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Tag: Diabetes

“Ouch! My toe!” What you need to know about Gout

October 14th, 2017 by The Hello Doctor Team

Gout is a kind of arthritis in which crystals of sodium urate produced by your body forms inside joints. You may suffer attacks of sudden burning pain, swelling and stiffness in a joint, and these attacks can happen over and over unless gout is treated. Left unattended over time, gout attacks can harm your joints, tendons, and other tissues. Gout is most common in men, and the joint usually affected is usually a big toe.

Causes

Gout is caused by too much uric acid in the blood. Having too much uric acid is not generally harmful, but when uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints.

  • Medications which affect kidney function
  • Low-dose aspirin can raise your blood uric acid levels
  • Obesity, hypertension (high blood pressure), diabetes and hyperlipidaemia (high blood fats)
  • Alcohol consumption
  • Joint injury, surgical stress, acute medical illness
  • Fad diets, fasting, and dehydration
  • Body temperature (gout tends to form in colder body parts)

Foods that are high in a substance called purines can raise the uric acid level in your blood – this includes seafood like sardines, mussels, anchovies, and salmon; organ meats like liver; and even some vegetables such as spinach. Eating just one of these foods or several of them together, can cause a gout flare.

Alcohol such as spirits and beer carry a double risk: they can raise the uric acid level in the blood and can make you dehydrated – both common gout triggers.

Symptoms

A common sign of gout is an attack of swelling, redness, tenderness, and sharp pain in your big toe at night, but you can also suffer a gout attack in your foot, ankle, or knee. The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years.

If you are experiencing gout symptoms, see your doctor – even if you aren’t in pain right now. It’s important to discuss treatment and lifestyle changes as uric acid build-up can still harm your joints.

Tests & Examinations

For people with an acutely swollen, red, painful big toe, where it is often hard to obtain joint fluid, a diagnosis can be made by the presence of a high blood uric acid level, but the only certain way to diagnose gout is to have a joint fluid analysis (arthrocentesis) test to see whether uric acid crystals are present.

The following examinations and tests help to diagnose gout:

  • Medical history and physical examination
  • Test to measure levels of uric acid in urine
  • Test to measure levels of uric acid in blood

While X-rays of hands and feet can be useful in the late stages of the disease, X-rays are not usually helpful in the early diagnosis of gout. When gout is in a late stage nodules, or even worn away or eroded areas of bone near joints may be seen. The pain of gout often causes people to seek medical attention before any long-term changes can be seen on an X-ray. But X-rays may help to rule out other causes of arthritis.

Treatment 

Initial treatment goals for gout are rapid pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage. Treatment includes medication and lifestyle changes to prevent future attacks.

To reduce the swelling, redness and pain of affected joints in a gout attack:

  • Rest the affected joint.
  • Take medication prescribed by your doctor.

Preventing recurrent attacks

Take a medicine that reduces uric acid levels in the blood, which reduces the risk of future attacks.

Take steps to reduce the risk of future attacks, such as controlling your weight, limiting your alcohol intake, as well as meat and seafood, and following a moderate exercise programme.

Sources: NHS, WebMD, Health.com

Can you reverse diabetes?

July 17th, 2017 by The Hello Doctor Team

You can manage it. You can control it. But can you reverse diabetes? It may sound too good to be true, but with drastic diet changes some of us can turn back the clock on this lifestyle disease.

There are two types of diabetes. In Type 1, your immune system attacks the cells in your pancreas that produce insulin; hence – no insulin.

Type 2 is known as the “lifestyle” type, because it’s largely brought on by unhealthy living, and genetics. With Type 2, your body produces insulin but doesn’t use it effectively. This means that glucose isn’t properly absorbed into the cells and accumulates in the blood, causing raised blood glucose levels.

Reversing the tide

Dr Wayne May, an endocrinologist from Cape Town, explains that Type 2 diabetes is reversible in patients who have significantly altered their diets and lost weight. Before we get too excited though, Johannesburg-based dietician, Michelle Daniels, cautions that a drastic change in diet ALONE will not contribute to the remission of diabetes.

Remission means having blood glucose levels in the normal range on little or no medication.

“Healthy eating in itself can improve your nutritional status, while carbohydrate awareness and management can help improve blood glucose levels. But more specifically, a low-calorie diet may influence diabetes going into remission,” Daniels says.

The research is getting there. In a clinical trial by researchers from the Newcastle University, all the participants reversed their diabetes by cutting their calorie intake to an extremely low 600 calories a day for two months. The diet consisted of liquid diet drinks and non-starchy vegetables.

After a week, the patients’ blood glucose levels returned to normal. The amount of fat in their liver and pancreas was also reduced, which helped restore their ability to make insulin and maintain diabetes remission.

A few months later, a few had regained some weight, but still had normal blood glucose control. Nonetheless, most of them remained diabetes-free.

Wake up your insulin cells

It isn’t clear why the diet reversed diabetes, but according to Professor Roy Taylor, the lead researcher of the study, it may be linked to how the body stores fat. Excess fat in the liver can spill into the pancreas, and obstruct insulin secretion and the liver’s response to insulin. This can lead to insulin resistance and diabetes.

Following a very low-calorie diet allows your body to use up fat from your liver, causing fat levels in your pancreas to drop. This “wakes up” the insulin-producing cells in your pancreas, and normalises your blood glucose levels.

“To have people free of diabetes after years with the condition is remarkable,” says Taylor. “This is a radical change in understanding Type 2 diabetes. It will change how we can explain it to people newly diagnosed with the condition.”

Researchers are optimistic about the results, daring to hope that, “We can get across the message that ‘yes, this is a reversible disease — that you will have no more diabetes medications, no more sitting in doctors’ rooms, no more excess health charges’ — that is enormously motivating.”

But as remarkable as these results may be, this diet is no quick fix and doesn’t mean a cure for diabetes. A very low calorie diet is extreme and should be undertaken with care and only if your doctor approves.

You’ll also need to maintain the change in the long term to keep your blood glucose levels in check and diabetes in remission. “Otherwise, all you will have done is temporarily push down your glucose levels into normal range,” states Dr May.

The study does reveal the importance of diet and weight loss in the management of diabetes, though. Obesity is now, more than ever, linked to Type 2 diabetes. “Working with a dietician can help individualise an achievable approach, and equip you with the tools necessary for making changes,” says Daniels. “Reading and having an understanding of nutritional information on food labels can also help you make sensible food choices.”

References:

5 Deadly conditions without symptoms

July 5th, 2017 by The Hello Doctor Team

No symptoms, no problem? Think again. Some of the most dangerous diseases are symptomless. Beware of these stealthy conditions.

Hypertension

It’s often called the “silent disease” as it has no indicators. “Many people may have hypertension for years without knowing it, which is why it’s so dangerous,” says Dr Stan Moloabi, Executive Healthcare Manager at the Government Employees Medical Scheme.

If your blood pressure is extremely high, you may get severe headaches, chest pain, and dizzy spells. Other symptoms include fatigue, vision problems, difficulty breathing, irregular heartbeat, and frequent nosebleeds.

The only way to know you have hypertension is with a blood pressure test. Even if you don’t have any symptoms or risk factors, you should get tested every one to two years, advises Dr Moloabi. If you have diabetes, heart disease, or kidney problems, you must have your blood pressure checked at least once a year.

Diabetes

According to Diabetes South Africa (DSA), about 90% of all people with diabetes are Type 2. And many of these cases go undiagnosed as there are very few warning signs. Symptoms may include dry mouth, excessive thirst and urination, fatigue, blurred vision, and slow wound healing. As the symptoms can be subtle and develop gradually, many people ignore them.

“It takes on average seven years for a person to get diagnosed with diabetes for the first time,” says Dr Larry Distiller, founder and managing director of the Centre for Diabetes and Endocrinology in Johannesburg. “Sadly, about 30% of people have already developed complications by the time they’re diagnosed.”

This highlights the importance of early diagnosis. Get screened for diabetes every year if you’re aged 35 and over, overweight, have high cholesterol, high blood pressure, or a family history of the condition. “A simple finger-prick test at your local pharmacy or clinic can diagnose the strong likelihood that you may have diabetes within a minute,” says DSA.

Cervical cancer

There are no symptoms linked to this type of cancer in its early stage, but once in its advanced stage, you may experience pain in your pelvis, an unpleasant vaginal discharge, and abnormal vaginal bleeding. As the cancer progresses and becomes invasive, you may also experience leg and back pain, blood in your urine, and bleeding from your rectum.

Fortunately, cervical cancer can be prevented with regular Pap smears – a screening designed to pick up cervical changes before they become cancerous. The earlier pre-cancer is found, the higher your chances for successful treatment and survival.

Women aged 21 to 65 should have a Pap smear every three years, advises Cape Town-based fertility specialist, Dr Sascha Edelstein.

Lung cancer

According to the National Cancer Institute (NCI), one in four people diagnosed with lung cancer show no symptoms of the disease. Symptoms usually only manifest when the cancer has advanced.

Signs to look out for include a chronic dry cough, shortness of breath, wheezing, and hoarseness. The trouble is that many of these symptoms are misidentified for other conditions like bronchitis. Lung cancer is often identified incidentally when a chest X-ray is performed for another reason.

There’s no way to prevent lung cancer, but you can reduce your risk by not smoking. If you’re a smoker or former smoker, go for an annual CT lung scan, recommends NCI. This test has been shown to reduce lung cancer deaths by 20%.

Glaucoma

This eye disease causes damage to the optic nerve from an abnormal increase of pressure in the eye. It’s the third leading cause of blindness worldwide, and is often called “the blinding disease” or “thief of sight” as it develops without any obvious symptoms. In fact, 50% of people in the developed world and 90% in developing countries don’t know they have it, according to the South African Glaucoma Society (SAGS).

Glaucoma progresses slowly and silently over the years, so by the time you recognise any symptoms, the damage to the optic nerve may already be very advanced. Symptoms to keep an eye out for, include severe eye pain (usually with nausea and vomitting), headaches, eye redness, blurred or cloudy vision, and seeing halo-like glows around bright lights.

The best way to protect your sight from glaucoma is to go for regular eye tests. This is especially important if someone in your family has glaucoma. “If you’re over 40, you should have your eyes tested every two years, and every year once over the age of 60,” recommends SAGS. It’s also a good idea to get checked out for glaucoma if you’re diabetic. The risk for glaucoma is twice as high in diabetics as in non-diabetics.

References:

 

5 reasons you’re weeing all the time

April 6th, 2017 by The Hello Doctor Team

When nature calls, we really have no choice but to answer. However, running to the bathroom one too many times a day can say much more about the state of your health than what you might think.

The average bladder can hold about one and a half to two cups of urine during the day and the average adult should urinate about six times a day. If you find yourself running to the loo more than six times each day, you might be at risk of illness.

It is important for the bladder to be emptied regularly and completely because stasis of urine can lead to bacteria multiplying in the bladder.

Although it might be easy to merely go with the flow and run to the bathroom, it can only be beneficial to your health to start taking note of why you might be weeing all the time. Here are five things that might help you to get behind the crux of your bladder problem.

Incontinence

Incontinence is the involuntary loss of urine. Urinary incontinence is more common among women because of the anatomy of their urinary tract. Men have well developed bladder necks, prostates and longer urethras which increase their resistance to urine flow and therefore incontinence is less common among men.

If a person’s incontinence is accompanied by blood in the urine, pain, difficulty to pass urine or an acute onset of urine, they should seek medical help as soon as possible.

Pregnancy

Constantly running to the bathroom is a pesky part of pregnancy. There are various reasons why you’ll need to urinate more when you have a baby on board. Firstly, your kidneys have to work harder to eliminate toxins from both you and the fetus. Secondly, as the baby, and you, get bigger, your uterus can place additional pressure on the bladder. This is predominantly why moms-to-be need to dash to the ladies room so often.

Urinary Tract Infection (UTI)

If you feel a burning sensation while urinating, there might be a chance that you have urinary tract infection (UTI). Between 25 and 30% of women will experience a urinary tract infection before the age of 40. A UTI is an infection involving part or all of the urinary tract and is caused by bacteria such as Escherichia (E.coli). UTIs can be very painful, and cause you to have a pressing desire to urinate – with difficulty holding it in! It’s important to get medical help when you experience symptoms of UTI as it can lead to serious health complications (like permanent kidney damage).

Caffeine

Certain external factors like caffeine, alcohol or carbonated drinks can cause a sensitive bladder which can ultimately lead to incontinence, especially in men. While this isn’t terribly common in women under 40, coffee can irritate bladder walls and spur your urge to go to the loo. If already have problems with urinary incontinence it’s a good idea to stick to less two cups of coffee a day.

Diabetes

In the worst case scenario, a frequent need to urinate may be an early sign of diabetes. When you have diabetes, high blood sugar leads to increased production of urine. Your kidneys are forced to work overtime to filter and absorb the excess sugar and you’ll feel the need to urinate more often. If you have a family history of diabetes, it may be valuable to take note of your peeing patterns to ensure early diagnosis before it’s too late.

References:

Diabetes: keep your eyes out for these red flags

September 22nd, 2016 by The Hello Doctor Team

As a diabetic, you probably know all about the potential complications of your condition: diabetic coma, blindness, ulcers, lost limbs to name but a few. Steering clear of these means you need only look after one thing: the perfect balance of blood sugar. But this can be a difficult task. How do you know you’re spiking or dipping, when your blood sugar monitor is not at hand?

Continue reading “Diabetes: keep your eyes out for these red flags”

Diabetes and your feet

August 11th, 2015 by The Hello Doctor Team

Diabetes is a chronic (lifelong) disease in which there are high levels of sugar in your blood.  Poor diet, too little exercise and obesity means that diabetes is on the rise, worldwide. Diabetes can be managed with healthy eating and medication, but it does put you at risk for several issues – one of these is problems with your feet. Continue reading “Diabetes and your feet”

The other side of diabetes: Facts you might not know

November 14th, 2014 by The Hello Doctor Team

Diabetes is one of the fastest growing diseases in the world and without a radical change in our lifestyle, it’s only going to get worse. Today is World Diabetes Day and the aim is educate people about the ins and outs of diabetes. But instead of looking the causes and symptoms, which you can find here, let’s look as some lesser known facts you might not know about. Continue reading “The other side of diabetes: Facts you might not know”

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