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Long-term conditions

Diabetes and hypertension

02 May 2025
Long-Term Conditions
02 May 2025
Volume 30 · Issue 5
home visit setting from a community nurse

Abstract

Over 4 million people in the UK are living with diabetes; the majority have type 2 diabetes and over two-thirds also have hypertension. Diabetes and hypertension increase the risk of complications such as stroke, myocardial infarction and premature death, and they also elevate mortality rates. This article uses a case history approach to illustrate the difficulty and methods for managing diabetes and hypertension in a reluctant patient. Drawing on practical clinical experience, it underscores the complex barriers to effective patient engagement and sustained adherence. The article also explores evidence-based strategies that can improve outcomes despite patient resistance.

Over 4.4 million people in the UK have diabetes, and over 90% of them have type 2 diabetes (Diabetes UK, 2024). The World Health Organization (WHO) (2024) defines this condition as:

‘a chronic, metabolic disease characterised by elevated levels of blood glucose, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults, which occurs when the body becomes resistant to insulin or does not make enough insulin. In the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin by itself. For people living with diabetes, access to affordable treatment, including insulin, is critical to their survival. There is a globally agreed target to halt the rise in diabetes and obesity by 2025.’

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cardiovascular disease
hypertension
premature death
stroke
type 2 diabetes