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Patients should use diuretics with caution if they have been diagnosed with any of the following conditions:
- Diabetes. Careful blood sugar monitoring is required when diabetics take diuretics because they increase the risk of hyperglycemia (high blood sugar). However, diabetics are commonly prescribed diuretics if the benefit (e.g., treatment of high blood pressure or heart failure) outweighs the risk. The ALLHAT study also confirmed the value of diuretics among patients with diabetes.
- Hyperlipidemia (for thiazide diuretics only). Excess fat (lipids) in the blood. At higher doses, thiazide diuretics are associated with elevations in cholesterol levels. Newer dosage regiments usually rely on lower doses of thiazide diuretics, which have reduced this problem.
- Severe liver or kidney disease or a history of kidney stones. The effect of the diuretic may be increased because of the slow removal of the drug from the body by these organs.
In addition, diuretics may make some disorders worse. Patients with the following conditions should discuss the risks with their physicians:
- Gout. A painful inflammation of the joint caused by an excessive amount of uric acid in the blood and deposits of urates in and around joints.
- Hearing problems.
- Pancreatitis. Inflammation of the pancreas.
- Menstrual problems or breast enlargement (potassium-sparing diuretics only).
Some studies have also suggested that diuretic therapy may actually increase cardiovascular risk because of the medication’s effect on potassium, magnesium, cholesterol and blood glucose levels. However, this risk may be lessened by using low-dose diuretics. | 
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