Diabetes and Hypertension Management

The medication step-up protocol adds losartan and hydrochlorothiazide after amlodipine for hypertension. The medication step-up protocol adds gliclazide and insulin after metformin for diabetes. All patients aged 40 and above at intervention facilities are screened by medical assistants regardless of presenting complaint. Referral is appropriate for very high blood pressure, severe symptomatic blood pressure, uncontrolled hypertension on three agents, high random plasma glucose, or uncontrolled glucose on maximum oral therapy.