Topic Overview

Diabetic neuropathy can cause low or high blood pressure.

• People who have extremely low blood pressure when they rise from a seated or reclining position (orthostatic hypotension) may benefit from wearing support stockings (also called compression stockings), which may keep blood from pooling in the legs. Increasing the salt in your diet and drinking plenty of fluids—as long as they don't contain sugar—can also help by preventing dehydration. Dehydration can make the drop in blood pressure worse when standing or sitting. Midodrine (ProAmatine) is a medicine commonly used to manage low blood pressure. Fludrocortisone, a corticosteroid medicine, may sometimes help relieve orthostatic hypotension.
• High blood pressure in people with diabetic neuropathy may be treated with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril (Lotensin) and enalapril (Vasotec). ACE inhibitors are preferred over other blood pressure medicines for people who have diabetes because ACE inhibitors don't affect blood sugar levels and they help protect the kidneys from damage. For more information about ACE inhibitors, see the topics High Blood Pressure (Hypertension) and Diabetic Nephropathy.