You don't need to have diabetes to know that blood pressure is a thing, an important thing! High, low and somewhere in between - you've most likely had your blood pressure checked at some stage and learned of the results pretty quickly. Me too! I submit to an arm squeezing at every appointment, In fact, I'm pretty sure that I had my BP checked at my pump set up appointment because... I don't know why. It just happened along with my height and weight. Glad to know I'm not too fat or short for pump funding! Phew! There is probably a NICE criteria for that.
BP at appointments, yes! let's focus on that one. I'm one of those "White Coat Syndrome" types. I know that's not the official name for it. Language Matters probably covers it under "Person with anxiety of medical professionals wearing light coloured lab coats" However you describe it, I have it. I think it stems from a real fear of attending my diabetes reviews as a child. If I wasn't passing out from the blood tests, I was being told off about my control, threatened with trips to the amputation ward or working extra hard on my blood glucose diary fiction for the last 90 days. It wasn't a great experience and it stayed that way for a long time.
Medical appointments, I suspect, are not designed to be fun. Today, they're less stressful but they're still not a day out with friends for a lovely lunch and a drink or two. They usually involve losing some of my blood and urine to a stranger and the fear of some terrible news lurks in the back of my mind at each visit to a waiting room... which is always too warm and always contains some absolute knob, coughing up their infectious disease in my face. I'm going off on a tangent. You get my drift, I'm sure.
Those settings appear to be unwittingly designed to increase our anxiety. For me, that appears to translate into elevated blood pressure, almost every time without fail. I've left many appointments with a rented BP machine tucked under my arm for home readings. On at least one occasion I took 24 hours worth of readings. More commonly, I'm asked to provide 7 days worth of home results. And I do! Of course I do. And they're always normal / within a healthy range or near to it, such as this one from last night:
That's reassuring, of course! I have enough to contend with without hypertension coming out to play. However, it's becoming a little tiresome to be told that my BP is "a bit high" in clinic when it's the clinic setting causing my numbers to nudge up. As is my want, I vented about this on Twitter only a week or two ago. David rightly noted that not only do they check for BP on these machines, they also check for irregular heart beats. I'm pretty sure that my home monitor (above) doesn't offer that function. I'm good with heart checks. We're often told that T1D can increase the chances of heart disease so, it makes great sense to have that particular organ checked out. Blood pressure can give our kidneys something to think about, too on top of the work T1D gives to them.
BP in clinic, though? I'm not alright with that one right now. I'll be providing my own readings and requesting that any taken during a heart check are ignored and not noted. That's going to be an interesting chat with that HCP, isn't it?!
We check our blood glucose a lot through CGMs and finger pricks. We try to keep it in a healthy range because that reduces our chances of diabetes related complications. Blood pressure is very important for many aspects of our health, too. I believe that frequent monitoring of BP should be seen as an essential aspect of T1D care but that frequent monitoring should be done in our usual day to day environments; home and work. Unusual settings, such as diabetes review appointments, are not places to obtain reliable blood pressure readings.
Blood pressure monitors are relatively cheap these days. It seems unlikely that the NHS would fund BP monitors for all diabetics so, if you can afford to pick one up, I do recommend getting one for a useful and accurate picture of your blood pressure.
And relax!
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