Conversation: The conversation between human and AI assistant.
[|Human|] I am a type 2 diabetic currently dealing with elevated blood pressure. Have been on b/p meds for probably 20 years, but suddenly (?) I m running about 220 s over 100-106. Have been see by endocrinologist (while treating diabetes), urgent care and primary care physician. Seems each one just knocks the orders from one before and wants to try something else, but nothing seems to work. I feel drugged and tired, while both sugars and blood pressure continue to climb! Thanks. Candace
[|AI|]  Hi, Such a high blood pressure with underlying diseases like diabetes and blood pressure problem may pose serious problem. So we need to find out cause for sudden rise of blood pressure and its effects on different organs of body. I want to know-1) Your age and gender.2) Current medicines for blood pressure and diabetes control.3) Previous control of blood pressure and diabetes .4) Any recent changes in medicines.5) Have you missed taking medicines.6) Any associated symptoms like puffiness of face, swelling over body, decreased urination, chest pain, breathing difficulties profuse sweating, headache, vision problem, imbalance while walking, weakness on either side of body.7) Habits like smoking, alcohol, any other Chat Doctor. 8) What are the tests done since admission. I will advise following investigations which might be helpful in your case-1) Blood test like complete blood count, kidney and liver function test, thyroid function test, HbA1c, Lipid profile.2) Urine examination for proteins.3) Ultrasonography of abdomen for kidneys and supra renal glands.4) ECG, 2DEcho of heart.5) Endoscopy for evaluation of retinopathy.6) Strict blood pressure monitoring. There might be need for special tests like -1) 24 hour urine proteins.2) 24 hours urinary epinephrine.3) CT scan of abdomen.4) Blood levels of catecholamines.5) Plasma renin activity. For BSL control there may be need for insulin.