In diabetes there is low renin levels associated with lower serum aldosterone. Total body sodium is elevated with normal or low activity of renin-angiotensin-aldosterone system, in some of these cases. The hypertensives may have higher than normal levels of serum insulin, which may lead to increased renal sodium and water reabsorption. Insulin resistant states have decreased vasodilatory response to insulin in skeletal muscle and also reduced synthesis of vasodilatory prostaglandin. Insulin resistance state associated with type2 diabetes also causes increased secretion of endothelins, which are vasopressors. Isolated systolic hypertension is said to be present when systolic pressure is more than 140 mmHg with normal diastolic pressure. The basic cause for this is loss of arterial elasticity associated with atherosclerotic process and diabetes is well known to produce premature and extensive atherosclerosis.