Health

Living with diabetes, hypertension possible, we’ve managed the two conditions for over 20 years –Patients

Amarachi Okeh

According to experts, hypertension and diabetes share some common risk factors and causes. A person who has one condition is often at an increased risk of developing the other. Managing these two conditions together can be very difficult and often comes with a heightened risk of blood vessel damage, heart attack, and kidney failure. However, Mrs. Florence Adefoluke and Mr. Olajide Olowu, who has lived with the two health conditions for years share their experiences, noting that with proper management complications can be avoided. AMARACHI OKEH reports

Sometimes in 1988, Mrs. Florence Adefoluke suddenly started feeling some itch in her private part which she mistook for a urinary tract or vaginal infection. All treatments she used failed to stop the itching until she visited a doctor and was informed she was in a pre-diabetes state after diagnosis.

She, however, didn’t realise how serious the condition would become.

“You know young people like myself then; I treated it for a while and before you say Jack Robinson it had escalated.

“Then in 2000, I was diagnosed with diabetes and have been on treatment since then.”

She recalled that after she was diagnosed, she was informed by the doctor of all the possible complications except one.

“I wasn’t told that I could develop a complication like hypertension. I was only told that if not well managed it could lead to glaucoma.

“In fact, in that same 2000 when I was diagnosed, I suffered a motorcycle accident, and was put on a bed for a complete year but when they checked my blood pressure, the nurses would be surprised that it was normal. They would say, ‘ah ah mummy, I like your nature, you don’t have any blood pressure.

“My blood pressure was 120/70, for the one year I was hospitalised. It never shot up until last year, 2021. Last year, I started having palpitations

“I’d be having palpitations, and I was afraid every time, everything will cause me to be afraid.

“I was thinking it was the trauma from that accident until I met Dr. Emmanuel Adeyinka who then explained to me that I was suffering from hypertension also.

Adefoluke, who is a retired teacher, and also a grandmother, said she suddenly started feeling afraid.

“The only sign that I had is getting afraid. My heart will be beating every time. That was the only thing I noticed.

“The doctors couldn’t say why I developed blood pressure. I can’t even say this is the reason I developed it, all my children are alive and I don’t have issues,” the baffled woman said.

“Later I read some things about this blood pressure that it is a result of blood arteries being blocked, that causes it mostly but Yoruba people will say it is because you are thinking too much.”

Mrs. Florence Adefoluke

Adefoluke, however, said she has strictly adhered to her medications and adjusted her lifestyle and diet to avoid complications despite how difficult and financially challenging it can sometimes be for her.

The retired educationist however has some advice for people battling any of or the two conditions

“People who are living with one or the two conditions should know that the best thing is to face it medically because it is a medical problem and then any advice they are given by their physicians they should follow strictly. It helps to lengthen one’s life span.”

A 2020 study conducted by medical experts at the Lagos University Teaching Hospital, Idi-Araba, on 216 patients between the ages of 34 to 89 years living with diabetes mellitus found that 70.8 per cent (seven in 10 of the patients) of the patients also had hypertension.

The study titled Patterns of drug use among type 2 diabetic patients with comorbidities attending a tertiary centre in Lagos, Nigeria led by Adedunni Olusanya revealed that the other comorbidities found within the focus group were dyslipidaemia, 49.1 per cent, obesity, 31.5 per cent, diabetes mellitus foot syndrome, 12.5 per cent, stroke, 7.9 per cent and chronic kidney disease. 6.9 per cent.

Only a person had suffered no comorbidity, the study says.

In the results of the research, the medical team from LUTH stated that “Comorbidities were present among 215 out of 216 (99.54%) participants and hypertension and dyslipidaemia were the most common comorbid disorders.”

According to the American National Centre for Biotechnology Information, hypertension and type 2 diabetes are common comorbidities.

Hypertension is twice as frequent in patients with diabetes compared with those who do not have diabetes. Moreover, patients with hypertension often exhibit insulin resistance and are at greater risk of diabetes developing than are normotensive individuals, they noted.

Data by the World Health Organisation put the figure of people living with diabetes all over the world at 422 million. The WHO also added that the prevalence of this noncommunicable disease is rising more rapidly in low- and middle-income countries than in high-income countries, noting that the African region accounts for a 27 per cent prevalence of hypertension out of the six regions of the world.

Nobody told me about diabetes when I was diagnosed with hypertension -Patient

According to experts, a person who suffers from diabetes is at increased risk of suffering from hypertension and a person living with hypertension is also at an increased risk of developing diabetes.

This was the case of Mr. Oladeji Olowu, a 70-year-old retired principal accountant who worked with a federal agency.

Recounting his experience with our correspondent, the retired civil servant stated that 30 years ago there was no information on the risk of developing diabetes following his diagnosis of hypertension.

He said he would have been a lot more cautious about his lifestyle if he had the necessary information, noting that the knowledge of diabetes or its link to hypertension was relatively unknown when he was diagnosed.

Sharing his experience with PUNCH HealthWise, he said, “I was dealing with high blood pressure before I knew about diabetes.

“There was so much pressure in the office that when you even take food to the office, you’d never have time to even eat it. So, I stopped taking food to work and instead started taking junk food.

“For those of us that were in accounting then, before you come in people are already there waiting for you, you’d not be able to eat.

“I’m sure that pressure worsened the high blood pressure I was managing and I must tell you that that pressure also worsened the diabetes condition that I was later diagnosed with in 1992 because I remember that at Apapa I was always taking soft drinks and meat pie.

“And you know, taking soft drinks is like taking sugar. That was what I used to take in the afternoon because you can’t find a way to go and eat anywhere.

“That was what I was eating in the office until one day I just went to a party one Saturday, started feeling somehow so I left the party to the clinic.

“They had thought it was malaria but decided they must check for sugar in my blood.

“When I got my result, they refused to allow me to go saying I must sleep in the hospital, that was the beginning of my diabetes problem.

The retired accountant added that “If someone checked earlier and the doctor informed me that ‘look, you might have diabetes in future, stay away from the sugary drinks, do not eat a lot of carbohydrates, eat with vegetables when you eat carbohydrates, you may not easily be caught up with it until probably at old age.’

“But they don’t say it, they only just tell you that they are two friends, if you have one, you’d eventually have the second one.

“But when I had hypertension, nobody was really talking about diabetes at that time. You know, 30 years ago, diabetes was not really known, it was hypertension that people were raving about until later people now discovered that there’s something called diabetes.

Olowu noted that despite managing the two conditions for over 30 years now, he has been able to lead a healthy and active life by adhering to his doctors’ medical and nutritional advice.

Why diabetes patients are at risk of developing hypertension complications 

A Consultant Endocrinologist with the Lagos University Teaching Hospital, Idi-Araba, Dr. Oluwarotimi Olopade said that one of the reasons why patients with diabetes mellitus develop hypertension complications eventually is due to late diagnosis.

He noted that by the time they are diagnosed with type 2 diabetes, complications have already set in. At the time a patient is being diagnosed, some form of organ damage must have been occurring.

He said that research has confirmed that people with diabetes over time can come down with hypertension as a result of injury to the kidney “because when people don’t have good glucose control, it will affect the structure of the kidney. That is the filtering system and when there’s damage to the kidney, the pressure within that filter is altered and rises, as it rises, it affects every part of the vessel and that is transmitted to the whole body so that is why people with diabetes can eventually come down with hypertension.

Also speaking with our correspondent, Dr. Emmanuel Adeyinka, noted that the two diseases are like brother and sister.

“You’d hardly find a person living with one who doesn’t have the other,” he said.

Adeyinka also said a person’s immunity plays an important role in warding off the development of the other disease.

Dr. Emmanuel Adeyinka

“Our immune system is not the same, if someone’s immune system is very low, they can develop both at the same time. The immune system has a relationship with all these ailments,” he said.

It is possible to manage diabetes without developing hypertension

The experts, however, said it is possible to manage diabetes without developing hypertension.

They said the early diagnosis of diabetes is crucial to the proper management of the disease so that it doesn’t cause any organ damage and also to prevent hypertension.

They reiterated that regular checking of blood sugar, blood pressure, and cholesterol levels can help indicate any abnormality in the body.

Adeyinka explained that if a person takes care of one, the chance of developing the other condition is low.

“If your immune system is good and your sugar is controlled and your BP is alright, you may not have the other one. It depends on someone’s treatment of the ailment, he said.”

Olopade stressed that diabetes can be properly managed to prevent coming down with hypertension.

“You can manage it by preventing complications. This is achieved by glycaemic control, lipid control and if possible, blood pressure control. Make sure the blood pressure and glucose do not exceed a certain range,” he said.

The experts also said adherence to dietary recommendations is a crucial part of the management of the two conditions, adding that it that can help a person living with one of the conditions not to develop the other.

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