A new long-term study has revealed a troubling health trend in the United States: the number of Americans living with both type 2 diabetes and high blood pressure has doubled over the last two decades, with 1 in 8 adults now affected. Even more concerning is the steep rise in mortality risk associated with this dual diagnosis—suggesting that the combo of these two chronic diseases may be deadlier than previously understood.Published in the peer-reviewed journal Diabetes Care, the study spans nearly 20 years and highlights how a rapidly increasing population is living with multiple metabolic risk factors—a condition that significantly raises the odds of heart disease, stroke, kidney failure, and early death.Researchers at Columbia University's Mailman School of Public Health mined health information from close to 49,000 American adults who took part in the National Health and Nutrition Examination Survey from 1999 through 2018. The National Center for Health Statistics conducted the survey, which captures interviews, laboratory tests, and physical exams to measure the health of the country.According to the study, only 6% of Americans in 1999 suffered from both type 2 diabetes and high blood pressure. By 2018, it had risen to 12%, or about 1 in 8 adults. Those with both conditions were more than twice as likely to die from any cause and three times more likely to die from heart disease than those with neither condition."Even having co-existing prediabetes and high blood pressure was linked to up to 19% greater risk of death," said lead researcher Dr. Nour Makarem, assistant professor of epidemiology at Columbia University.This is important because it indicates that heightened risk begins even before someone officially qualifies by clinical criteria as having diabetes or hypertension.Why This Compounds To Health Risks?Having either condition on its own—type 2 diabetes or high blood pressure—already raises one's risk for severe complications but when they occur together, their interaction in the cardiovascular system is much more destructive.Approximately two out of three patients with type 2 diabetes have high blood pressure or are prescribed medication for it. Among individuals with both disease states, about 33% died over a median 9-year follow-up period.For individuals with only one condition, the mortality rate remained at 20–22%, whereas individuals with neither condition suffered from a mere 6% fatality during the same period of time.The research identified that in comparison with individuals with:Hypertension alone, developing both conditions increased the risk for all-cause mortality by 66% as well as cardiovascular death by 54%.Type 2 diabetes alone, but with both conditions, overall risk of death was 25% higher and greater than two-fold increased cardiovascular mortality.Why This Disease Pair Is So Deadly?Both type 2 diabetes and high blood pressure are "silent killers." Alone, they tend to produce no discernible symptoms until complications—such as stroke, heart failure, or kidney damage—arise. Combined, however, they provide a deadly combination of cardiovascular stress.Diabetes disables the body's ability to keep blood sugar in balance. High glucose levels destroy blood vessels and organs by repeated damage.Hypertension makes the heart work harder to circulate blood, which hardens and weakens the arteries.When both conditions occur together, this speeds up the deterioration of the arteries, kidneys, and heart, making heart attack, stroke, and end-stage renal disease requiring dialysis or transplantation more likely.Early Warning Signs That Are Often MissedAnother significant takeaway of the research is that the danger of death starts even prior to a full-blown diagnosis. Prediabetic and high-blood-pressure persons—even if they are below diagnostic levels—had a 19% greater risk of mortality.Although type 2 diabetes can quietly develop without apparent symptoms, there are some early warning signs that should never be overlooked—particularly if you're at risk. The sooner you detect diabetes, the less complicated it is to control and prevent long-term complications. Even slight symptoms deserve a chat with your doctor.- One of the first and most indicative symptoms of high blood sugar is urinating more often, particularly at night. As blood glucose increases, the kidneys work around the clock to flush out the excess glucose. When they're unable to keep pace, glucose leaks into the urine, causing more frequent trips to the bathroom.- Too much sugar in the urine not only impacts hydration—but also is a breeding ground for bacteria and yeast. This increases the likelihood of infections in the urinary tract and yeast infections, particularly in women. If you find that you have persistent infections that are difficult to clear, you might want to be tested.- Another visible clue is the appearance of dark, velvety patches of skin, typically found in body folds like the neck, armpits, or groin. These areas may indicate insulin resistance—a common precursor to diabetes.- If you’re eating regularly but still feel hungry all the time, your cells may not be properly absorbing glucose. As a result, your body stays in a constant state of seeking energy, driving persistent hunger.- Ironically, even though you are hungrier, you may actually lose weight unexpectedly. Since there's not enough glucose flowing into cells, your body starts to break down muscle and fat for energy.- This energy shortage also leads to constant fatigue and weakness. You could be tired, even with a good night's rest. Dehydration caused by frequent urination only adds to that pervasive fatigue.- Another troubling symptom is blurred vision, which can appear and disappear. High blood glucose can harm the tiny blood vessels in the eyes, leading to more severe conditions—blindness, if not treated.- Most people experience a tingling or numb feeling in their hands or feet. This is caused by nerve damage from years of high blood sugar levels. Refereed to as diabetic neuropathy, this can also result in long-term chronic pain or loss of sensation.This result highlights the importance of early screening and proactive prevention measures, particularly for individuals in their 30s and 40s who are unaware they're at risk. The research also reignites debate around various forms of diabetes, many of which have different risks:Type 1 Diabetes: Autoimmune condition in which the pancreas releases no insulin.Type 2 Diabetes: A metabolic disorder in which the body fails to utilize insulin. Frequently associated with obesity, a diet lacking in nutritious foods, and physical inactivity.Prediabetes: A silent diabetes precursor with no warning signs.Gestational Diabetes: Appears during pregnancy and increases risk of type 2 diabetes in the future.Of these, type 2 diabetes is the most common and can be directly associated with lifestyle modifications that are often possible.This highlights the pressing need for public health approaches to prevent and manage these diseases and to halt these negative trends," Dr. Makarem stressed.At present, approximately two-thirds of adults with diabetes have blood pressure above 130/80 mm Hg or are taking antihypertensive therapy.Since most symptoms are mild or undetectable, screening is necessary on a regular basis. The American Diabetes Association suggests that all adults over the age of 45 should be screened for diabetes. If you are younger but have risk factors that include obesity, being inactive, having a poor diet, or a family history of diabetes, you need to be tested too.Screening is typically a straightforward blood test. If normal, the ADA recommends repeat testing at three-year intervals to track changes.As an ageing population, inactive lifestyles and obesity on the rise, the co-epidemic of diabetes and high blood pressure is set to expand unless there are systemic changes.