Diabetes has now become one of the common chronic diseases among the elderly. In addition to diabetes, other common chronic diseases among the elderly mainly include cardiovascular and respiratory diseases such as hypertension, coronary heart disease and senile dementia. These chronic diseases are increasingly threatening people’s health. When elderly patients with diabetes are combined with these chronic diseases, they often need to take drugs for these chronic diseases in addition to glucose-lowering drugs. These drugs, if taken improperly, can sometimes raise blood glucose and reduce the efficacy of glucose-lowering drugs, and sometimes make blood glucose drop too low and even cause hypoglycemic coma. Today, we will introduce the effects of diabetes mellitus combined with other chronic diseases on blood glucose. 1, diabetes combined with hypertensive disease antihypertensive drugs are mainly five categories: angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor antagonists (ARB), beta-blockers, calcium channel blockers (CCB) and thiazide diuretics. Beta-blockers can both inhibit insulin secretion and block glycogenolysis, affecting blood glucose regulation and raising blood glucose. Therefore, propranolol is a cautionary drug. Betaxolol, on the other hand, has strong selective effect on the heart, and can be used for patients with coronary heart disease and hypertension who have combined diabetes. However, for elderly diabetic patients with recurrent hypoglycemia, beta-blockers should be used with caution because they may mask the symptoms of hypoglycemia and increase the duration of hypoglycemia, thus increasing the series of problems caused by hypoglycemia. Diuretics are usually thought to be unsuitable for diabetic patients, such as dihydroketuria, which has been found to have adverse effects on glucose metabolism in recent years, and long-term use can lead to mild elevation of fasting glucose and glycated hemoglobin and insulin, and reduced sensitivity to insulin, and is not advocated. Another commonly used diuretic, indapamide, has the least effect on plasma lipid and glucose metabolism of all diuretics and can be used by diabetic patients, but still requires monitoring of blood glucose during administration. Calcium antagonist therapy has a small effect on glucose metabolism and can generally be used in older diabetic patients. Angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists do not affect glucose metabolism, and by blocking the renin-angiotensin-aldosterone system, they can produce a variety of cardiac and renal beneficial effects, and also enhance insulin sensitivity and improve insulin resistance, so they are especially suitable for elderly patients with diabetes combined with hypertension, especially for hypertensive patients with diabetic nephropathy. 2, diabetes combined with coronary heart disease, hyperlipidemia Elderly patients with diabetes with coronary heart disease or hyperlipidemia often need to take lipid-lowering drugs, including statins such as atorvastatin is generally considered to have a small impact on blood sugar, but recent studies have concluded that statins may increase the risk of diabetes, should be noted, in addition, the long-term application of statins need to pay attention to the serious adverse effects of these drugs to myopathy. The beta-lipid-lowering drugs can be used in patients with diabetes mellitus with high triglycerides and have no effect on insulin secretion and blood glucose control, but they should be used with caution in patients with renal insufficiency. Another class of lipid-lowering drugs, niacin or its derivatives, may have an effect on blood glucose and are generally not recommended for use in elderly diabetic patients. Cholesterol absorption inhibitors have little effect on blood glucose and can be used in patients with diabetes mellitus with hypercholesterolemia. Aspirin, one of the commonly used drugs in patients with coronary heart disease, can slow down the metabolism and excretion of oral hypoglycemic drugs, and at the same time increase the efficacy of sulfonylurea hypoglycemic drugs, so attention should be paid to the risk of hypoglycemia when used together with sulfonylurea hypoglycemic drugs in elderly diabetic patients. In addition, anticoagulants such as bicoumarin and warfarin are also prone to induce hypoglycemia, and the possibility of hypoglycemia should be closely monitored when used in elderly diabetic patients. Diabetes combined with chronic bronchitis Chronic bronchitis often occurs in the elderly, commonly known as “old slow bronchitis”, infection is the main factor of chronic bronchitis, while repeated infections or long time without effective control will lead to fluctuations in blood sugar in diabetes difficult to control. Therefore, patients with diabetes combined with chronic bronchitis should use antibiotics reasonably at the early stage of viral or bacterial infection to control the infection as soon as possible in order to reduce the impact of infection on blood glucose. When elderly diabetic patients with chronic bronchitis, they often need to use glucocorticoids because of shortness of breath. Hormones will increase the decomposition of liver glycogen, which can make patients’ blood sugar rise and weaken the effect of hypoglycemic drugs, and at the same time reduce the decomposition and utilization of glucose by organs, tissues and cells, so it will make blood sugar rise, so when these patients use hormones, in order to better control blood sugar, sometimes they need to use insulin temporarily, and after stopping hormones Therefore, these patients sometimes need to use insulin temporarily for better blood glucose control when using hormones, and after stopping hormones, they can return to the previous glucose-lowering program. In addition, old patients with chronic cough often have cough, and need to pay attention to the drugs used to stop cough, many cough drops have sugar in them, which may affect blood sugar after taking them, so you should choose sugar-free cough drops as much as possible.