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Why am I unable to manage my hypertension?

Q: I am a 39 years old diabetic man and took insulin for the same, as my sugar levels were around 300 mg/dl. After a year my blood sugar level became normal and now I have normal blood sugar levels without any medication or insulin. Two years back I had hypertension and I take Telma 40 mg but still my blood pressure is around 130/90 mmHg. My blood test reports show normal BUN and creatinine levels but my urine test report showed presence of micro-albuminuria and protein. Do I have a kidney disease? Also, I had done a scan of the abdomen, which showed normal kidneys. Please advise.

A:Appearance of microalbumin in the urine is the first sign of kidney disease in diabetics. It is reversible at this stage. Once the albuminuria is more than 300 mg in 24 hours then it is called proteinuria. After this stage it is usually progressive. You should target you BP to be less than 120/75 mmHg and keep glycosylated haemoglobin (a marker of blood sugar control) to less than 6.5%. Monitor microalbuminuria and glycosylated haemoglobin 3 monthly to achieve the targets.

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