Managing Diabetes and High Blood Pressure – 9 Support Strategies for Family Caregivers

Diabetes and high blood pressure  make for quite the unwelcome pair. Not only do these often-linked conditions make day-to-day life for the person experiencing them more difficult. But they can also have a significant impact on family members, who may increasingly find themselves in the role of caregiver rather than son, daughter, or spouse.

Hands up if that’s you. And if so, what can you do to balance being proactive to maintain your family member’s health without exhausting yourself? Diabetes UK reported the country is in a “rapidly escalating diabetes crisis“, adding more should be done to prevent people from getting the condition.

It’s a tricky balance to get right. While there’s no simple fix, there are a number of strategies that can make your role as a caregiver more effective and less isolating. We’ll go through a list of these strategies today, broken down into three main areas:

• Lifestyle management for diabetes and high blood pressure
• Practical tools and resources
• Healthcare assistance

First, though, let’s briefly touch on the relationship between diabetes and high blood pressure (hypertension) and why it’s so important to pay attention to.

Are diabetes and hypertension related?

Yes, there’s a significant overlap between the two. Case in point:

Around two-thirds of adults diagnosed with diabetes are either on medication to treat hypertension or have elevated blood pressure (over 130/80 mm Hg).

It’s also been found that those with hypertension are more than twice as likely to develop type 2 diabetes.

Biologically, this makes sense. When someone has diabetes, many of the causes and factors contributing to diabetes also lead to hypertension.

But what about the other way around, when hypertension comes first?

This is a newer concept and is still being developed in research to have a better understanding of why hypertension can predispose people to diabetes.

Still with us after that summary?

Phew! To give more context, here are some of the main risk factors for hypertension and diabetes, as well as information on whether they can be positively (or negatively) influenced by someone’s lifestyle.

_{Source: Diabetes and Hypertension: Is There a Common Metabolic Pathway? ncbi.nlm.nih.gov}

Now, ready for the strategies? Let’s dive in.

Lifestyle management for diabetes and high blood pressure

Strategy #1 – Aid in healthy weight maintenance.

The data is undeniable. Being overweight is one of the main causes of diabetes and high blood pressure. No surprise, then, that the rates of type 2 diabetes have increased in the past 20 years along with obesity rates.

Taking a more active role in your family member’s weekly online or in-store grocery shop can be a great place to start. Even a shop that’s 5% or 10% healthier is a move in the right direction.

If you’re not sure what to buy, here are three dietary targets to aim for:

• Reduce the amount of high-salt foods, such as canned soups and pizza
• Increase the amount of high-fibre foods, such as lentils and avocados
• Increase the amount and variety of fruits, vegetables, and lean proteins (though be mindful of sugar intake)

There’s also been encouraging research on the relationship between intermittent fasting and blood pressure. It’s worth learning more about this if it’s an area of health you and your family have yet to explore.

Strategy #2 – Keep an eye on their alcohol intake.

Those over the age of 35 are more likely to develop high blood pressure when they drink regularly. Even one drink per day is enough to increase the risk.

Just like it’s harder to resist snacking on chocolate biscuits once you know they’re in the kitchen, it can be a lot harder for those who like alcohol to resist once they know it’s in the house.

This isn’t to say someone with diabetes and high blood pressure  is never allowed a small beer or a glass of wine. Really, it’s all about moderation. Making alcohol something for special occasions (for example, when at a restaurant) rather than drinking at home is a big step forward.

Strategy #3 – Motivate them to exercise.

Considering the likelihood of developing hypertension and diabetes rises in middle and older age, it can be harder for people to find the time or energy to fit regular exercise into their weekly routine.

Nevertheless, it’s vital to have some kind of movement plan in place.

Science has highlighted how both aerobic and resistance-based exercise improves glucose regulation for those managing type 2 diabetes. The cardiovascular benefits for those looking to lower their blood pressure are also clear.

Some people naturally enjoy being on the move. But others may view exercise as challenging, pointless, or intimidating. If your family member is in the latter group, there are a few options you could try:

• Help them to set realistic goals and a visible way of tracking progress.
• Get equipment for hand-grip exercises that they can do while seated.
• Go for walks in pleasant locations (such as green areas) or suggest doing short follow-along workouts from home.
• Offer rewards. It can add extra motivation to have something nice to look forward to after exercise, whether that’s going to a cafe, watching a film, or having a nice meal.

Want to get more advice on exercise routines?

Check out our quick guide on the best exercises for high blood pressure.

Strategy #4 – Encourage them to quit smoking.

Studies have shown how stopping smoking can lower the risk of heart attacks by at least 50%. It also reduces the likelihood of atherosclerosis, which can be caused by high blood pressure or high cholesterol.

Going “cold turkey” to quit smoking is no easy endeavour. Ultimately, you can only do so much for your family member. But here are a few pointers that can help:

• Provide distractions to assist them with managing withdrawal symptoms.
• Schedule social activities in places that don’t allow smoking.
• Encourage them to sleep well, as being well-rested increases willpower and may reduce cravings.
• Give a morale boost when they need it. Remind them of how they are taking back control of their health (and saving money too).

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Practical tools and resources

Strategy – #5 Purchase a hassle-free 24/7 blood pressure tracker.

The blood pressure cuff was a great invention 100 years ago. But at this point, it’s outdated. Why?

There are several common issues people face:

• The cuff is fiddly to keep putting on and taking off.
• Single readings can be unreliable, leading to unsuitable treatment.
• People forget or are too busy to measure their blood pressure often enough.

Also important to note is that the time of day does affect blood pressure. Readings are generally lower in the morning. So, it’s recommended to measure blood pressure at different times of day and night to get an accurate average.

Since it’s not practical for your family member to wake up in the night to use the cuff, they may benefit from Aktiia’s easy 24/7 blood pressure monitor? The clinically validated tool measures blood pressure around the clock, providing helpful data to share with doctors and other healthcare professionals.

Strategy #6 – Reference trusted publishers and professional organisations for further guidance.

With all the information available online these days, it’s hard to know where to turn. Which article to read? Which PDF guide to download?

Always use reliable sources. Here is a list of publishers and organisations that are known to provide robust advice for those with diabetes and high blood pressure :

• NHS: The NHS website is the best place to start if you need an overview of information on the causes, diagnosis, and treatment of hypertension and diabetes.
• NICE: The National Institute for Health and Care Excellence (NICE) is a wonderful resource to read evidence-based guidelines on all aspects of health and social care in the UK.
• diabetes.co.uk: There are excellent tips on here for people in the UK with type 1 or type 2 diabetes. You can find suggestions on navigating life with diabetes, dietary choices, exercise, and mental health, among other topics.

Strategy – #7 Seek out local or online support groups.

If you’ve yet to reach out to a helpline or local group, please don’t hesitate. Caring can be a stressful and lonely experience. Speaking with other people in similar situations, you may find it generates new ideas and even friendships.

Here are a few networks to take a look at:

• Blood Pressure UK. You can contact the information line, find tips on lowering blood pressure, or become a member to get personalised advice from a specialist hypertension nurse.
• The British Heart Foundation: Join in-person support groups and online communities, read their free (and award-winning) Heart Matters magazine, or call their Heart Helpline if you have any questions.
• Diabetes UK: Benefit from the research and resources of the leading charity in the UK for people with diabetes. They also have a telephone line, support forums, and local groups, and arrange various events.

Healthcare assistance

Strategy #8 – Book regular appointments with their doctor.

Depending on how functional your family member is in their current state of health, they may struggle to contact their doctor or clearly communicate how they feel.

In general, those with diabetes and high blood pressure  will need to get a routine check-up at least every 3-6 months.

Symptoms can change, for worse or for better. Tests that often need to be run regularly include:

• A1C
• Blood pressure
• ECG or EKG
• Eye health
• Fasting blood sugar
• Kidney function
• Lipid profiles

Prescription medications may be updated based on the outcome of these tests. The doctor will be able to assess the current symptom pattern and adjust the type or dosage of medication if needed.

One quick tip here. Make sure to prepare any questions or concerns you or your family member have for the doctor in advance. Writing them on a piece of paper or your smartphone can ensure the time in the doctor’s office is put to the best use.

Strategy #9 – Request extra care.

Caring for someone with diabetes and high blood pressure  often presents different types of challenges – physical, emotional, social, and financial.

Consider checking out Carers UK if you’re struggling at the moment.  They’re a useful non-profit organisation that helps family carers with energy bills, council tax, and applying for Carer’s Allowance.

Other resources you may want to bookmark for the future include:

• The NHS social care and support guide for advice on requesting practical care
• Diabetes UK’s guide on supporting someone with diabetes – your family member may also find their free Diabetes Education course useful
• The British Heart Foundation’s support for carers guide

We hope the nine strategies above offer some potential options to help you and your family to treat and manage these conditions.

Finally, for more information on Aktiia’s 24/7 blood pressure monitor, feel free to go to this page to see how it works.

Disclaimer: If you are concerned about your blood pressure, it is best to speak to your doctor. They can advise on the best way to manage your blood pressure.

Sources:

SkyNews, Diabetes in the UK at its highest level ever, April 13, 2023 – https://news.sky.com/story/diabetes-in-the-uk-at-its-highest-level-ever-with-charity-saying-more-than-5-million-britons-live-with-condition-12855707

Nighttime Blood Pressure Phenotype and Cardiovascular Prognosis, November 02, 2020 – https://www.ahajournals.org/CIRCULATION

NCBI, Diabetes and Hypertension: Is There a Common Metabolic Pathway?, January 2012, – https://www.ncbi.nlm.nih.gov/articles-PMC3314178

Diabetes and High Blood Pressure. Hopkins Medicine, July 2019, – https://www.hopkinsmedicine.org/health-diabetes-and-high-blood-pressure

Symptoms & Causes of Diabetes. National Institute of Diabetes and Digestive and Kidney Diseases, December 2016, – https://www.niddk.nih.gov/health-information-diabetes-symptoms-causes

Diabetes UK, Number of people with obesity almost doubles in 20 years, November 2019, – https://www.diabetes.org.uk/news-number-obesity-doubles-twenty-years

HSE Live, How alcohol affects blood pressure and the heart, November 2019, – https://www2.hse.ie/alcohol-effects-on-your-blood-pressure

NCBI, The essential role of exercise in the management of type 2 diabetes, July 2017, – https://www.ncbi.nlm.nih.gov/articles-PMC5846677

Benefits of Quitting Smoking. National Heart, Lung, and Blood Institute, April 2022, – https://www.nhlbi.nih.gov/smoking-benefits-to-quit

All About Your A1C. CDC, September 2022, – https://www.cdc.gov/diabetes-managing-blood-sugar

NHS, Social care and support guide, January 2015, – https://www.nhs.uk/social-care-and-support-guide

Support for carers, British Heart Foundation, October 2020, – https://www.bhf.org.uk/support-for-carers