I am final year mbbs student. My mother 56 years is diabetic for 10 yrs. Ppbs 230; fbs 130, hba1c 7.7, 24 hr microalbumin 404. receiving insulin past 1 years 30/70 human mixtard. Her bp 160/80 .Diabetic nephropathy with nephrotic range proteinuria. Doctor suggested telmisartan 80 mg with hydrochlorothiazide 12.5 mg. Sir my query is hydrochlorothiazide safe in diabetes as it impairs glucose tolerance further and alters lipid profile. Please suggest fluid and protein salt restrictions.

Dr. Sajeev KumarGeneral Physician32yrs exp

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As a MBBS student you need to control diabetes even more strictly and you can discuss all details with treating physician frankly. Hee may have reason for his suggestion and all drugs have some complications and if the benefits outweigh the risks we recommend the drug .Hydrochlorothiazide is a diuretic that treats water retention by reducing the amount of salt absorbed by the body. This is especially important in patients with high blood pressure, kidney disorders and diabetes. Diabetes is a metabolic disease characterized by high levels of sugar in the bloodstream. 

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