If you have been feeling increasingly thirsty, need to urinate frequently or are unusually fatigued, you may be experiencing the early symptoms of type 2 diabetes. A recent study has found that treating type 2 diabetes as early as possible helps to reduce the risks of future complications.

Scientists from Oxford and Edinburgh Universities analysed data spanning over 40 years from the UK Prospective Diabetes Study (UKPDS). The results revealed that there was a significant and lasting legacy of early intervention in managing type 2 diabetes.

Benefits of early intervention in diabetes

Treatment with insulin or sulphonylurea tablets immediately after a diabetes diagnosis led to 17% fewer heart attacks, 26% fewer complications associated with diabetes, like kidney failure and vision loss, and 10% reduction in mortality. Compared to managing type 2 diabetes through diet, early treatment with metformin led to 31% fewer heart attacks and 20% fewer deaths.

Data collected over four decades is now revealing that protective effects are long lasting. The researchers believe that effectively reducing blood sugar levels early on creates a ‘memory’ effect even if blood sugar levels rise at a later date.

“People may have type 2 diabetes for several years before being diagnosed as they may have few symptoms until their blood sugars become substantially elevated… Playing catch-up with blood glucose control is not sufficient.”

The importance of regular diabetes health checks

This week is Diabetes Awareness Week in the UK and this year the focus of the campaign is the importance of diabetes health checks in preventing serious complications arising. These include:

Blood tests

This is a regular test that checks your average blood sugar levels over the preceding months, your cholesterol levels to see how much fat is in your blood and your kidney function. A urine sample is also taken to check for signs of kidney disease.

Physical examination

Your blood pressure will be measured as well as your weight and height to assess your BMI.

Diabetic eye check

Not an annual check necessarily but an eye check involves photos taken of your eyes to see how diabetes is affecting them, as it can damage the blood vessels and cause diabetic retinopathy.

‘Knowing your numbers’ is essential. Our annual health checks include a blood test for HbA1c which checks for type 2 diabetes as well as assessing your blood pressure, cholesterol and glucose levels, and they are recommended from 45 years onwards.

For more advice on diagnosing and treating early type 2 diabetes call +44 (0)20 4580 1152 or email [email protected] to organise a consultation.

As temperatures rise and summer beckons, it’s unsurprising that May’s focus is skin cancer and sun awareness. The British Association of Dermatologists has long campaigned for greater knowledge of sun safety, and this year, their particular focus is informing the public about non-melanoma skin cancer and how best to check your skin.

Although most of us are aware of melanoma, the deadliest form of skin cancer, recent research has found that more people are now dying of non-melanoma skin cancer (NMSC) than malignant melanoma.

Conducted by researchers in France, the study analysed data collected by the World Health Organisation and found that non-melanoma skin cancer accounted for more deaths worldwide. Worryingly, they thought this number could even be higher as NMSC is sometimes left out of national cancer registries’ figures as it is considered less serious than other types of cancer.

What is non-melanoma skin cancer?

As with melanoma, NMSC is linked to exposure to UV rays through the sun or tanning beds. Over the last decade, melanoma skin cancer rates have increased by a third and NMSC by 42% in the UK as our attitudes to tanning and sun exposure have changed.

“It is vital we protect our skin from UV rays whether it is from sunlight or sun beds. In my opinion sun beds should have a health warning, considering the risk they carry,” comments GP London W1’s Dr Ravi Brar.

Melanoma is caused by mutations in skin cells called melanocytes, whereas NMSC usually develops in cells in the epidermis, or outermost layer of skin. The two most common types of non-melanoma skin cancer are basal cell carcinoma, accounting for about 75% of skin cancers, and squamous cell carcinoma, accounting for about 20% of skin cancers.

Signs of non-melanoma skin cancer

Whether for melanoma or non-melanoma skin cancer, early detection is critical. More than 75% of NMSCs are first noticed by patients or people close to them, so it is vital to recognise the early warning signs.

• appearance of a lump or patch on the skin that doesn’t heal after a few weeks
• cancerous lumps are typically red, firm, and shiny
• cancerous patches are often flat, scaly, and irregularly shaped
• a sore that won’t heal
• a growth with raised edges
• a wart-like growth that might bleed or crust over
• a skin lesion that itches

Certain risk factors, such as a family history, pale skin that burns easily, and a large number of moles or freckles, can increase one’s chances of developing NMSC.

“Mole mapping serves as a valuable tool for monitoring individuals who have numerous moles and skin lesions, especially those that are large or have irregular shapes, as well as individuals with a personal or family history of skin cancer,” Dr Brar explains.

“If a patient has concerns with any of their skin lesions, it is important for them to seek appropriate guidance. With the aide of dermoscopy, these lesions can be assessed at higher magnifications thus helping with its diagnosis.”

“I developed an interest in skin and skin health about five years ago. The skin is our largest organ, and it’s the first thing everyone sees. If you’re unwell in any way, changes to your skin are often the first sign. The skin is amazing, and it is important knowing how and when to protect it and when to seek help.”

If you’ve noticed any concerning skin changes, book an appointment with one of our GPs.

April marks both IBS and Bowel Cancer awareness months, and these two conditions also share many similar symptoms as they affect the same part of the body.

Our health is shaped by a complex interaction between many factors, especially when conditions have overlapping symptoms, which can often lead to anxiety and confusion. Consulting a healthcare professional at an early stage is essential, as they can accurately distinguish and diagnose different conditions and help you manage your health effectively.

What are the symptoms of IBS?

Irritable Bowel Syndrome, or IBS, is a chronic condition affecting the large intestine. The bowel or large intestine is at the end of your digestive tract or colon.

The most common symptoms of IBS are changes to regular bowel movement, whether that is constipation or diarrhoea. Other symptoms can include abdominal pain, bloating, and a sensation that bowel movements are incomplete. Mucous in the stool is very common and is often whitish.

Even though it is a long-term condition, symptoms often fluctuate in frequency and severity. Certain foods can trigger symptoms of IBS, as well as stress, anxiety and hormonal changes.

Mild to moderate IBS is usually managed with lifestyle changes. Severe symptoms that are affecting quality of life may require medication.

IBS is typically diagnosed by taking a comprehensive medical history and reviewing your symptoms. This will cover your medications and if you’ve had any recent infections or periods of stress. A family history will also be taken to see if there are any instances of celiac disease or colon cancer. Testing is usually to rule out other conditions.

What are the signs and symptoms of colon cancer?

Symptoms of colon cancer can include changes to your bowel habits that last for more than a few days. This could be the following:

• abdominal pain
• cramping
• diarrhoea
• constipation
• iron deficiency anaemia
• blood in your stool or rectal bleeding
• narrowing of the stool
• mucous in the stool, usually bloody or dark black
• the feeling that bowel movements aren’t complete
• the urge to have a bowel movement when there is no need
• fatigue
• unexplained weight loss
• weakness

Colon cancer will be diagnosed by taking a complete medical history as well as checking whether there is a family history of colon cancer. Risk factors include colorectal polyps, type 2 diabetes and ulcerative colitis, as well as a poor diet and lack of physical activity. In addition to a physical examination, diagnostic tests include blood and stool tests, a colonoscopy, tissue biopsy, and imaging tests, such as an X-ray or CT scan of the colon and rectum.

Can IBS lead to colon cancer?

This is a common concern, but although IBS can be very uncomfortable, it rarely leads to more severe health problems. Unlike inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease, IBS does not cause inflammation, a critical factor in colorectal cancer risk.

However, this doesn’t mean you should ignore symptoms and should seek immediate medical advice if you’re experiencing new symptoms such as unexplained weight loss or rectal bleeding.

Did you know that from the moment you stop smoking your body starts to repair the damage? Within 20 minutes, your pulse and blood pressure start to reduce and within eight hours of having your last cigarette, oxygen levels in your blood return to normal. By the second day, carbon monoxide in your blood will be gone completely. And now, research has shown that stopping smoking at any age reduces the risk of cancer.

A major new study, analysing medical data from nearly 3 million Koreans between 2002 and 2019, found that the chances of developing cancer halved in people who had quit for at least 15 years, compared to those who continued to smoke.

The study also showed that the younger you are to quit, the greater the benefits. Smokers who quit before the age of 50 had their risk of lung cancer fall 57% compared to smokers, while those who quit at 50 or older experienced a 40% reduction in lung cancer risk over the same time period.

What happens when you quit smoking?

After 1 day

• Carbon monoxide is one of the hundreds of noxious chemicals present in cigarette smoke; it replaces the amount of oxygen in your blood, depriving the body of this nourishment. Within the first 24 hours, the carbon monoxide and oxygen levels in your blood return to normal

After 1 week

• You may notice a heightened sense of smell and taste as the previously damaged nerve endings that control these senses start to regrow
• You may feel breathing is easier as the bronchial tubes relax
• Energy levels increase

After 1 month

• Lung function improves as the cilla, tiny hair-like structures which move mucous out of the lung, begin to work normally
• Circulation improves as blood pumps through the heart and muscles more easily

After 9 months

• After 9 months, a person’s lung function increases by 10%

After 1 year

• Smoking damages your heart by limiting oxygen flow and damaging the lining of the arteries. Quitting smoking reverses these effects and after one year your risk of a heart attack and coronary heart disease becomes half of that of someone who still smokes

After 5 years and more

• Your risk of certain cancers including lung cancer is significantly reduced
• At the 15-year mark, your chance of a heart attack becomes equal to a person who has never smoked

For more advice and support in quitting smoking, call +44 (0)20 4580 1152  to arrange a GP consultation with one of our GPs.

Heart attacks could be better prevented in those suffering unexplained chest pain, according to recent research funded by the British Heart Foundation into cardiovascular disease risk factors.

It is thought that over a million UK adults visit their GP every year due to chest pain, but for many the cause remains a mystery despite undergoing diagnostic tests.

However, people who suffer from this type of ‘unattributed’ chest pain are a higher risk of developing heart problems and researchers at Keele University have now identified the key risk factors that increase the likelihood of this occurring.

Published in the European Journal of Preventive Cardiology, the study was based on data from over 600,000 GP records of patients that had experienced unattributed chest pain between 2002 and 2018 and followed them up for at least five years.

Their analysis showed that one year after first presenting to their GP with mystery chest pain, patients were 25% more likely to have a ‘cardiovascular event’. This increased heart attack risk persisted for the next ten years.

Cardiovascular disease risk factors identified in study:

Diabetes

Diabetes significantly amplifies the risk of cardiovascular disease, even with well-managed glucose levels. You are twice as likely to have heart disease or a stroke than someone who doesn’t have diabetes, and typically at a younger age. The longer you live with diabetes, the more likely you are to have heart disease.

Regular check-ups, healthy eating habits, weight control and consistent physical activity are essential for diabetes management.

High blood pressure

High blood pressure increases cardiovascular risks by overburdening the heart, leading to muscle thickening and stiffness. This abnormal functioning increases the chances of stroke, heart attack, kidney failure, and congestive heart failure. When coupled with obesity, smoking, high blood cholesterol or diabetes, high blood pressure elevates the risk of heart-related incidents.

Smoking

Nicotine, found in both cigarettes and e-cigarettes, accelerates heart rate and raises blood pressure, promoting clot formation and arterial plaque build-up. Smokers are not only more likely to experience heart attacks, strokes and angina than non-smokers, but at a much younger age.

Obesity

Excessive body fat, especially around the waist, contributes to an increased risk of heart disease and stroke, independent of other risk factors. Overweight and obese individuals with cardiovascular risk factors can implement lifestyle changes to shed excess weight and address issues like high blood pressure, cholesterol, and blood sugar.

Steps to reduce heart attack risk

The team at Keele University hope these findings will assist doctors to spot those at high risk so they can offer preventative treatments and lifestyle advice. Modelling showed that if all current smokers living with obesity were supported to lose weight and quit smoking, the mean 10-year risk in this group would fall from nearly 22% to around 16%.

Please call +44 (0)20 4580 1152 to make an appointment with one of our GPs to discuss your heart attack risk.