Ask the doctor - thirst and diabetes

Womans finger having a gloucose test

Click here for the main Ask the doctor page, with questions and answers on 25 health topics, from our magazine doctors

I’m incredibly thirsty lately. I drink gallons of water and also feel very tired. Is there something wrong with me?
If you’re constantly thirsty, diabetes is one condition that needs to be ruled out. Insatiable thirst, increased urination and tiredness are among the symptoms. There is another condition called diabetes insipidus, when your body’s way of regulating water becomes dysfunctional and you pass lots of urine and become incredibly thirsty. It’s rare but may come on after a head injury, if you take lithium medication or have a kidney disorder. If you suffer from dry mouth, this can also make you feel excessively thirsty. It can be the result of medical conditions or treatments with drugs such as amitriptyline (commonly used to treat pain). Some people suffer from a rare condition called psychogenic polydipsia in which a person feels compelled to drink water. Changes in diet, excessive consumption of caffeine or excessive sweating can also make you feel very thirsty.
Dr Pixie McKenna, Best (Feb 13)

I have diabetes and work in an open-plan office. It’s embarrassing having to lay all my glucose-monitoring kit on my desk, so I don’t check as often as I should. Surely someone can come up with a simpler system.
I can suggest a couple of options. If you have a smart phone, the iBGStar (£48 from Boots) is a tiny glucose meter that turns your iPhone or iPod into a glucose monitor. With its Diabetes Manager App you can check your blood glucose levels on the go. Or try the Mendor Discreet all-in-one monitor, which contains meter, lancing device and a cartridge of 25 strips in one unit. It’s available free from your diabetes nurse or at www.mendordiscreet.co.uk. Replacement strips are available on prescription.
Dr Sarah Brewer, Prima (Feb 13)

I have a burning sensation in my feet that is really annoying me. It’s worse at night when I’m lying in bed. What do you think it could be?
This can be caused by undiagnosed diabetes, thyroid problems, or a deficiency in vitamin B12. But in some cases it can have no apparent cause and simply crop up out of the blue! Chat to your GP about taking a blood test to rule out the conditions mentioned above. Meanwhile, try to avoid wearing tight shoes and choose footwear with a high instep. Don’t wear bed socks and try to ease the burning in cool water for 15 minutes before bed. If none of this helps, then you may need a prescription medication to numb the nerves at night, eg Amitriptyline.
Dr Pixie McKenna, Best (Oct 12)

I have diabetes and drive a lot for work, so I need to make sure my blood sugar doesn’t go too low. Which monitor should I use?
Perhaps surprisingly, the first question is whether you need to monitor your blood sugar at all. Of the three million people in the UK with diabetes, about 90% have type 2 diabetes, which can often be controlled for many years without insulin. Insulin can cause low blood sugar, leading to confusion, loss of consciousness, heart attack and even death. It’s also responsible for up to 30 major UK road traffic accidents every month. The most commonly used group of medicines to treat type 2 diabetes are sulphonylureas, which, oddly enough, are also major culprits in causing low blood sugar. But other tablets used for controlling sugar in type 2 diabetes don’t carry the same risk, and I rarely recommend anyone with diabetes checks their blood sugar at home unless they’re taking insulin or a sulphonylurea. If you are, then new monitoring systems like the iBGStar really fit in with a modern lifestyle. You can just plug it in to an iPad or iPhone, and it automatically updates all your results, letting you instantly see the effect of changes in your diet, exercise or illness on your blood sugar.
Dr Sarah Jarvis, Good Housekeeping (Aug 12) 

I have type-2 diabetes controlled with diet. I’ve heard that cinnamon is a good natural treatment, but are there any side effects?
Cinnamon bark contains unique substances that can have a beneficial effect on glucose tolerance and insulin resistance and help reduce cholesterol and triglyceride levels. You can increase the amount of cinnamon in your diet by making curries and the Turkish aubergine dish imam bayildi. Cinnamon tea and cinnamon supplements are widely available, too. Cinnamon is also helpful for women with polycystic ovary syndrome. There are no signi cant side effects reported, but if you have diabetes, monitor your blood glucose levels carefully when changing your diet.
Dr Sarah Brewer, Prima (Jul 12)

I have Type 1 diabetes and use a kind of insulin called Mixtard 30. I was shocked when my GP told me it’s being withdrawn in a few weeks – how can life-saving medications be taken away from patients without notice?

Unfortunately, any pharmaceutical company can stop making a medicine at any time – sometimes for safety reasons, sometimes because not enough people are using it to make its ongoing manufacture viable, sometimes because newer and better alternatives are freely available. On the whole, these companies are very responsible, and will try to make alternative arrangements if possible. In this case, the company gave six months’ notice that it was stopping production of Mixtard 30, although that’s not long if you’ve been taking it for years. In fact, there are lots of newer alternatives, which statistically provide better control and have fewer side effects. You must speak to your GP, consultant or diabetes nurse as soon as possible to ensure a smooth transition.
Dr Sarah Jarvis, Good Housekeeping (Nov 10)  

I have type 2 diabetes and my doctor used to tell me to take a mini aspirin every day to reduce my risk of heart disease. Now he’s told me to stop. Why?

Because UK guidelines for taking aspirin when you have diabetes recently changed. It used to be recommended routinely, but experts now say you shouldn’t take it if you don’t have heart or circulatory problems. New research suggests the possible side effects, such as stomach irritation, abnormal bleeding, and peptic ulcers may outweigh the possible benefits. But if you already have heart disease or are at risk of stroke, the benefi ts continue to outweigh the risks. Doctors therefore now give personal advice about the mini aspirin, rather than recommending it as routine. For more information, visit diabetes.co.uk.
Dr Sarah Brewer, Prima (Oct 10)

 

Click here for the main Ask the doctor page, with questions and answers on 25 health topics, from our magazine doctors

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit netdoctor.co.uk

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