By raising blood glucose levels, the thiazide and related diuretics can reduce the effects of the antidiabetics and impair the control of diabetes. 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 would seemprudent.
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