International Journal of General Medicine (Sep 2024)

Evaluating Blood Pressure Variability in Type 2 Diabetic Patients: An Insight into Non-Dipping Patterns and Their Clinical Implications

  • Shaphe MA,
  • Alshehri MM,
  • Alajam RA,
  • Alfaifi B,
  • Hakamy A,
  • Aldhahi MI,
  • Ahmad A,
  • Khan A,
  • Aafreen,
  • Khan AR

Journal volume & issue
Vol. Volume 17
pp. 4445 – 4454

Abstract

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Mohammad Abu Shaphe,1 Mohammed M Alshehri,1 Ramzi Abdu Alajam,1 Bushra Alfaifi,1 Ali Hakamy,2 Monira I Aldhahi,3 Ausaf Ahmad,4 Ashfaque Khan,5 Aafreen,5 Abdur Raheem Khan5 1Department of Physical Therapy, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; 2Respiratory Therapy Department, College of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia; 3Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University (PNU), Riyadh, Saudi Arabia; 4Department of Community Medicine, Kalyan Singh Government Medical College Bulandshahr, Uttar Pradesh, India; 5Department of Physiotherapy, Integral University, Lucknow, IndiaCorrespondence: Abdur Raheem Khan, Department of Physiotherapy, Integral University, Lucknow, India, Email [email protected]: Hypertension (HTN) is prevalent in individuals with type 2 Diabetes Mellitus (T2DM), doubling the risk of developing chronic complications. Despite normal routine checks, many patients with diabetes exhibit abnormal blood pressure (BP) profiles identified by 24-hour ambulatory Blood Pressure monitoring (ABPM). This study aimed to analyse blood pressure variability in patients with diabetes to enhance current knowledge and improve clinical practice.Methods: This cross-sectional study obtained ethical approval from Jazan University and involved 58 patients with type 2 Diabetes Mellitus (T2DM) who adhered to the strict inclusion and exclusion criteria. Comprehensive clinical and laboratory data, including demographic, clinical, and essential laboratory parameters, were collected using a standardized form. Blood Pressure (BP) was meticulously monitored using the Sun Tech Oscar 2 ABPMR device, with measurements commencing between 8 am and 10 am, extending over 24 hours. The study calculated averages and evaluated systolic and diastolic percentage dipping during 24-hour, daytime, and night-time intervals. Participants classified as “dippers” experienced a BP reductions of at least 10%.Results: Fifty-eight normotensive T2DM patients, with a mean age of 45.51 ± 6.7 years, were monitored over 24 months. Among the 58 individuals assessed using ABPM, a non-dipping pattern was observed in 45 participants (77.58%), whereas 13 (22.41%) exhibited a dipping pattern. Postprandial and fasting blood sugar levels were distinct; the dipper group demonstrated better post-meal glucose control (p=0.02), whereas the non-dipper group had superior fasting glucose control (p=0.04). The dipper group showed a higher 24-hour average systolic BP (p=0.00) and increased dipping percentages for systolic and diastolic BP during sleep.Conclusion: Over 77% of ABPM-evaluated individuals showed non-dipping patterns, with a higher BMI being strongly associated. Laboratory findings revealed distinct variations in the postprandial and fasting blood sugar levels, suggesting a potential genetic predisposition.Keywords: hypertension, T2DM, ABPM, cardiovascular, haemodynamic

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