I feel sick when I eat anything sweet... so could it be diabetes?

IF I eat anything sugary, I feel nauseous. I can’t think why, but I’m keeping off all sugar in all foods – even a teaspoon in a cup of tea. Could it be diabetes?

DIABETES does not usually cause symptoms of nausea in reaction to sugar, but regular nausea or indigestion are definitely symptoms to talk to a doctor about. Nausea is something we all feel from time to time with infections, from medications or after too much alcohol. Indigestion is very common and often related to certain foods. It may not be the sugar content that causes the problem but the quantity eaten, or other aspects such as fat, acidity or spices which tend to irritate the stomach.

Gallstones can be another cause. These are stones that form in the gall bladder, a tiny organ in the liver. If they become irritated, they can cause people to feel very queasy and sick after heavy and fatty meals.

Regular symptoms such as nausea or indigestion, alongside weight loss or fatigue, are usually nothing serious. But the difficulty is that they can be insidious signs of underlying silent cancers. This is why I would always recommend a chat with a doctor about this. Checking weight, blood pressure, taking bloods and having an abdominal examination and a stool test could alleviate concerns and rule out anything sinister.

As for diabetes, type 2 is very common and testing is quick and simple via a blood test or urine test at the GP surgery. GPs should offer this as standard, particularly for someone at higher risk such as those over 40, or over a certain weight. This can usually be arranged with a nurse or healthcare assistant.

I WAS diagnosed with high blood pressure five years ago and take pills daily. Recently, I did an at-home test and noticed my blood pressure is higher than usual. I can’t get through to my GP – shall I up my dose?

DON’T change doses of tablets without a discussion with your own doctor. If you can’t get through on the phone, try to access using an electronic consultation or by phoning later in the day and making a routine appointment.

High blood pressure is a really important issue: it puts people at long-term risk of heart disease, strokes and heart failure. Even if you’ve been diagnosed, it is important to take blood pressure readings regularly, as in most cases changes in blood pressure wouldn’t cause noticeable symptoms.

The best way to keep a check on blood pressure is with an athome monitor. We advise patients to take their blood pressure twice a day for a week or two using a monitor approved by the British and Irish Hypertension Society. Ask your pharmacist to recommend one. They’re also available from the British Heart Foundation online shop (giftshop. bhf.org.uk). A basic model costs £19.99, which is good value considering what a life-saver they can be. But it is important to take your reading properly as it is easy to get wrong. You need to sit down, with both feet on the floor, not be talking to anyone, and put the cuff in the right place – there are excellent guides on the British Heart Foundation website.

Readings can then be submitted to the GP to decide on further medication or if a change is necessary at all. Many nurses in GP surgeries monitor blood pressure and may be able to advise, too. If blood pressure is too high, losing weight, increasing exercise and reducing salt intake will all help, even for someone already on medication.

MY RIGHT hand feels very sore and itchy, and this only dissipates when I run it under hot water. Is this normal? I don’t feel it in my left hand.

HEAT is a form of pain relief. This is why people have always used hot water bottles and heat rubs to quell pain, so it is not surprising for hot water to have that effect on your pain. Heat is particularly useful for what is known as neuropathic pain – pain that occurs from nerve damage. This is the type of pain we see in long-term diabetes or after shingles: it is a particularly burning and ‘hot’ type of pain (so it does seem paradoxical that heat reduces it).

A sore hand may be the result of neuropathic pain. Most commonly, this would be a problem called peripheral neuropathy – damage to the tiny nerves at the end of the limbs caused by diabetes, B12 deficiency or an old arm injury.

If it responds well to hot water, it may be worth trying a warming cream. Capsaicin cream, which contains chemicals similar to the ones that make chillis hot, are available from a pharmacist for this. A GP can explore blood tests and investigations to diagnose the cause of peripheral neuropathy. I have seen a lot of sore and itchy hands during the pandemic thanks to the sensible advice to wash hands thoroughly and use alcohol gel. This has resulted in a number of people experiencing hand dermatitis, which is like eczema but is a response to the irritants in soap and alcohol.

If this is the cause of soreness and itchiness, it should respond to a nightly steroid cream. Speak to your pharmacist about this.

Another good idea is washing the hands with an emollient rather than soap: aqueous cream can be a good soap substitute.