Living with Diabetes
The Unexpected Connection Between Glucose and Blood Pressure in Children Living with Diabetes
Published: Dec. 17, 2025
Updated: Dec. 19, 2025
9 min read
We typically think of blood pressure as a health concern that mainly affects older adults, but diabetes can have an impact on blood pressure at any age. Children and adolescents living with diabetes are at higher risk of experiencing issues with blood pressure than kids who don’t live with the condition.1,2 Between 6 and 16 percent of kids and teens living with T1D experience high blood pressure, or hypertension, while 25 percent of those living with T2D experience hypertension.1,2 It’s a good idea for parents and caregivers of children living with type 1 diabetes (T1D) or type 2 diabetes (T2D) to understand the relationship between diabetes and blood pressure to give them insight into how best to support their child’s long-term health.
What is Blood Pressure?
Blood pressure is the force that blood moving through the circulatory system puts on the arteries, which are responsible for transporting blood that carries oxygen from your heart to the rest of your body. Arteries are flexible like a garden hose. They expand and contract as the heart rhythmically pumps blood through them. There needs to be a certain level of blood pressure to ensure that blood can reach every part of the body.3
Blood pressure is measured by looking at systolic pressure, which is the amount of pressure in the arteries when the heart pumps blood into them, and diastolic blood pressure, which is the amount of pressure in the arteries when the heart fills with blood again between heartbeats. These measurements are written as a fraction, for example, 120/80 mm Hg, which is read as 120 “over” 80.3
Normal blood pressure can vary by a child’s age, gender, and size. For adults, normal blood pressure is at or under 120/80 mm Hg.4 Hypertension Canada generally defines hypertension, or high blood pressure, in children 6 to 11 years old as blood pressure above 120/80 mmHg and above 130/85 mm Hg in children 12 to 17 years old.5 Having blood pressure under 90/60 mm Hg is generally considered to be hypotension, or low blood pressure.6
Though they are related, there is a distinct difference between blood pressure and blood sugar. Blood pressure refers to how hard blood is pushing against the arteries. Blood sugar is the amount of a type of sugar called glucose that’s present in the blood. Experiencing high glucose, or hyperglycemia, doesn’t mean increased blood pressure at the moment. However, glucose levels can have an effect on blood pressure as time goes on.
Understanding the Relationship Between Blood Pressure and Blood Sugar in Children
People who live with diabetes are at higher risk of experiencing issues with blood pressure, especially hypertension.7 Over time, hypertension can contribute to the development of complications that involve the heart, arteries, veins, and small blood vessels, including diabetic retinopathy, which happens because of damage to the blood vessels in the eyes; diabetic neuropathy, which involves damage to the blood vessels that keep nerves healthy; and cardiovascular diseases like heart attack and stroke.8
High blood pressure can develop because experiencing high glucose levels over time causes the walls of the arteries to become narrow and lose their flexibility.9,10 This means that even though there might be the same amount of blood in the arteries, they can no longer expand to accommodate it, increasing the internal pressure on the artery walls. To imagine what this is like, think about the pinch you feel when you squeeze into a tight pair of jeans versus relaxing into stretchy sweatpants. You feel greater pressure when you’re wearing stiff jeans, even though your body hasn’t changed at all.
While doctors have a good understanding of how living with diabetes for many years can lead to issues with blood pressure, they still aren’t sure why children may experience elevated blood pressure even though they haven’t lived with diabetes for very long.
Having a high body mass index (BMI) or experiencing overweight or obesity is associated with a greater risk of experiencing hypertension.1,2 Studies are also looking into whether experiencing serious hyperglycemia, or high blood sugar, has a lasting impact on blood pressure. Many children experience hyperglycemia before they are aware that they’re living with diabetes. Often, a hyperglycemic event that results in diabetic ketoacidosis—a toxic buildup of acids called ketones—is what leads to a T1D diagnosis.11
Diabetes and Low Blood Pressure
Low blood pressure, or hypotension, can also contribute to cardiovascular complications. When the blood isn’t flowing properly, it can clot, leading to heart attack or stroke. As a person manages diabetes throughout their life, experiencing high blood sugar can contribute to the development of a diabetes complication called autonomic neuropathy. This condition happens when the nerves that control the internal organs, including the heart, get damaged. Autonomic neuropathy can cause problems with heart rate and blood pressure, which may lead to low blood pressure.12-14
Dehydration is a more pressing cause of low blood pressure in kids and teens. People living with diabetes are at higher risk of experiencing dehydration than those who don’t. Again, high glucose levels can be the culprit behind dehydration as the body gets rid of excess glucose through urination, taking water with it.14 Dehydration lowers the amount of water in the blood, reducing the total volume of blood circulating in the body. When there isn’t as much blood in the arteries and veins, it causes low blood pressure. However, when we’re experiencing dehydration, the body tries to ensure that blood pressure doesn’t drop too low. Sometimes, this can lead to an overcorrection that causes high blood pressure.15
Managing Blood Pressure for Long-Term Health and Well-Being
Looking after your child’s blood sugar levels can help both of you manage their blood pressure and lay the foundation for their long-term health. Having higher blood pressure during childhood can lead to experiencing hypertension into adulthood, increasing the risk of experiencing diabetes complications later in life.5 Even if your child is already experiencing higher blood pressure, there are steps you can take to support their health as they grow up. Here are just a few things you can do to make a positive change in your child’s blood pressure.
Stay in the Know About Your Child’s Blood Pressure
Identifying high blood pressure is the first step in managing it. Diabetes Canada recommends that all children living with T1D and T2D get screened for hypertension at least twice a year.[16] Children living with T2D should be screened when they are diagnosed and at every doctor’s appointment, or at least twice a year.[17]
Hypertension Canada notes that children’s blood pressure needs to be measured several times to confirm a diagnosis.[5]5 Some people experience abnormally high blood pressure at the doctor’s office because they’re nervous about their visit, known as white coat blood pressure. If your child gets a little anxious around doctor appointments, it’s a good idea to let their doctor know that this could be affecting their blood pressure readings.
People living with diabetes may also experience changes in blood pressure at different times outside of their appointments, which the doctor won’t catch if they only measure blood pressure in the clinic. Children living with diabetes may not experience the natural drop in blood pressure that usually happens when we sleep. This elevated blood pressure at night can go undetected and potentially contribute to the development of complications down the road.[5]5 Your doctor may recommend using an ambulatory blood pressure monitor (ABPM) to see what’s going on with your child’s blood pressure between visits.
Prioritize Glucose Monitoring and Management
Reducing hyperglycemia, lowering A1C , and ensuring that your child’s glucose levels stay within the target glucose range you’ve established with the help of their doctor can contribute to their overall health and well-being as they grow up. Guiding your child through the process of learning to care for themselves and building healthy habits empowers them to continue looking after their diabetes management into adulthood, helping them reduce the risk of long-term complications.
Diabetes Canada generally recommends that children and adolescents under 18 who are living with T1D aim for an A1C at or below 7.5% with a target glucose range between 4.0 and 10.0 mmol/L.[16]16 Those living with T2D should aim for an A1C at or below 7.0%.17
There are many factors that affect glucose levels in children and teens. It can be especially challenging for teens to control their glucose levels because the hormonal changes they’re going through can lead to insulin resistance and hyperglycemia.18 Teens living with T1D typically have an A1C about 1% higher than adults.[18]18 It’s important to work with your child’s doctor and diabetes care team as they move through all the stages of growth to ensure that their diabetes management plan continues to meet their changing needs.
One of the ways to get insight into your child’s glucose management is to use a continuous glucose monitoring (CGM) system like the Dexcom G7 CGM System. Dexcom G7 can provide glucose readings throughout the day and night directly on your own or your child’s smartphone, smartwatch , or handheld receiver, without the need for routine fingersticks.*†‡ Dexcom G7 also connects to the Dexcom Follow app, enabling parents and caregivers to view glucose readings remotely on their own device, as long as they have a wifi connection.†§|| You can set up a custom notification to alert you and your child when their glucose has been above a certain threshold for a period of time. With glucose readings in the palm of their hand, your child can learn how certain habits, foods, and physical activities impact their glucose. It can also give you and your child’s diabetes care team the opportunity to spot patterns and identify causes of high glucose so you can address them together.
Support Your Child’s Glucose Management and Blood Pressure with Dexcom CGM
Decreasing hyperglycemia and improving your child’s glucose control contribute to their overall health and can have a positive impact on their blood pressure. Using Dexcom CGM Systems, including Dexcom G7, have been shown to help lower A1C and increase the amount of time individuals spend in their target glucose range.19-23 With Dexcom G7, you can get the insights you need to support your child’s glucose management and help them learn how to take care of their glucose independently, setting them up for a healthier future.
* For a list of compatible devices, visit www.Dexcom.com/compatibility.
† Compatible smartphone is required to pair a new Dexcom G7 sensor with an Apple Watch. Dexcom G7 users must continuously have their smartphone within 6 meters to utilize Share/Follow. Share/Follow is not available with Apple Watch by itself.
‡ Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
§ Followers must have compatible smart devices to use the Dexcom Follow app. To view a list of compatible devices, visit dexcom.com/compatibility.
|| Separate Dexcom Follow app and internet connection required. Internet connectivity required for data sharing.
† Compatible smartphone is required to pair a new Dexcom G7 sensor with an Apple Watch. Dexcom G7 users must continuously have their smartphone within 6 meters to utilize Share/Follow. Share/Follow is not available with Apple Watch by itself.
‡ Fingersticks required for diabetes treatment decisions if symptoms or expectations do not match readings.
§ Followers must have compatible smart devices to use the Dexcom Follow app. To view a list of compatible devices, visit dexcom.com/compatibility.
|| Separate Dexcom Follow app and internet connection required. Internet connectivity required for data sharing.
1 Downie ML, et al. An Update on Hypertension in Children With Type 1 Diabetes. Can J Diabetes. 2018;42(2):199-204. doi:10.1016/j.jcjd.2018.02.008
2 Cioana M, et al. Prevalence of Hypertension and Albuminuria in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(4):e216069. doi:10.1001/jamanetworkopen.2021.6069
3 Managing Blood Pressure. Heart & Stroke. 2023. Accessed October 23, 2024. https://www.heartandstroke.ca/-/media/pdf-files/canada/health-information-catalogue/en-managing-your-blood-pressure.pdf?rev=ad8b90f1eecc4f389360a6d51ba83bf9
4 High blood pressure. Heart & Stroke. Accessed October 23, 2024. https://www.heartandstroke.ca/heart-disease/risk-and-prevention/condition-risk-factors/high-blood-pressure
5 Rabi DM, et al. Hypertension Canada's 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. Can J Cardiol. 2020;36(5):596-624. doi:10.1016/j.cjca.2020.02.086
6 Low Blood Pressure. Cleveland Clinic. Reviewed October 7, 2023. Accessed October 23, 2024. https://my.clevelandclinic.org/health/diseases/21156-low-blood-pressure-hypotension
7 Diabetes and High Blood Pressure. Johns Hopkins Medicine. Accessed October 23, 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-high-blood-pressure
8 Tobe SW, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Treatment of Hypertension. Can J Diabetes. 2018;42 Suppl 1:S186-S189. doi:10.1016/j.jcjd.2017.10.011
9 La Sala L, et al. The link between diabetes and atherosclerosis. Eur J Prev Cardiol. 2019;26(2_suppl):15-24. doi:10.1177/2047487319878373
10 Diabetes and Blood Pressure. Diabetes UK. Accessed October 23, 2024. https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/blood-pressure
11 Glackin S, et al. Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes. Pediatr Diabetes. 2020;21(2):358-365. doi:10.1111/pedi.12960
12 Low blood pressure. Mount Sinai. Reviewed February 2, 2023. Accessed October 23, 2024. https://www.mountsinai.org/health-library/diseases-conditions/low-blood-pressure
13 Autonomic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed February 2018. Accessed October 23, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/autonomic-neuropathy
14 Watts, M. Dehydration and Diabetes. Diabetes.co.uk. Updated October 29, 2023. Accessed October 23, 2024. https://www.diabetes.co.uk/dehydration-and-diabetes.html
15 The Link Between Dehydration and Blood Pressure. February 2, 2023. Accessed October 23, 2024. https://health.clevelandclinic.org/dehydration-and-blood-pressure
16 Wherrett DK, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 1 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S234-S246. doi:10.1016/j.jcjd.2017.10.036
17 Panagiotopoulos C, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 2 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S247-S254. doi:10.1016/j.jcjd.2017.10.037
18 Teen Toolkit. Breakthrough T1D. 2013. Accessed October 23, 2024. https://www.breakthrought1d.org/wp-content/uploads/2013/10/JDRFTEENTOOLKIT.pdf
19 Beck RW, et al. JAMA. 2017;317(4):371-378.
20 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.
21 Martens T, et al. JAMA. 2021;325(22):2262-2272.
22 Laffel LM, et al. JAMA. 2020;323(23):2388-2396.
23 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-7.
2 Cioana M, et al. Prevalence of Hypertension and Albuminuria in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021;4(4):e216069. doi:10.1001/jamanetworkopen.2021.6069
3 Managing Blood Pressure. Heart & Stroke. 2023. Accessed October 23, 2024. https://www.heartandstroke.ca/-/media/pdf-files/canada/health-information-catalogue/en-managing-your-blood-pressure.pdf?rev=ad8b90f1eecc4f389360a6d51ba83bf9
4 High blood pressure. Heart & Stroke. Accessed October 23, 2024. https://www.heartandstroke.ca/heart-disease/risk-and-prevention/condition-risk-factors/high-blood-pressure
5 Rabi DM, et al. Hypertension Canada's 2020 Comprehensive Guidelines for the Prevention, Diagnosis, Risk Assessment, and Treatment of Hypertension in Adults and Children. Can J Cardiol. 2020;36(5):596-624. doi:10.1016/j.cjca.2020.02.086
6 Low Blood Pressure. Cleveland Clinic. Reviewed October 7, 2023. Accessed October 23, 2024. https://my.clevelandclinic.org/health/diseases/21156-low-blood-pressure-hypotension
7 Diabetes and High Blood Pressure. Johns Hopkins Medicine. Accessed October 23, 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/diabetes/diabetes-and-high-blood-pressure
8 Tobe SW, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Treatment of Hypertension. Can J Diabetes. 2018;42 Suppl 1:S186-S189. doi:10.1016/j.jcjd.2017.10.011
9 La Sala L, et al. The link between diabetes and atherosclerosis. Eur J Prev Cardiol. 2019;26(2_suppl):15-24. doi:10.1177/2047487319878373
10 Diabetes and Blood Pressure. Diabetes UK. Accessed October 23, 2024. https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/blood-pressure
11 Glackin S, et al. Ambulatory blood pressure and carotid intima media thickness in children with type 1 diabetes. Pediatr Diabetes. 2020;21(2):358-365. doi:10.1111/pedi.12960
12 Low blood pressure. Mount Sinai. Reviewed February 2, 2023. Accessed October 23, 2024. https://www.mountsinai.org/health-library/diseases-conditions/low-blood-pressure
13 Autonomic Neuropathy. National Institute of Diabetes and Digestive and Kidney Diseases. Reviewed February 2018. Accessed October 23, 2024. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/autonomic-neuropathy
14 Watts, M. Dehydration and Diabetes. Diabetes.co.uk. Updated October 29, 2023. Accessed October 23, 2024. https://www.diabetes.co.uk/dehydration-and-diabetes.html
15 The Link Between Dehydration and Blood Pressure. February 2, 2023. Accessed October 23, 2024. https://health.clevelandclinic.org/dehydration-and-blood-pressure
16 Wherrett DK, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 1 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S234-S246. doi:10.1016/j.jcjd.2017.10.036
17 Panagiotopoulos C, et al. Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada: Type 2 Diabetes in Children and Adolescents. Can J Diabetes. 2018;42 Suppl 1:S247-S254. doi:10.1016/j.jcjd.2017.10.037
18 Teen Toolkit. Breakthrough T1D. 2013. Accessed October 23, 2024. https://www.breakthrought1d.org/wp-content/uploads/2013/10/JDRFTEENTOOLKIT.pdf
19 Beck RW, et al. JAMA. 2017;317(4):371-378.
20 Beck RW, et al. Ann Intern Med. 2017;167(6):365-374.
21 Martens T, et al. JAMA. 2021;325(22):2262-2272.
22 Laffel LM, et al. JAMA. 2020;323(23):2388-2396.
23 Welsh JB, et al. J Diabetes Sci Technol. 2024;18(1):143-7.