Blood Pressure Management

As described above, hypertension is common comorbidity of diabetes. High blood pressure increases the risk of cardiovascular disease and microvascu-lar complications. Maintaining a systolic blood pressure < 130 mmHg and diastolic pressure < 80 mmHg in diabetic persons is of great benefit [26,27]. Blood pressure should be measured at every visit. Drug therapy e.g., ACE inhibitors, ARBs, ^-blockers, diuretics, and calcium channel blockers, in addition to behavioral and lifestyle changes is advised.

A State-Based Model for Management of Type II Diabetes 35 3.5.6 Lipids Management

As described in the corresponding section, patients with type II diabetes are particularly susceptible to lipid abnormalities. Lipid management strategies should be aimed at reducing LDL cholesterol, raising HDL cholesterol, and lowering triglycerides. Healthy lipid levels have shown to reduce the risk of cardiovascular complications and mortality. Lifestyle changes including nutritional changes, physical activity, smoking cessation, and weight loss should be considered as initial strategies to achieve lipid levels. Drug therapy including statins, fibrates, and niacin is indicated when lifestyle changes alone are ineffective.

Patients with healthy lipid levels should be tested once a year, while patients who do not meet the lipid goal levels should be monitored more often.

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