and we'll get some baseline numbers going. I'd heard similar about the 200 number, that's why I was alarmed. Thanks! >Good God, no! :-) > [quoted text clipped - 5 lines] > >Thanks! While she is there, what menu variations is she accepting? What does she usually eat for breakfast, lunch and dinner at home? Is she vegetarian and are you cooking her traditional foods or is she accepting your Western menus? If she has had significant changes to her usual way of eating on this visit, which may have led to quite different carb counts at meals, she may be making incorrect adjustments to her insulin doses among other things. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Lancet Change - St Swithun's Day) http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan) >> Good God, no! :-) >> [quoted text clipped - 7 lines] > > While she is there, what menu variations is she accepting? None. My in-laws take over my kitchen when they visit, as if it were their own (with my blessing). They are vegetarians and do not eat eggs or cheese. They do eat yogurt with their meals sometimes, which I just learned yesterday is HIGHHIGHIGH with sugar!! They alternate either having rice with their veg. dishes, or home made chappatis (tortilla like Indian bread). > What does she usually eat for breakfast, lunch and dinner at home? Is > she vegetarian and are you cooking her traditional foods or is she > accepting your Western menus? I do not cook for my in-laws (their preference). Mostly curries, rice pillau (sp?) type meals, dal dishes (like lentils) BUT the problem is she uses a TON of olive oil for the cooking (one GALLON in three weeks!) since so many of the dishes are fried, and TONS of salt...both of which are not good for her! She's overweight (probably obese according to the body fat charts although she's not that big to me) and after seeing her BP the other day, I know those things aren't good. My husband talked to them and learned they already have a home BP monitor, but don't feel it's necessary to dig out of their suitcases because 'she feels fine' and is 'symptom free'--isn't hypertension called "the silent killer" because generally there aren't any symptoms? :-( > If she has had significant changes to her usual way of eating on this > visit, which may have led to quite different carb counts at meals, she [quoted text clipped - 7 lines] > http://loraldiabetes.blogspot.com (Lancet Change - St Swithun's Day) > http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan) > >> Good God, no! :-) > >> [quoted text clipped - 12 lines] > or cheese. They do eat yogurt with their meals sometimes, which I just > learned yesterday is HIGHHIGHIGH with sugar!! Plain yoghurt isn't, as long as it's allowed to get nice and zingy. The milk sugar is eaten up by the cultures. > They alternate > either having rice with their veg. dishes, or home made chappatis > (tortilla like Indian bread). Now *those* are very high carb and will turn into sugar starting even before they hit the stomach. > > What does she usually eat for breakfast, lunch and dinner at home? Is > > she vegetarian and are you cooking her traditional foods or is she [quoted text clipped - 3 lines] > pillau (sp?) type meals, dal dishes (like lentils) BUT the problem is > she uses a TON of olive oil for the cooking (one GALLON in three weeks!) How's that a problem? Olive oil is a very good choice, and if she weren't eating so much starch it would likely be very good for her. Fats and oils do nothing to the blood sugar. > since so many of the dishes are fried, and TONS of salt...both of > which are not good for her! Salt, maybe. > She's overweight (probably obese according > to the body fat charts although she's not that big to me) and after > seeing her BP the other day, I know those things aren't good. What do you have against olive oil? > My husband talked to them and learned they already have a home BP > monitor, but don't feel it's necessary to dig out of their suitcases [quoted text clipped - 5 lines] > > may be making incorrect adjustments to her insulin doses among other > > things. Sounds like she's eating as she would at home. I'm guessing she doesn't monitor that religiously at home either? PP, T2 >>>> Good God, no! :-) >>>> [quoted text clipped - 31 lines] > weren't eating so much starch it would likely be very good for her. > Fats and oils do nothing to the blood sugar. *We* are the ones who introduced her to olive oil during one of their visits years ago. :-) I know they have nothing to do with blood sugar, but they DO affect weight, which has an effect on diabetes/blood sugar? >> since so many of the dishes are fried, and TONS of salt...both of >> which are not good for her! > > Salt, maybe. When I was growing up, my mother had hypertension and wasn't allowed to eat ANY salt. I don't have that problem and don't really know anyone else with it, has that medical advise changed since then? (70s/80s) >> She's overweight (probably obese according >> to the body fat charts although she's not that big to me) and after >> seeing her BP the other day, I know those things aren't good. > > What do you have against olive oil? I have nothing at all, but you don't think that going through a GALLON of olive oil or ANY type of oil in 3 weeks is a lot?? >> My husband talked to them and learned they already have a home BP >> monitor, but don't feel it's necessary to dig out of their suitcases [quoted text clipped - 7 lines] > Sounds like she's eating as she would at home. I'm guessing she doesn't > monitor that religiously at home either? It's why her kidneys shut down last summer, and she wound up in ICU for 3 weeks and missed her grandbabies' birth. *sigh* :-( > PP, T2 >>> Good God, no! :-) >>> [quoted text clipped - 12 lines] >or cheese. They do eat yogurt with their meals sometimes, which I just >learned yesterday is HIGHHIGHIGH with sugar!! Unless it's sweetened, that's not usually a problem, as PP advised. > They alternate >either having rice with their veg. dishes, or home made chappatis >(tortilla like Indian bread). But that is. I found I could handle one roti/chappati at a meal in India, but more than that could be a problem. However, the rice could be a significant problem. it all depends on quantity and, to some degree, the type of rice. Basmati is probably best. >> What does she usually eat for breakfast, lunch and dinner at home? Is >> she vegetarian and are you cooking her traditional foods or is she [quoted text clipped - 3 lines] >pillau (sp?) type meals, dal dishes (like lentils) BUT the problem is >she uses a TON of olive oil for the cooking (one GALLON in three weeks!) Can't see why the olive oil would be a problem. Why do you think it is? >since so many of the dishes are fried, and TONS of salt...both of >which are not good for her! She's overweight (probably obese according >to the body fat charts although she's not that big to me) and after >seeing her BP the other day, I know those things aren't good. We're discussing diabetes and blood glucose. Excessive salt may or may not be healthy - but it won't affect her BGs directly. Nor will the fact that the food is fried. She is in more danger from the batter or breading in fried foods than from the oils. >My husband talked to them and learned they already have a home BP >monitor, but don't feel it's necessary to dig out of their suitcases >because 'she feels fine' and is 'symptom free'--isn't hypertension >called "the silent killer" because generally there aren't any symptoms? :-( Agree with your feelings there. I call that the Ostrich method of medical management. Stick your head in the sand and hope any problems go away. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Lancet Change - St Swithun's Day) http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan) >>>> Good God, no! :-) >>>> [quoted text clipped - 12 lines] > > Unless it's sweetened, that's not usually a problem, as PP advised. We use plain, non-fat yogurt, but there's 15 grams of sugar per 1/2 cup. That's not high? It's okay for diabetics? She probably uses at least 1 cup per day. >> They alternate >> either having rice with their veg. dishes, or home made chappatis [quoted text clipped - 38 lines] > http://loraldiabetes.blogspot.com (Lancet Change - St Swithun's Day) > http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan) |
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