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.

Also Read: Cancer Survivors Share The Small Wins That Helped Them Heal

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.

Also Read: Colon Cancer Is Rising In Millennials- But This One Symptom Still Feels Too Embarrassing To Talk About

Why Type 2 Diabetes And High Blood Pressure Compound 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 Type 2 Diabetes and High Blood Pressure Pair 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 Missed

Another 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.

New Zealand has stepped up surveillance after the first detection of a dengue and Zika-carrying mosquito larvae in the country.

The larval species was confirmed as 'Aedes aegypti' — known to carry diseases including dengue fever, yellow fever, Zika, and chikungunya, across the globe.

As New Zealand does not normally have the mosquito species, the larvae detected were counted as "exotic".

The mosquito species did not cause any outbreak, but were spotted during a routine surveillance program in Auckland.

"The National Public Health Service has commenced a heightened surveillance and interception programme following mosquito larvae being collected from a routine surveillance trap at Queens Wharf, Auckland, on Monday 30 March," Health New Zealand said in a statement.

Health New Zealand reported that exotic species were occasionally found at ports and airports.

Not A Public Threat Yet

The health body noted that the larvae were not considered a public health or biosecurity threat yet because there was no indication they had become established.

But the agency aimed to continue "intensive monitoring for at least three weeks".

"The monitoring would take place within a 400m radius of the site where the larvae were identified. Health Protection Officers would place mosquito traps in the survey area," the statement said.

"These have been hidden away from plain sight so they are not disturbed, for example, in old tyres, bushes, or pools of water. We ask members of the public to avoid touching or disturbing these traps if they find them, as it may disrupt our monitoring and trapping efforts," medical officer of health Dr David Sinclair said.

Sinclair said New Zealanders were most at risk from diseases transmitted by mosquitoes when travelling overseas, including to Pacific Island countries and territories where dengue fever was known to be present.

Dengue Surging In 17 Countries

The US Centers for Disease Control and Prevention recently issued a travel alert of dengue outbreaks across 17 countries.

The CDC alert issued on March 23 identified 17 countries reporting an increased number of cases of dengue. These include: Afghanistan, Bangladesh, Bolivia, Colombia, Cook Islands, Cuba, Guyana, Maldives, Mali, Mauritania, New Caledonia, Pakistan, Samoa, Sudan, Timor-Leste, Vietnam, and the United States territories of American Samoa, Puerto Rico, and the US Virgin Islands, where local transmission is already common.

Also read: Long-term Exposure To Air Pollution Increases Fatality Rates In Dengue: Study

What Is Dengue?

Dengue is a disease caused by a virus spread through mosquito bites. It is transmitted through infected mosquitoes, primarily the species Aedes aegypti.

The breakbone fever is caused by an infection with any of four different dengue viruses. These include:

• Dengue virus type 1 (DENV-1 or DEN-1)

• Dengue virus type 2 (DENV-2 or DEN-2)

• Dengue virus type 3 (DENV-3 or DEN-3)

• Dengue virus type 4 (DENV-4 or DEN-4)

Also read: New dengue vaccine over 80% effective, prevents severe disease for up to 5 years

Common Symptoms of dengue include:

• Sudden onset of high-grade fever.

• Intense headache

• Severe muscle, joint, or bone pain.

• Skin Rash that often appears 2–5 days after the fever starts

• Nausea and Vomiting

• Minor bleeding

• Fatigue.

The COVID Cicada variant, currently circulating in 23 countries, is likely to affect children more than the previous variants.

Children have largely escaped severe illness from the SARS-COV-2 virus.

However, the new Cicada variant with around 75 genetic changes in its spike protein is likely to disproportionately affect children, as per an expert, who noted its presence in the UK.

“Some people have done analysis on this, suggesting it may be more prevalent among young children. Children get infections all the time, but this might be something to do with the fact that they have never been exposed to Covid vaccines," Prof Ravindra Gupta, of Cambridge University, who advised the UK government during the pandemic, was quoted as saying to The Mirror.

“So this is something we’re looking at in the lab to try and work out why. The problem with this is that it is an infection that spreads fast. Eventually, it ends up in someone vulnerable," he added.

Key Symptoms

Symptoms seem to be similar to those of other recent variants and include

• sore throat,
• cough,
• congestion,
• fatigue,
• headache
• fever.

Also read: Cicada Variant: Will The Current COVID Vaccine Provide Protection?

What Do The 75 Genetic Changes Mean?

Cicada, a descendant of the Omicron variant that emerged in 2021, was first detected in South Africa in 2024. However, it disappeared soon after, only to emerge early this year.

Prof Gupta told the publication that “the Cicada variant developed the 75 mutations to escape immunity, and it evolved by incubating a single patient for over a year”.

"This 'patient zero' would have been unable to clear the virus due to a compromised immune system," due to HIV or anti-cancer drugs.

Further, he explained that due to 75 mutations to the spike protein, the body’s antibodies will take a longer time to fight the Cicada variant.

However, there is no evidence yet that it is likely to cause more severe disease.

Will The Cicada Variant Cause Severe Illness?

The Cicada variant is particularly concerning as it provides no immune protection to people with previous infection or even vaccination.

Yet, the World Health Organization and health experts advise that existing COVID vaccinations can help prevent severe illness and hospitalization.

"It would appear that all the protections we have from our experience with the virus and with vaccines probably offer more limited—not zero—but more limited protection against this strain," Dr. William Schaffner, professor of infectious diseases at Vanderbilt University Medical Center, was quoted as saying by Time.

Also read: COVID Variant BA.3.2 Spreads To 23 Countries: Is The Variant Under Monitoring A Cause Of Worry?

How To Safeguard

Dr. Sai Balasubramanian, a doctor and healthcare strategy executive, writing in Forbes, stressed the need to follow COVID practices such as masks and hand hygiene.

"Healthcare professionals recommend taking general precautions, similar to those used to prevent most viral transmission: get vaccinations when appropriate, wear masks in crowded areas or indoors where there is a high risk of transmission," he said.

He also urged “avoid individuals who have known illness or infections, wash hands frequently, and continue to stay apprised of local community guidelines and the infection spread”.

GLP-1 drugs are powerful tools that can improve health, but it comes with risks and caveats. While these are medical therapies, they are being misused as cosmetic products by cosmetologists, physiotherapists, dermatologists, among others.

To curb its misuse and improve public health, the Indian government today issued guidelines on its use, while also flagging risks around it.

In an official statement issued today, the government has stated that it will roll out stricter inspections to curb the misuse of GLP-1 drugs in the country and will punish those who violate the rules.

“GLP-1 drugs are a significant medical breakthrough in treating type 2 diabetes and obesity, but they are not without risk. The drugs carry a wide range of side effects - from common symptoms like nausea and vomiting to severe complications including pancreatitis, kidney injury, and bowel obstruction. These risks make it essential that GLP-1 drugs are only taken under the supervision of registered medical practitioners/specialists,” the statement said.

In the wake of its hype over weight loss, the country's regulatory authorities have taken firm steps to prevent unsupervised use and malpractices in the supply chain.

It has “strongly advised” patients and the public to” consult a qualified medical specialist before use, and to obtain these medications with prescription only through legitimate, regulated channels”.

“Stricter inspections and surveillance will continue in the coming weeks. Businesses that break the rules will face license cancellation, fines, and legal action,” the statement said.

Also read: GLP-1 Drugs: Why India Needs Stricter Rules Now

What Are The Side-effects Of GLP-1 Drugs?

GLP-1 drugs work to keep food in the digestive system for longer – making people feel fuller for longer, thus reducing appetite and inducing weight loss. Hence, the drugs are also prescribed to people with obesity.

However, when done without clinical oversight, it can lead to severe health complications.

There are various side effects to taking GLP-1 drugs, including nausea and dizziness, to pancreatitis and medullary thyroid cancer.

Some serious side effects include

• Pancreatis
• Thyroid Cancer
• Acute (Sudden) Kidney Injury
• Worsening Diabetes-Related Retinopathy
• Gallstone & Bile Duct Blockage
• Rapid loss of fat in the face
• Wrinkles
• Sunken eyes

GLP-1 medications may also complicate various health conditions, such as allergic reactions, with shortness of breath and low blood sugar.

Rush For Generic Weight Loss Drugs

The government's advisory comes as patent for semaglutide -- an active ingredient in diabetes and anti-obesity drugs, specifically Wegovy and Ozempic -- expired on March 20.

This has led to a rush among Indian pharma companies to launch cheaper generic versions, significantly increasing affordability and access for millions battling Type 2 diabetes and obesity.

Also read: CDSCO threatens action against pharma companies for promoting GLP-1 weight-loss drugs

Major Indian drugmakers who launched their generic semglutide injection in the country in March include Sun Pharmaceutical Industries, Zydus Lifesciences, Alkem Laboratories, and Dr. Reddy’s Laboratories.

WHO Guidelines on GLP-1 drugs

Amid the increasing prevalence of GLP-1 drugs, the World Health Organisation (WHO), late last year, acknowledged its role in treating obesity.

However, it warned that medications like GLP-1 alone will not solve the problem affecting more than one billion people worldwide.

The global health body also issued conditional recommendations for using these therapies as part of a comprehensive approach that includes healthy diets, regular physical activity, and support from health professionals.