Why Thiazides Are ContraIndicated in Diabetes

Patients with diabetes may take thiazide diuretics, right? In patients with hypertension, the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7)1 and the American Diabetes Association (ADA)2 recommend the use of thiazide diuretics (usually in addition to an angiotensin-converting enzyme (ACE) inhibitor).

Why are thiazides responsible for hyperglycemia? In addition, it is hypothesized that thiazide diuretics down-regulate peroxisome proliferator-activated receptor gamma, reducing insulin release, as well as stimulating the reninangiotensin-aldosterone pathway, resulting in higher aldosterone levels and hyperglycemia.

Helpful three-part strategy for a low-fat, plant-based, whole-food diet that treats and avoids Prediabetes/Diabetes II (also cures/prevents high blood pressure and high cholesterol). Very comprehensive description of insulin resistance and its treatment.

I’m pleased the book gave solid facts and information on why a low-carb, high-fat diet is not sustainable.

Diet works if you adhere to it, as simple as that. It is simple to sustain this diet long-term.

Why is HCTZ not recommended for diabetes? Hydrochlorothiazide’s adverse metabolic effects on the diabetic risk profile include abnormalities in lipids, hypokalemia, impairment of glucose metabolism, and therefore the development of type 2 diabetes via increasing hepatic insulin resistance.

Why Thiazides Are ContraIndicated in Diabetes – RELATED QUESTIONS

What effect do thiazides have on glucose?

These findings imply that hypokalemia produced by thiazides is related with elevated blood glucose levels. The treatment of thiazide-induced hypokalemia has the potential to correct glucose intolerance and prevent the development of diabetes in the future.

Why are diuretics avoided in diabetic patients?

Diuretics may influence blood glucose levels because they inhibit glucose metabolism. When the body is unable to properly break down glucose, the glucose level in the blood increases.

What is the best diuretic for diabetics?

We conclude that Indapamide is safe and effective for decreasing blood pressure and leads to improved glucose and lipid management in diabetic and dyslipidemic individuals compared to conventional diuretics.

How exactly do thiazides induce hypoglycemia?

One prevalent idea posits that thiazide-induced potassium depletion is responsible for lower insulin secretion and/or insulin sensitivity, resulting in impaired glucose tolerance and hyperglycemia.

Why are thiazides responsible for hyperuricemia?

Thiazide diuretics are linked to higher levels of serum uric acid (SUA). They enhance the direct reabsorption of urate in the proximal renal tubules [3]. The presence of a high SUA is an independent risk factor for gout [2]. These drugs enhance SUA levels and may hence increase the risk of gout.

Which hypertension medication is best for diabetics?

Angiotensin-converting enzyme (ACE) inhibitors are indicated as first-line antihypertensive medicines for diabetic patients to avoid or postpone microvascular and macrovascular consequences.

Can HydroCHLOROthiazide be used with diabetes?

hydroCHLOROthiazide metFORMIN HydroCHLOROthiazide may raise glucose levels and impair diabetes management. To take both drugs safely, you may need a dosage change or more regular monitoring of your blood sugar.

How can diuretics produce hyperuricemia?

This is possible because diuretics stimulate urine, hence decreasing the quantity of fluid in the body. However, the leftover fluid is more concentrated, which might increase the likelihood of developing gout crystals. Some diuretics inhibit the kidneys’ excretion of urate, which is a component of uric acid.

Can diuretics raise blood sugar levels?

Popular drugs such as statins and diuretics may increase your blood sugar levels, which can be problematic regardless of whether you have diabetes.

Why is Lasix not recommended for diabetes?

If you have diabetes, Lasix may impact your glucose levels. Regularly test your urine or blood and report any significant changes to your doctor. Your skin may become more sensitive to sunlight if you are using Lasix.

Why is furosemide contraindicated in the treatment of diabetes?

Furosemide may interfere with glucose regulation and diminish the efficacy of normal insulin and other diabetic treatments. Closely monitor your blood sugar levels. During and during treatment with furosemide, you may need to alter your diabetic prescription dosage.

Is diuretic safe for diabetics?

According to the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial, diuretics (water pills) are more effective than newer and more expensive drugs in the treatment of high blood pressure and prevention of some kinds of heart disease in patients with type 2 diabetes (ALLHAT).

What is the first-line treatment for hypertension in patients with diabetes?

Angiotensin converting enzyme inhibitors (ACEIs) are the first-line treatment for hypertension in diabetic hypertensives, but may be substituted with angiotensin II receptor blockers (ARBs) if patients are intolerant.

Why are beta-blockers contraindicated for diabetic patients?

In insulin-dependent diabetics, beta-blockers may prolong, exacerbate, or change hypoglycemia symptoms, but hyperglycemia seems to be the primary concern in noninsulin-dependent diabetics. Potentially, beta-blockers may raise blood glucose levels and counteract the effect of oral hypoglycemic medications.

How does thiazide induce DKA?

In these individuals, a large increase in glucose may lead to the development of diabetic ketoacidosis (DKA). In this instance, the fast increase in HgA1c in the weeks after thiazide administration provides more evidence that drug-induced glucose dysregulation likely caused DKA.

Do diuretics promote insulin resistance?

Conclusions. The use of diuretics is connected with insulin resistance and uric acid levels in the blood, and may lead to poor glucose tolerance.

Which diuretic does not raise uric acid levels?

Evidence-Based Response Thiazide diuretics may be administered to the majority of hypertensive individuals with a marginally higher risk of gout.

Why do thiazide diuretics produce hypercalcemia?

Hypercalcemia caused by thiazide usage is a well-recognized clinical condition. Thiazides promote sodium excretion by inhibiting the thiazide-sensitive NaCl transporter in the distal convoluted tubule, which is intimately associated with calcium transport (5).

Why do diuretics lower the excretion of uric acid?

Diuretics lower urate excretion dose-dependently by enhancing urate reabsorption and reducing urate secretion [2,6-9]. (figure 1). In most countries, treatment of asymptomatic hyperuricemia is not indicated.

What is the best beta blocker for diabetics?

Carvedilol is better to metoprolol in the management of glucose metabolism in individuals with type 2 diabetes and hypertension [2]. Also, research indicates that carvedilol does not worsen insulin resistance, contrary to what was shown in a direct comparison with metoprolol [18].

Why are ACE inhibitors the preferred medication for diabetic hypertensive patients?

The ACE inhibitors were deemed the optimal treatment for diabetes-hypertension because they had favorable effects on renal function beyond those resulting from BP management alone.

Is amlodipine contraindicated in diabetes?

The safety profile of amlodipine 10 mg in diabetic individuals was comparable to that reported in non-diabetic patients and in prior trials employing high-dose amlodipine.

This is the finest diabetic book that I have ever read. The excellent ones all recommend a high-carbohydrate, low-fat, plant-based diet, but this one explains why we should follow this diet. I have been a whole-food, plant-based eater for around five years, but I ate too many nuts, nut butters, and seeds despite the fact that they are entire foods.

As soon as I read the explanation in this book, I saw why too much fat was harmful. My insulin consumption went from 30 units per day to 12 units per day, and it seems to be moving even lower, and my blood sugar management has improved to the point that it is almost predictable, while on a high-fat diet, my blood sugar was like a random walk.

I adore this book! BTW, except when I’m fasting, I’m never hungry. Intermittent fasting is not required, but it does help you lose weight and activate your cellular defenses. Eating according to the advice in this book will help mend your metabolic disease, and you will lose weight. Good luck!!!!