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Does A Bp Of 138/44 Require An ER Consultation?

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Posted on Sat, 9 Dec 2017
Question: Is he in danger? This morning: blood pressure of 138/44 with a heart beat of 86 to 95, recently diagnosed with type 2 diabetes, Temp normally 97.3 now 98.6 lost a toe due to stepping on a nail (blood sugar of 440 when taken to ER) this happened during hurricane XXXXXXX Diagnosed w type 2 diabetes in ER, could not get sugar down or antibiotics to stop infection and low grad fever, 4th day in hospital toe was removed. Home for about 4 weeks, home now. Daily taking a morning shot of insulin, an evening shot of insulin. Dr added Metforman 1 week ago. Last night, vomited, had slight sight related problem similar to a stuffy head when having a bad cold but no cold. Temp normally 97.3 now 98.6. What should I do?
doctor
Answered by Dr. Mirjeta Guni (1 hour later)
Brief Answer:
About Diabetes and high temperature;

Detailed Answer:
Hello and thank you for asking!
The blood sugar is normal, anyway one value does not suggest a lot.
I would suggest to continue with metformine twice and reduce gradually the insuline doses (especially if he is overweight).
If the infection of the toe is eliminated than there should be tried to find a cause for the high temperature, it is a viral infection or does he need antibiotic? As the temperature persists I would suggest to see a physician and repeated the inflammation markers ( proteine C reactive and white blood cells).
Hope i have been helpful.
Kind regards,
Dr.Mirjeta
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Mirjeta Guni (38 minutes later)
my concern was based on all the facts shared.

*The main concern was that his BLOOD PRESSURE was 138/44, Heart rate (at rest) 86 to 95 usually his BP is much higher. With a light headed or hard to describe change in vision on feelings in his eye/head region was giving me concern. We are only recently learning how to deal with Type 2 Diabetes so perhaps we are doing something wrong. He does take a pill, I could not tell you the name of it, a small white round pill perscribed, he thought it was a blood thinner but the last visit, the DR said it was a BP pill.
doctor
Answered by Dr. Mirjeta Guni (3 hours later)
Brief Answer:
About blood pressure;

Detailed Answer:
Welcome back!

The blood pressure is not altered by the glucose level.

138 mm/hg is not considered low, but if he has had higher values for a long time than it may be perceived as low by his body, but he needs to adapt to normal values.

Secondly, orthostatic hypotension ( low blood pressure when standing up) may also be a cause of his symptoms.

Anyway, the symptoms you described are due to blood pressure alterations and the doctor who prescribed the treatment should be informed about his symptoms. If it is necessary he will change the therapy.

Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Mirjeta Guni (2 days later)
Blood pressure (top) 138 is OK / 44 is NOT-It is LOW, THAT IS MY CONCERN.
138/44.

Thanks for trying anyway.
doctor
Answered by Dr. Mirjeta Guni (5 hours later)
Brief Answer:
About diastolic blood pressure,

Detailed Answer:
Hi again!
The difference of systolic and diastolic blood pressure you reported is high ( 138-45).
To check properly the diastolic blood pressure is difficult in some cases and a medical professional should confirm it before true
Ying to find the cause of this abnormal difference or isolated systolic blood pressure.
Regards,
Dr.Mirjeta
Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2414 Questions

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Does A Bp Of 138/44 Require An ER Consultation?

Brief Answer: About Diabetes and high temperature; Detailed Answer: Hello and thank you for asking! The blood sugar is normal, anyway one value does not suggest a lot. I would suggest to continue with metformine twice and reduce gradually the insuline doses (especially if he is overweight). If the infection of the toe is eliminated than there should be tried to find a cause for the high temperature, it is a viral infection or does he need antibiotic? As the temperature persists I would suggest to see a physician and repeated the inflammation markers ( proteine C reactive and white blood cells). Hope i have been helpful. Kind regards, Dr.Mirjeta