DR MARTIN SCURR answers your health questions

Last year I was diagnosed with type 2 diabetes and was prescribed 500 mg of metformin daily. But I decided to overhaul my lifestyle by eating healthy and as a result I lost 2nd and my HbA1c score dropped from 92 to 36. So should I keep taking metformin or can I stop?

Des Pike, Pontypool, Torfaen.

What a great achievement and I applaud your commitment and dedication.

Type 2 diabetes is a serious condition that is affecting more and more people in the UK, mainly due to rising obesity rates.

The condition causes blood sugar (glucose) to rise to dangerously high levels.

While many people experience few or no symptoms, these high levels can cause serious complications if not controlled, including damage to the eyes and nervous system, along with an increased risk of heart disease from rapidly accelerating atherosclerosis (where the arteries become hardened). ).

In type 2 diabetes, the body stops responding well to insulin, a hormone that helps clear glucose from the blood and transport it to muscle cells where it is used for energy. Instead, glucose builds up in the body, causing long-term damage.

Type 2 diabetes is a serious condition affecting more and more people in the UK, mainly thanks to rising obesity rates

A marker of diabetes is sugar in the urine. A blood sugar test may then be performed to confirm the diagnosis.

But this is a snapshot, and a more telling result comes from an HbA1c blood test, which provides a measure of your average blood sugar level over the past two or three months.

People with type 2 diabetes are advised to get their HbA1c value below 48 mmol/mol.

Your excellent self-control has lowered yours from 92 to just 36 mmol/mol, effectively putting you into ‘remission’.

But you must stick to your lifestyle and diet plan or else your weight will increase again and your diabetes may return.

As for whether you should continue to take metformin, take your GP’s advice, but I expect the prescription will stop if regular HbA1c tests confirm that your readings are in the safe zone.

Your excellent self-control has lowered yours from 92 to just 36 mmol/mol, effectively helping you in

Your excellent self-control has lowered yours from 92 to just 36 mmol/mol, effectively putting you into ‘remission’. But you must stick to your lifestyle and diet plan or else your weight will increase again and your diabetes may return

I have Barrett’s esophagus. I constantly have mucus in my throat and seem to be coughing constantly. I was prescribed Beconase which doesn’t help much. Any ideas?

Ian Balloch, Grangemouth.

Barrett’s esophagus, as I hope has been explained to you, occurs as a result of gastroesophageal reflux disease (GORD), where acid leaks from the stomach into the esophagus, leading to heartburn and possibly a recurrent cough.

In the long run, the constant exposure to acid can cause cells at the base of the esophagus to change, making the lining red and thickened. In a small proportion of cases (less than 1 percent), these altered cells can become cancerous.

The conventional treatment for Barrett’s is proton pump inhibitors (PPIs), drugs such as omeprazole that suppress acid production. However, between 10 and 40 percent of patients continue to experience symptoms despite taking prescription medication.

It’s likely that your symptoms — cough and mucus in the throat — are due to ongoing reflux, called “silent” reflux at night.

Previously, this was the subject of some debate, but it is now believed that GORD can indeed lead to nasal conditions such as sinusitis in some people. The fact that you have been given Beconase (generic name beclomethasone) steroid nasal spray to reduce inflammation suggests that this is what your doctor thinks you may have.

However, since this has not helped you, I have two suggestions for you to discuss with your GP.

First, you may need to be prescribed a stronger steroid nasal spray, such as fluticasone, to be used at night and in the morning. And second, your current dose of PPI may not be enough to suppress your acid production. Sometimes some patients need 40 mg or even 80 mg once a day.

Write to Dr. scurr

Write to Dr. Scurr on Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email [email protected] co.uk — provide your contact details. dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context and always consult your own GP if you have health problems.

In my opinion… patients do better with the same GP

Imagine if there was a simple approach that improved patient satisfaction, led to better management of long-term conditions and would reduce the need for hospital referrals and admissions.

In fact it exists – it’s the ‘named GP’ system, where each NHS patient is assigned a GP who is responsible for overseeing their care.

But a recent study found that only half of patients now see the same GP.

And this isn’t going to improve because there aren’t enough GPs to go around.

This is a long standing problem. Our leaders need to think not just now, but 20 years from now: we need more medical schools and more incentives to go to primary care.

The doctor-patient relationship is not a luxury: it saves both money and lives.

Imagine if there was a simple approach that improved patient satisfaction, led to better management of long-term conditions and would reduce the need for referrals and hospitalizations

Imagine if there was a simple approach that improved patient satisfaction, led to better management of long-term conditions and would reduce the need for referrals and hospitalizations

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