June 17, 2000
Question from Glenside, Pennsylvania, USA:
I was in very bad control prior to my crisis, which led to getting the pump (which changed my life for the better). At that time, for the first time, I had high blood pressure and am now taking an ACE inhibitor. Might not the high pressure readings (150/90) at that time have been related to the high blood sugars? Is it advisable for my doctor to consider taking me off the ACE inhibitor temporarily to see whether I need it, now that my blood sugars are much improved (HbA1c=7.2)?
High blood pressure can occur even if you don’t have diabetes, and it is important to keep the blood sugar under control to decrease the chance of developing more serious kidney problems. ACE inhibitor are also recommended for diabetics with normal blood pressure but small amounts of protein in their urine (microalbuminuria) to prevent or delay the onset of kidney problems. If you were overweight and lost weight with your improved control, there is a small possibility that you might be able to stop the blood pressure medication (assuming you also have no protein in your urine). It can be very dangerous to stop blood pressure medication abruptly. I would not make any changes in this medication without consulting with your doctor. If you are doing well on the medication with no side effects, it might not be worth the risk to stop it to see what happens.