Diabetes Mellitus and Hypertension—A Case of Sugar and Salt?

Abstract

The majority of patients with diabetes mellitus (DM) have hypertension (HTN). A specific mechanism for the development of HTN in DM has not been described. In the Zucker, Endothel, und Salz (sugar, endothelium, and salt) study (ZEuS), indices of glucose metabolism and of volume regulation are recorded. An analysis of these parameters shows that glucose concentrations interfere with plasma osmolality and that changes in glycemic control have a significant impact on fluid status and blood pressure. The results of this study are discussed against the background of the striking similarities between the regulation of sugar and salt blood concentrations, introducing the view that DM is probably a sodium-retention disorder that leads to a state of hypervolemia.

Prevalence and risk factors of diabetes mellitus and hypertension in North East Tunisia calling for efficient and effective actions

“…The Table 5 summarized the number of hospitals in the six districts of Zaghouan. In addition, the high salinity of the drinking water in the region of BirMchergua 27 may affects the endocrine system of inhabitants and leads to the development of diabetes and hypertension via sodium-retention mechanism 28 , 29 .…”

Home Blood Pressure in Health and Disease

“…Diabetes and hypertension are intrinsically linked (204). First and foremost, they both increase the risk of CVD independently, and the risk may be higher than each on their own when both occur in the same individual (205).…”

“…Lowering BP reduces this risk, but whether this risk reduction is explained by the actual reduction of BP, or by the inhibition of RAAS, is debated (208). Thus, causality has not been established, and chronic inflammation, which is present in both diabetes, hypertension, and obesity, could also play a role (204,208).…”

A possible follow‐up method for diabetic heart failure patients

“…According to the "sugar, endothelium, salt" study, glucose concentrations have a significant effect on plasma osmolality, while glycaemic changes have the same effect on fluid status and blood pressure. There are striking similarities between the regulation of sugar and salt blood concentrations 45 . Hypervolaemia induces increased shear stress in arteries, resulting in elevated endothelial cell cytosolic calcium, leading to activation of endothelial nitric oxide synthase (eNOS) and the production of nitric oxide (NO).…”

“…There are striking similarities between the regulation of sugar and salt blood concentrations. 45 Hypervolaemia induces increased shear stress in arteries, resulting in elevated endothelial cell cytosolic calcium, leading to activation of endothelial nitric oxide synthase (eNOS) and the production of nitric oxide (NO). This causes vasodilation.…”