What to do

[modhu65]

Hello
For about 10 years my uncle aged 57 now has been suffering from hypertension. His current BP is 140/85. He is taking Telma AM ( 40+5). Along with the medicines he takes Ativan 1 mg and Prasilex ( Escitalopram) 10mg as he is prone to irrational anxieties. His blood sugar is 98 before breakfast. He walks for 40 minutes in the evening daily. Should he continue all these medicines?
Regards
Modhu

[SassyLassie]

Unless told otherwise by his doctor, yes, he needs to be on them. Only an experienced MD can help him get off, if he needs to be off, that is.

[jemma116]

Type 2 diabetes is a chronic disease which is indicated by high levels of sugar in the blood. Type 2 diabetes develops when your body does not respond correctly to insulin.  Insulin is a hormone released by the pancreas and its role is to break down the sugar for it to be absorbed into the body's cells.  The most common form of diabetes is Type 2 diabetes.

Being overweight does not necessarily mean that you have or will get diabetes.  But being overweight with a big belly increases your chances of developing type 2 diabetes as does family history low activity level and poor diet.   In other words if you have a close family member with diabetes, the risk of you developing the disease is greater.

I know of many thin people (who have never been overweight) who have Type 2 diabetes.

In Type 1 diabetes the pancreas does not produce any insulin.

[mkh9]

Yes to clarify, as I said your uncle should stay on his medications until he see's a change in his blood levels and blood pressure (bp) and that his doctor says it is okay to go off of the medications. When I said you don't need oil I mean added oil such as adding oil to a frying pan. You get enough oils in the foods you eat naturally if you eat a whole plant based diet.

Yes 98 is a normal value for a fasting blood sugar. But is it is high normal as 70-100 is the normal range. There is lots of research and data to show that you can lower your blood sugar and bp with diet and exercise. It is rare but a few cases of diabetes type II are resistant to a dietary change. Most type II diabetes is due to being overweight. I agree if you want to recheck for diabetes the hemoglobin A1C is the better choice.

Is his blood pressure much higher when he isn't on all these meds? How long has he been on the Prasilex? I believe this is Clonazepam which is an anti-anxiety, anti-convulsant type of drug. This is highly addictive and very hard to get off of. So, if he has been on it for a short time I would ask your doctor to switch him to something less difficult to get off of. If they want him to be on it for life then it is ok. But just realize he won't be able to get off of it easily if he has been on it for months or years. If long term he will have to go off using valium or another drug to help get him off of it and it will take months. If he has only just started it they can get him off of it much quicker. I know because I am on Clonazepam for a migraine variant.
mkh9
thanks,
mkh9

[jemma116]

Hello modhu65,

The answer to your question is "YES" your uncle must continue with his medications unless told by his doctor to reduce or stop the medicines.

Diet and exercise can help to lower and control sugar levels and high blood pressure, but this does not mean that he can stop taking his medications.  His doctor is the best person to advise him because his doctor will be monitoring his sugar levels and blood pressure on a regularly basis, if not, then he should be (about once a year if everything is stable).

With diabetes, it also depends which type he has.  Type 2 diabetes can be controlled by diet and exercise, but not always.  It is still important to cut out or restrict the consumption of sugar, sweets, cakes, biscuits and white products.  Wholemeal foods are slower to break down by the body and won't spike up his sugar levels quickly and then drop quickly.

A reading of 98 mg/dl (5.4 mmol/l) is excellent and nothing to worry about.
If the reading drops below that then he would feel unwell and have what is called hypoglycaemia and he would need to have something sugary or glucose tablets straight away.  In the UK readings of If his readings of 125 mg/dl are considered as being Type 2 Diabetes and would either be controlled by diet or diet and medication.

Sugar levels that are very high and can make the person very unwell need medical attention and this is called hyperglycaemia.  
Very high sugar levels are dangerous (as well as very low) and his medications would have been adjusted by the doctor if that was the case.

There are lots of reasons why we get high blood pressure and diabetes as we get older.  Don't get the wrong idea that fat and oils are bad for us.  The body does need some good fats to help it function properly.  Vitamin D and A are some of the vitamins that are essential for the body to function properly these are fat soluble vitamins.  You can find lots of information on these vitamins on the web site, but there is also a forum on this site specifically to Vitamin D.

With regard to the high blood pressure, as you mentioned that your uncle suffers from irrational anxiety, he would benefit from some form of relaxation techniques to help him to control his anxiety attacks.  And yes, you are quite right in thinking that anxiety and stress (and a diet high in salt) will push up his blood pressure.  His doctor could refer him to specialist counsellor that deals with these issues.  Forms of relaxation can be anything from Yoga, listening to music, he does his walks which is a good thing, swimming and anything that helps him to relax and unwind.  Avoiding stressful situations and learning how to deal with stressful situations will also help him to keep his blood pressure at an acceptable level.

Sugar levels are always lowest in the mornings and are also referred to as "fasting" sugar levels.    His readings will differ depending on what he eats and does.  A HBA1C blood test is the more accurate test and this tells the doctor the average blood glucose levels over a period of 3 months.  
A glucose test that your uncle does only tells him how much sugar is in his blood stream at the time of him testing his sugar on his diabetic glucose monitor.

Cutting out or reducing his intake of salt will also help to reduce high blood pressure.  Read the labels on products with regard to the amount of sugar and salt that it contains.  Low fat does not necessarily mean low sugar.  He should also make sure that he drinks plenty of water and avoid getting dehydrated.

Hope this helps you to understand.

Best wishes.

[mkh9]

First none of us are doctors on here. So I would say yes to keep on the same meds at first. If he is willing to change his diet radically to a vegan diet with no added oil he could actually lower his blood pressure and become non diabetic or normal blood sugar and eventually get off the meds. The diet I am on is basically a whole plant based diet called the McDougall diet but there are several that are the same by other doctors. He has a  book called the Starch solution that explains the diet plus why things work. You have to eat whole grains, no white sugar, no white flour, eat lots of greens and starches like sweet potatoes and brown rice and no sodas, no alcohol. No fish no eggs, no meat. My husbands blood pressure was 140/90 and it is now 120/70. Also his weight went down from 210 to 180. He should walk or jog if he can. He isn't that old he should be able to walk then later run unless his doctor says not to because of a heart problem. There is also a good video called Forks over Knives. It is interesting and shows how you can actually reverse heart disease (atheroschlerosis) by this type of diet. Oil is not needed you cook with water instead. Oil is in plant foods and oil is only for gaining weight. Evevyone thinks you need oil but you don't the book explains is all. As for the anxiety he can try biofeedback. It worked very well for me. You have to try an integrative medicine doctor for this. I admit I cheat a bit on the diet especially  in the beginning. I now drink vanilla soy or almond milk instead of milk. And I got past eating cheese. I never thought I could. Eating out is hard you have to choose restaurants that have veggies and rice instead of fried foods. All restaurants put oil in their foods so try to keep it to a minimum. If he did all these things and was willing to do it you would definitely see a change in his bp and weight and he could get off the meds eventually. There are some seminars on this. If you go to drmcdougall.com he has some you can go to but also on line information. He was a former heart surgeon and working with other doctors found from the China Study and other studies that it worked so well he was more happy working with patients in his clinics to get them on this diet rather than do surgery. It is a thought. You can read the China Study or A book by Dr. Pulde and Lederman called Keep it Simple , Keep it Whole and so forth. The more you understand the better you will feel.