How to lower high blood sugar levels in a hypertensive patient?

Q. My mom's blood sugar level is high in her recent blood test. Please suggest treatment options.

Answered by
Dr. Nagaraj
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Dec 10, 2020 and last reviewed on: Sep 01, 2023

Hello doctor,

As of today, my mother's fasting blood sugar levels had come up 123.2 mg/dl, and HbA1c is 6.5%. Average blood glucose is 140 mg/dl. In the blood test taken before three months, her fasting blood sugar was at 118 mg/dl, whereas HbA1c was 6.1%. She did not take any medicines but was under diet restriction. Before that, her blood sugar levels were not significantly high as of the above two.

She is 49 years old and taking Telpres CT 40/6.25 for high BP for the past few years.



Welcome to

I had a look at the report (attachment removed to protect patient identity). Her blood sugar levels are on the higher side (fasting, average levels). And her HbA1c (glycated hemoglobin) is exactly at 6.5 %, which is the cut-off point for diagnosing diabetes. I could also see the increasing trend of HbA1c for the past three months. I wanted a few answers to suggest appropriately.

Did she have any symptoms? How is her appetite (increased or decreased)? How is her waterworks (urine) habits, is it increased or decreased? Does she wake up at night to urinate? If yes, how many times? Is there a change in her weight? If yes, how much and over how many days?

Thank you doctor,

She has resting pain (when she goes to bed) in her shoulder, and her urine habit is slightly decreased. She wakes up very rarely at night. No much change in the weight.



Welcome back to

It looks like she has diabetes. Though not typical symptoms, her average blood glucose levels and HbA1c levels define it. We need to evaluate further with comprehensive blood and urine check-up. Let us do them six weeks from now. In the meantime, let her start tablet Glycomet 500 mg (Metformin) one in the morning, 15 minutes before breakfast. Once we have full blood and urine reports, let us review the medications. Let her continue her BP medicine (hoping her BP is in control). Also, she has to exercise or walk briskly for at least 20 minutes daily. Reduce the daily consumption of sugar to half of what she is taking now.

She has a frozen shoulder, common in people with high blood sugar levels (assuming she has no other ailments or trauma to the shoulder). It requires supervised shoulder exercises. Please visit a physiotherapist who will guide you further.

Investigations to be done:

Blood: CBC (complete blood count), fasting blood sugar, postprandial blood sugar, HbA1c, blood urea, serum creatinine, serum electrolytes, fasting lipid profile.
Urine: urine routine, albumin/microalbumin.

Probable diagnosis:

DM T2 with HTN (Diabetes mellitus type 2 with hypertension).

Treatment plan:

Tablet Glycomet 500 mg before breakfast for six weeks.

Regarding follow up:

Follow up with investigations report at six weeks.

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