In the UK, the number of people with type 2 diabetes has nearly doubled in the last 15 years, and more than 2.4 million people are at high risk of developing type 2 diabetes.

November is National Diabetes Month which aims to raise awareness of the signs and symptoms of this serious health concern and ways to manage the condition.

Now, a new study has suggested that patients with type 2 diabetes who follow a low-carb diet may be able to stop taking medication. Researchers in the US found that a low-carbohydrate diet could improve beta-cell function. Beta-cells are endocrine cells in the pancreas that produce and release insulin. This is the hormone that controls our blood sugar levels.

Controlling your blood sugar response

People with type 2 diabetes have a compromised beta-cell response to blood sugar. It’s thought that eating too many ’empty carbs’ in the form of food full of sugar and white flour. These foods have a high glycaemic index, which means a blood sugar spike after eating.

The study, published in The Journal of Clinical Endocrinology and Metabolism, followed patients with type 2 diabetes, half on a low-carb diet and the other half on a high-carb diet, and examined their beta-cell function and insulin secretion at the outset and after 12 weeks.

Patients on the carb-restricted diet ate 9% carbohydrates and 65% fat, while those on the high-carb diet ate 55% carbohydrates and 20% fat. Those following the low-carb diet saw significant improvements in the acute and maximal beta-cell responses.

“This study shows people with type 2 diabetes on a low-carbohydrate diet can recover their beta-cells, an outcome that cannot be achieved with medication,” commented University of Alabama Professor Barbara Gower.

There are many diabetes treatments available to help manage the condition. Everyone is different so that treatment will vary depending on your needs. Medication may be necessary to keep your blood sugar levels healthy.

You’ll usually be offered metformin tablets first to keep your blood sugar healthy. If metformin is not suitable for you or is not keeping your blood sugar levels at the appropriate level, then you may need to take a different medicine, such as insulin.

Other ways to manage type 2 diabetes

Some patients can manage type 2 diabetes with lifestyle changes and weight management. There’s evidence to show that the Mediterranean-style diet can promote weight loss and improve blood glucose management in people with type 2 diabetes.

Weight loss injections are proving an effective treatment for type 2 diabetes. At GP London W1, we follow NICE recommendations, prescribing this medication for weight loss for patients with a BMI over 30 or those with a BMI over 27 if they have an associated weight-related health condition such as pre-diabetes or diabetes.

For more advice on managing type 2 diabetes, call +44 (0)20 4580 1152 or email [email protected] to arrange a consultation at GP London W1.

Hormone replacement therapy (HRT) and the menopause are rarely out of the news as celebrities and doctors alike have – rightly – raised the often devastating impact of menopausal symptoms on women and made wider accessibility to HRT a matter of national debate.

The question of HRT prescribing has recently come under the spotlight and reignited the controversy over what level of oestrogen it is safe to prescribe.

“We have seen some patients in the last couple of weeks concerned about their HRT dosage in light of recent press attention, and it is important to put their minds at rest,” explains GP London W1’s Dr Justine Setchell. “As a practice, we follow recommended guidelines, and I’m on the British Menopause Society’s specialist register. Very occasionally, some patients do require a slightly higher than normal dose, but this should always be prescribed with additional progesterone to protect the uterus as well as more frequent scanning.”

Women who are suffering from primary ovarian insufficiency (POI), also known as premature ovarian failure, which is when the ovaries stop working normally before the age of 40 or those who have experienced surgical menopause before the age of 51 need HRT to mitigate the long-term health risks.

“I have a patient who had gone into premature menopause in her early 30s, and she’s now 41 and needs higher doses of oestrogen. The recent press exposure had made her anxious so she wanted to know if she should drop her dosage, and I had to reassure her that she needs it to protect her bones, her brain and her heart until at least the age of 51, the average age of the menopause.”

Are you applying HRT properly?

If you’re still experiencing menopausal symptoms on HRT, it might not always be the dose that’s the problem. It might be the delivery system if you’re not absorbing enough HRT. So, if a patch isn’t working, you may do better with a gel or spray.

Application can also be an issue. It is essential to wait until oestrogen gel is dry, but this can sometimes be forgotten during the morning rush. Similarly, it is vital that the skin does not have any oils on it. If we use SPF in the areas we apply HRT, then this can reduce its efficacy.

Alternatives to HRT

“HRT is perfectly safe in the recommended dose, and you shouldn’t suffer from menopausal symptoms. It’s also important that patients know that there are increasing numbers of alternative, effective non-hormonal treatments available should HRT not be appropriate/wanted.”

Drugs such as Fezolinetant have been groundbreaking in the non-hormonal treatment of vasomotor symptoms such as hot flushes and research is ongoing looking at similar drugs for use in breast cancer patients who are unable to use oestrogen.

“We are also seeing a lot more younger women who are concerned they are perimenopausal. Often, they are still ovulating, if not quite as regularly, so they may not ovulate every cycle. Rather than prescribe HRT, I’ll often start then with a plant-based product that acts similarly to oestrogen in the body, and this may be enough at this point.”

Lifestyle changes and the menopause

“Alongside prescribing HRT, it is also vital that we talk to our patients about their diet, exercise, work, life stressors, sleep patterns, and other lifestyle factors. I see high-flying executives who have extremely high cortisol levels that probably won’t improve unless they are able to address some of these issues.

“It’s impossible to fix everything with just a patch or a gel, and other significant health problems may arise in the future if these lifestyle factors aren’t addressed.”

For more menopause advice, call +44 (0)20 4580 1152 or email [email protected] to arrange a consultation at GP London W1.

Nutrition and wellness companies are increasingly promoting continuous glucose monitors, which can reveal which foods spike and then crash blood sugar levels. Users are often surprised by the sugar hidden in many common foods. In fact, it’s estimated that 74% of packaged foods contain added sugar, even those marketed as ‘healthy’ or ‘natural’.

1. Yoghurt: Yoghurt can have lots of nutritional benefits. It can be high in protein, calcium, vitamins, and probiotics, enhancing the gut microbiome. However, flavoured yoghurts are usually packed with sugar – even more than in a chocolate bar.
2. Bread: We are now all aware that white bread isn’t good for you, but even ‘multi-grain’ bread can contain high sugar levels.
3. Granola: The main ingredient is rolled oats, which are an amazing source of fibre, vitamins, and minerals. Therefore, granola is usually marketed as a healthier substitute than most breakfast cereals. However, even if the products state they are’ whole grain’ or ‘fortified with vitamins and minerals’, it doesn’t mean there’s no sugar.
4. Instant porridge: Another popular breakfast that can be high in sugar, especially the flavoured versions.
5. Dressings, sauces, and marinades: Sugar sneaks into most savoury sauces to enhance flavours.
6. Dried fruits: Dehydration concentrates sugar content, so this popular snack is often naturally higher in sugar.
7. Nut or seed butters: These have become increasingly popular for their health benefits, as they are high in protein, healthy fats, and nutrients. However, many shop-bought brands do contain added sugars.
8. Non-dairy milk: Similarly, many non-dairy milk alternatives that have become popular in recent years contain added sugar.
9. Energy or protein bars: Unfortunately, the energy in these bars often comes from a hefty dose of added sugar.
10. Bottled smoothies: Home-made blends of fruits and vegetables combined with protein powders can make a great start to the day. However, commercially produced smoothies are typically sweetened to improve flavour and ensure a longer shelf life.

For more advice on making healthy life choices, call +44 (0)20 4580 1152 or email [email protected] to arrange a GP consultation.

Every September, the charity Blood Pressure UK promotes the importance of knowing your numbers when it comes to your blood pressure, as one in two strokes and heart attacks are caused by high blood pressure.

One in three UK adults have high blood pressure, yet half of those do not know it or aren’t receiving treatment. These figures are alarming, so what are the essential health metrics that we should all be aware of to prevent the development of serious health conditions?

It’s a numbers game

Certain numbers add up to good health, and unlike your family history, gender, or age, they are metrics that can be modified by your choices. Knowing what your numbers are and whether they are in a healthy range is critical, as the first stages of high blood pressure or cholesterol, for example, are often symptom-free.

The 6 essential health metrics

1. Your blood pressure

Your target: 120/80 mm Hg or less

Blood pressure is the force of blood pushing against your artery walls. If it is consistently too high, known as hypertension, your heart has to work harder, and your arteries become damaged. Often known as the ‘silent killer’ due to its lack of symptoms, hypertension can lead to heart attacks and strokes.

2. Your cholesterol levels

Your target: Total blood cholesterol should be 5mmol/l or less

Cholesterol is a fatty substance, or lipid, in your blood that the body requires for many essential functions. However, too much cholesterol can build up and combine with other substances to form plaque or fatty deposits. These cause your arteries to harden and narrow, creating blockages that can lead to strokes or heart attacks.

Plaque build-up typically produces no symptoms, often until too late, so checking cholesterol levels with a blood test is essential. This will check for levels of HDL (‘good’ cholesterol) or LDL (‘bad’ cholesterol), but overall, your total should be below 200.

3. Your Body Mass Index

Your target: Between 18.5 and 24.9

Your Body Mass Index, or BMI, is a calculation of your weight and height, which can determine whether you are overweight or obese. It’s vital as excess body fat increases your risk of many serious health problems, from diabetes to sleep apnoea.

As a single measure, it is not a perfect test of metabolic health as it does not assess the amount of fat or how it is distributed or measure your frame, so it can be thrown off by high muscle mass.

4. Your waist-to-hip ratio

Your target: 0.85 or less for women and 0.9 or less for men

According to a recent study, your waist-to-hip ratio might be better than BMI in predicting future health problems. It measures fat distribution around the abdominal area as fat stored in this region contributes to cardiovascular disease, high blood pressure and diabetes.

5. Your resting heart rate

Your target: An average resting heart rate for adults is between 60 and 100 beats per minute (bpm)

Measuring your resting heart rate and other markers, such as your blood pressure and cholesterol, can help gauge your current heart health. A high resting heart rate can increase your risk of cardiovascular disease.

6. Your blood sugars

Your target: For most people without diabetes, normal blood sugar levels are between 4 and to 6 mmol/L before meals and less than 8 mmol/L two hours after eating

High blood sugar is when there is too much glucose or sugar in your blood, usually because your body isn’t producing insulin in the case of type 1 diabetes or if the body doesn’t use insulin properly to control blood sugar levels, leading to type 2 diabetes. If blood sugar levels are too high for too long, it can damage your heart, blood vessels, eyes, kidneys and nerves.

At GP London W1, we use the latest health testing technology during our Comprehensive Medicals to identify health risks or issues, such as diabetes, high cholesterol, or high blood pressure, so you can take proactive charge of your health and well-being.