The short answer

Both conditions are managed to a target chosen for the person in front of the provider, not to a single national number. In older adults the balance shifts: the benefit of a tighter number is weighed against dizziness, falls, low blood sugar, kidney function and the burden of extra medication. The work is mostly review — readings, side effects, laboratory monitoring, and adjusting one thing at a time.

Why targets are individualised

  • Blood pressure that is fine sitting may drop sharply on standing, which is how people fall.
  • Tight blood-sugar control raises the risk of low blood sugar, which is more dangerous in later life.
  • Kidney function changes what doses are safe and what medicines are appropriate.
  • Several medications together can do more harm than the last increment of control prevents.
  • What you want from treatment matters, and it is a legitimate part of the decision.

Home readings: the part you control

  1. Use a cuff that fits, on the upper arm

    Wrist devices are less reliable. Bring the cuff to a visit once so it can be checked against a clinic reading.

  2. Measure at consistent times

    Sitting, feet flat, arm supported, after five quiet minutes. Two readings a minute apart, then write both down.

  3. Add a standing reading if you get dizzy

    Sitting, then standing after one minute. A clear drop explains a lot of unsteadiness.

  4. Record blood sugar with context

    Time, value, and whether it was before or after food — a number without context cannot be acted on.

  5. Bring dated readings to every visit

    A page of dated readings changes decisions in a way that a single clinic number cannot.

What monitoring usually involves

TestWhy it is used
Hemoglobin A1cAverage blood sugar over recent months
Basic or comprehensive metabolic panelKidney function, electrolytes, glucose
Lipid panelCholesterol, as part of cardiovascular risk
Urine testing for kidney proteinEarly kidney involvement in diabetes or hypertension

Frequency is individual. What each test means is explained in common primary care blood tests and understanding A1c and cholesterol results. Presence orders testing locally and quotes the price first.

Virtual, in person, or emergency

  • Virtual: reviewing readings, adjusting medication, discussing side effects, reviewing results, follow-up after a change.
  • In person: new dizziness or falls, new swelling, new breathlessness, a foot wound, or anything needing examination.
  • Emergency: anything on the red-flag list above, without waiting for a call back.

General education. Do not change a dose, skip a medicine or set your own target from this page — those are decisions for a visit.