[Medical Q&A] What are the blood pressure and blood lipid control targets for patients with type 2 diabetes?

Author: Liu Bing, deputy chief physician, Beijing Friendship Hospital, Capital Medical University

Reviewer: Yuan Mingxia, Chief Physician, Beijing Friendship Hospital, Capital Medical University

The blood pressure control target for diabetic patients should also be individualized. Generally, for diabetic patients with hypertension, the blood pressure target is <130/80 mmHg. For elderly diabetic patients or those with severe coronary heart disease, a relatively loose blood pressure target can be determined. When the blood pressure level of diabetic patients is >120/80 mmHg, lifestyle intervention should be started to prevent the occurrence of hypertension. When the blood pressure is ≥140/90 mmHg, antihypertensive drug treatment can be considered. When the blood pressure is ≥160/100 mmHg or higher than the target value by 20/10 mmHg, antihypertensive drug treatment should be started immediately, and a combined treatment plan should be applied.

Lowering total cholesterol and low-density lipoprotein cholesterol levels can significantly reduce the risk of macrovascular disease and death in diabetic patients, and is the main goal of lipid-lowering treatment for diabetes. Lowering low-density lipoprotein cholesterol is the primary goal. According to the risk of atherosclerotic cardiovascular disease in patients, low-density lipoprotein cholesterol should be reduced to the target value. For patients at very high risk of atherosclerotic cardiovascular disease, the control target of low-density lipoprotein cholesterol is <1.8mmol/L; for patients at high risk of atherosclerotic cardiovascular disease, the control target of low-density lipoprotein cholesterol is <2.6mmol/L. Diabetic patients should have their blood lipids (including total cholesterol, triglycerides, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol) checked at least once a year. For those who receive lipid-lowering drug treatment, check the patient's compliance, lifestyle, and blood lipid changes after 4 to 12 weeks. By rechecking blood lipids, understand the patient's response to lipid-lowering drugs and detect adverse drug reactions as early as possible. Repeat once every 3 to 12 months as needed.