DR. ELLIE CANNON: I have type 2 diabetes which gives me cold feet… how do I keep them warm?

I’m 85 and have type 2 diabetes. I’ve suffered from cold feet for years, which get worse in winter. I have tried soaking my feet in hot water, massages and emulsifying creams but nothing seems to work. Can you help?

Cold feet are often associated with circulatory disorders. And poor circulation can be an integral part of living with type 2 diabetes. It is also a common complaint as we age.

With diabetes, high blood sugar levels can damage the smaller blood vessels in the feet and toes, restricting blood flow to the area and leaving the feet cold. The skin is also at risk as it cannot heal without good blood circulation.

Using a rich moisturizer is a good idea to prevent cracking of the skin. Annual foot checks – in diabetes clinics or family doctor’s surgeries – are essential. Talk to your family doctor if this is not the case.

The team can also use a test called ABPI to check the blood supply from the arteries in the feet. This indicates the extent of damage to the blood vessels.

Circulation is best when diabetes is well controlled. That means taking the optimal medication and getting frequent blood tests. Keep cholesterol levels low and blood pressure at normal levels to avoid further damaging the arteries.

Regular exercise is also important, as it improves circulation — studies suggest it can improve circulation and blood vessel health by 20 percent. Regular bursts of relatively intense aerobic exercise are more beneficial than occasional prolonged episodes.

In the meantime, it may be worth investing in a pair of diabetic socks, which are specifically designed to keep feet warm and dry while slightly improving circulation in that area.

I often suffer from unexplained hives – I suspect they are stress related. In the last few weeks I have noticed that my fingertips are red and swollen. They hurt when touched. Are the two problems related and what can be done? I am a 44 year old woman.

Hives, also called urticaria, appear as an itchy, patchy rash. Usually the problem is triggered by contact with things you may be allergic to, such as: B. food or pollen. It can also happen at certain temperatures. For example, some people get cold-related hives from the wind, while others have a heat-related problem that can occur after eating spicy food.

Hives often appear with other symptoms, such as swelling of the hands, feet, and face. When this happens, doctors call it angioedema. The hives and swelling can feel like a burning sensation.

Headaches, joint pain and swelling are not uncommon.

It’s not always clear what’s triggering the patient’s symptoms, but it’s a sign that the immune system is overworked — specifically, that the mast cells are overactive.

These cells release the chemical histamine that is responsible for the rash and swelling. Sometimes hives are linked to an autoimmune condition, where the body is reacting to its own cells.

These types of diseases such as Conditions such as rheumatoid arthritis can also cause joint swelling and swollen fingers, so it’s important to have this combination of symptoms checked out by a GP.

Hives should be treated with daily antihistamines. Sometimes a doctor may advise taking a more frequent dose. Other medications include steroids and a drug called montelukast, but this is a short-term fix. In some severe cases, specialized rheumatologists can prescribe strong immunosuppressive drugs.

Stress-related hives can be particularly annoying. A vicious circle is created: the physical problem leads to stress, which aggravates the hives. Any stress-relieving activity, such as exercise or relaxation methods, will help break the cycle.

I can’t sleep because I have constant breathing problems. Every night I have to get up for half an hour, drink a hot drink to help me breathe, and then go back to bed. My family doctor prescribed me various nasal drops, with no effect. A consultant has confirmed that my nasal passages are clear. Can you suggest something? i am 84

When someone has trouble breathing at night, doctors usually suggest they take a special sleep study. This includes monitoring breathing, oxygen levels and heartbeat throughout the night. A family doctor can refer patients for this test, which is usually done in a hospital sleep clinic.

Trouble breathing at night could be a problem called obstructive sleep apnea. Usually with this condition, parts of the airways, like the windpipe, narrow when you sleep, but it can also happen when the nasal passages or sinuses are blocked.

This is not always apparent when examining a patient. Lying horizontally at night can cause the nasal passages to become swollen with fluid or become inflamed. You won’t necessarily have the same problem during the day if you stand up straight.

An easy way to tell if this is the case is to try sleeping with a pillow propped up on you. It may also be worth trying a nasal dilator — these are soft plastic devices that sit in your nose at night and increase airflow.

If the sleep study shows sleep apnea, it means you actually stopped breathing overnight. Patients are offered a treatment known as CPAP — a pressurized face mask that keeps the airways open at night and prevents them from collapsing.

Although the device looks quite scary and can take some time to get used to, many patients find it life-changing.

Denied a loved one’s records? let me know

Have you had trouble accessing medical records?

I recently learned of a case where the son of a woman who died in a nursing home was told he could not see his mother’s notes for privacy reasons. That seems crazy.

Data protection law set by the General Data Protection Regulation (GDPR) prohibits companies and public bodies from sharing personal information about us that they may hold. But it only applies to the living.

The son tried to find out what happened to his mother as the circumstances – during the pandemic when visiting was impossible – are not clear.

It is important for people to be able to access such information in order to understand what happened to loved ones. It is also a legal right.

The nursing home appears to have misconstrued the law to block the son’s request, adding frustration and confusion to the distress.

I would like to know if anyone else has been told not to see the medical records of a loved one who has died. Write to me at DrEllie@mailonsunday.co.uk – I’d be happy to investigate.

People over 74 can still have a gut test

Many readers reached out last week to my comments on colon cancer screening — and why testing stops when you’re 74.

It seems like an arbitrary limit, but in fact it’s based on evidence showing that older adults are more likely to get false positives from testing.

This means patients are likely to be told they have a problem when they don’t, leading to needless worry and pointless, invasive testing.

However, anyone over the age of 74 can request a free screening kit by calling 0800 707 60 60.

It’s crucial that you see your GP right away if you notice any symptoms – blood in the toilet, gas, or a change in bowel habits.