Blood pressure

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There's no question that blood pressure plays a key role in the development of complications of diabetes. Your child's blood pressure should be measured each time he sees the doctor. An increase in the average blood pressure of children is especially harmful for the child with T1DM. Here are just some of the reasons for the increase:

^ Children are getting fatter. ^ Children are more sedentary than before.

^ Children with diabetes may have increased sensitivity to salt, which raises blood pressure.

^ Children with diabetes may lack the nighttime fall in blood pressure that normally occurs in people without diabetes.

In order to tell if your child with T1DM has high blood pressure, you have to know the normal levels of blood pressure for his age and height. (See the nearby sidebar "The meaning of blood pressure numbers" for more detailed explanations of each type of blood pressure.) Table 7-1 shows the highest normal blood pressure at each age.

Table 7-1

Maximum Normal Blood Pressure at Different Ages

Age

Maximum Blood Pressure

Newborn

70/45 mm Hg

5

115/75 mm Hg

6-12

125/80 mm Hg

13-15

126/78 mm Hg

16-18

132/82 mm Hg

Over 18 139/89 mm Hg

Over 18 139/89 mm Hg

To compare your child's blood pressure with other children his age and height, go to www.nhlbi.nih.gov/health/prof/heart/hbp/hbp_ped.pdf. This takes you to The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Scroll through the document to find Blood Pressure Levels for Boys (Table 3) and Girls (Table 4) by Age and Height Percentile. Check the tables to see if your child is above the 90th percentile, which is considered too high.

High blood pressure worsens all the complications of diabetes, and controlling blood pressure slows or reverses the progression of the complications. Blood pressure is treated with lifestyle changes like exercise and weight loss and medications if needed.

You can check your child's blood pressure (and your own) using one of the home blood pressure monitors that you can buy in pharmacies. The Panasonic and Omron models are reliable, accurate, and not very expensive.

For much more information on every aspect of high blood pressure, check out my book High Blood Pressure For Dummies, 2nd Edition (Wiley).

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