By raising blood glucose levels, the thiazide and related diuretics
can reduce the effects of the antidiabetics
and impair the control
. However, this effect appears to be dose-related, and is less frequent at the low doses now commonly used for hypertension. Hyponatraemia has rarely been reported with chlorpropamide
com- bined with a thiazide and potassium-sparing diuretic.
This interaction is of only moderate practical importance. Recent guidelines on the treatment of hypertension in diabetes
recommend the use of thiazides.
However, if higher doses are used, increased monitoring of diabetic control