Diabetes can affect both the nerve supply and blood supply to the feet. The condition which affects the nerves is known as Neuropathy. Common symptoms of neuropathy include tingling (pins and needles) or a burning sensation in the feet. Neuropathy means that the feet are less sensitive to damage or variations in temperature. To prevent neuropathy getting worse (or occurring if not already present) try to keep your blood sugar levels as near normal as possible (between 4-9mmols/l). People with diabetes should be taught how to care for their feet to avoid problems in the future.

Top Tips: Wash feet daily and dry well, especially between toes. Check feet daily for any wounds or sore areas. Use a moisturiser to keep skin supple. Never use sharp instruments or corn plasters. Ensure shoes fit well- have your feet measured. If problems occur seek advice from your GP or Practice Nurse.

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This may be due to some nerve and circulation damage due to your diabetes, there is medication that could relieve the pain discuss this with your GP.

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You are absolutely right to take more exercise, and it does not have to be a punishing regimen either. Walking is a cheap and very effective way to increase your activity levels and hopefully loose a bit of weight, and this is extra useful with a healthy diet with lots of fruit and fresh vegetables. Other healthy measures include stopping smoking and drinking only small amounts of alcohol. You would probably find it useful to talk to your local diabetes dietitian about healthy eating and activity levels. Many GP practices now have weight management clinics if you did not want to see a dietitian you may find a more local clinic service like this more appealing. One of the biggest reasons to discuss your diet and exercise plans with somebody else is that you are more likely to stick to your new extra activity goals if you have a regular review.

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I am not aware of a particular web-site, but I would imagine you local dietetic service would be able to point you in the right direction. Other options are for books with carb values, or even some new weighing scales have the option of giving carb values for certain foods. Have a chat with diabetes UK too, as they may have something on their web-site which might be useful. Please do remember though, that carb values on web-sites and in books are going to be approximate, as the true value will depend entirely on the weight of the fruit in question. Carbohydrate counting went out of fashion a few years ago, but I am very happy to see it becoming more widely used again. It seems silly to advise people to eat healthily, then not tell them the value of the foods they are consuming. I would imagine your local diabetes or dietetic department at your local or regional hospital has an advice sheet on exactly this issue.

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The old adage, “everything in moderation” still holds whether you are a person with diabetes or not. Some of my patients find it helpful to do a food diary as it really helps to highlight what you actually do eat. Life is about compromise and with the help of your local dietician I am sure a diet that suits you and your diabetes can be found. The recommendation for alcohol for people with diabetes is 3 units per day, 1 unit is half a pint of beer, 1 short or 1 small glass of wine. And sweet foods are not completely taboo, keep it plain, e.g. scone, plain biscuits, a little of what you fancy.

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Gyms do put these warning notices up as you quite rightly said for legal reasons around health and safety. People with diabetes can use these types of facilities but you need to be aware of several safety issues: in saunas it may be a good idea to wear flip flops, if the sauna gets very hot you may not be aware that it is burning your feet. The effect of heat in steam rooms and saunas speeds up the action of insulin (makes it work more quickly), which could cause a hypo (have lucozade or hypo treatment near by as a precautionary measure). Over exposure in either settings can cause softening of the skin and potentially skin damage.

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If you are surfing, you are going to be burning a lot of calories. So, theoretically, to gain one pound of body weight per week, you would need to consume an additional 500 calories per day above your typical intake. Get the right balance: eat enough carbohydrate – 60% of your calorie intake. Your body will break down protein (muscle) if your carbohydrate intake is too low. For example: 100g of rice = 383 calories, pasta 100g = 342 calories, 1 slice of bread = approx 70 calorie, 100g sultana bran cereal = 303 calories. Consume between 1-1.4g protein per kg of body weight per day e.g. 70kg = 98g protein/day = 15% of your daily calorie intake. Supplement food intake with liquid foods, eg: milk-based drinks/shakes. Include a low fat, high protein food with each meal, e.g. fi sh. Keep your fat intake low, 20-25% of calorie intake, to prevent gains in body fat. Good luck and here’s to some good sets.

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The key to being successfully active is to find something you like, otherwise it will seem like a chore and is less likely to be achieved. The hardest part is getting started! Once motivated you may be surprised how enjoyable it is. It doesn't have to be a conventional form of activity like the gym. Maximise on what you are already doing – walk but walk for longer or at a quicker pace. The ideal would be to walk at a steady pace (so you are puffed, but can still speak) for 40 minutes at least 5 times per week. If you are short of time, look to do something at home like using an exercise bike, mini trampoline, fold-away
treadmill, DVD exercise programmes, or armchair exercises from your local physiotherapist.

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It is thought that when a person first starts on insulin it can cause some weight gain, up to approximately ½ stone (2.5kg) after this the weight should plateau. Completing a food diary is a very good way of reviewing your food intake versus exercise taken. It may be that you are not doing as much exercise as you think. An average 30mins of walking uses 100kcals and 30mins of swimming 200-300kcals.

Unfortunately insulin is a hormone which can cause weight gain but there may be other reasons for your weight gain. Are you on any other treatment, have you been tested for under active thyroid? My advice would be to discuss with your diabetes health care team, maybe a dietetic review would be of benefit and an alternative insulin regime if you are feeding the insulin.

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Unfortunately insulin is a hormone which can cause weight gain but there may be other reasons for your weight gain. Are you on any other treatment, have you been tested for under active thyroid? My advice would be to discuss with your diabetes health care team, maybe a dietetic review would be of benefit and an alternative insulin regime if you are feeding the insulin.

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As your ability to do exercise is limited, to try and lose weight it will mean having to reduce your food intake further. To lose 1-2lbs per week your daily calorie intake needs to be reduced by 300-500kcals. For example if you have a sandwich at lunchtime with two slices of bread, have an open sandwich, one slice of bread and you have reduced your intake by approximately 100kcals. Some people find meal replacement shakes quite effective not only are they a set amount of calories they can also be filling and help with satiety.

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If you are diagnosed with diabetes, and make some changes to your diet and maybe even your exercise/activity levels, then find you are able to maintain healthy (normal or near normal) blood glucose levels then that is great. Unfortunately it does not mean that you no longer have diabetes, it is just that your current diabetes control and treatment is excellent. Continue to monitor and attend clinics for regular check-ups. Diabetes is a progressive condition, so many people find that over time, their blood glucose control may start to drift away from an ideal range, so extra diet and exercise may be required to keep your levels in the normal range. Other people find they need to move from diet only treatment to tablet and diet treatment to maintain control of their blood glucose levels. Some people with type 2 diabetes may even find they need to move onto diet and insulin treatment to keep their blood glucose levels in the healthy range. This is often related to the progressive nature of the condition.

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This advice to eat 5 pieces of fruit a day is part of a healthy eating regimen for people with or without diabetes. I understand your confusion as it is quite true that fruit does contain fructose (fruit sugar). However, fruit also contains fibre which slows down the absorption of the sugar making it less likely to make your blood glucose rise rapidly. A piece of fruit (an apple, pear or a banana) after a meal is a healthy option and is unlikely to affect the overall control of your diabetes especially if you take regular exercise.

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The most obvious reason why potatoes and pastry make your blood glucose rise is the amount of starchy carbohydrate they have in them. Although potatoes, pasta, rice, bread and cereals taste savory when you eat them, your body turns them into glucose when you digest them, so they raise your blood glucose levels for quite a long time after you have eaten them. Starchy carbohydrates are an excellent source of glucose which we use for energy, but those with diabetes have to be a bit careful how much starchy carbohydrate foods we eat. It sounds as though you might find it useful to have a chat with a diabetes dietitian or your own practice nurse if your local GP practice runs a diabetes clinic, then you can discuss how different foods effect your blood glucose levels.

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From what you have told me it rather sounds as though you have type 2 diabetes treated with insulin. This is not unusual, many people who are newly diagnosed with type 2 diabetes find that their treatment needs change over the years, and they may move from diet alone to diet and tablets, then onto diet and insulin. Your type of diabetes remains type 2 even though you are now using insulin. A person who is diagnosed with type 1 diabetes uses insulin from diagnosis, and remains on insulin throughout.

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Stress can cause erratic blood glucose levels, if your blood glucose levels go higher and you feel unwell then your treatment needs to be altered and therefore you would need to discuss this with your diabetes health care team. If you do not feel unwell and your blood glucose is not rising further then I would leave things as they are, things should settle down as you go through the grieving process.

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Blurred vision may be caused by fluctuations in your blood glucose levels, so it is worth taking a blood glucose test next time you find you have blurred vision. Your blood glucose level may be too high, or you may be too low. You can always ring up your optician if you forget to ask next time, I am sure they would be happy to talk to you about it.

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Your blood glucose levels are probably the cause of your mood swings, your diabetes treatments need to be tailored to your shift pattern, therefore I suggest you speak to your diabetes health care team. A dietetic review of your diet is required, having just coffee to start your day is not sufficient even a glass of fresh orange juice would be better.

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It is unfortunate you are having such a problem with your teeth. It is known that those with type 1 diabetes have slightly altered saliva to those without diabetes, and this may be a factor that means some people with diabetes have greater problems with their teeth than those without diabetes. Possibly one of the best ways to help your body fight infections of any kind is to try to keep your blood glucose levels as near normal as possible. Any infections thrives in a warm sweet environment, so stable blood glucose levels will certainly help. Your dentist will have already spoken to you about general mouth care, but ensuring you regularly see a dental hygienist might also help with this problem. Antibiotics are often used to help eradicate dental infections, so remember to complete any course of antibiotics your dentist may prescribe.

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Impotence is a common complication for men with diabetes. It is caused by poor circulation and nervous system complications, but it doesn't mean you will become infertile. If you would like to find out more about what can be done to help, speak to your doctor, or call Diabetes UK on 020 7424 1000.

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Fluctuating blood sugar levels are not uncommon around the monthly period. If your blood sugar levels are going down below normal so that you are hypoglycaemic it would be safer to reduce your insulin dose at the beginning of your period, especially if you can predict the day with some certainty. It would be safe to start initially with a 2 unit reduction the first month and check your blood sugar levels - if that isn't sufficient then you could try a 4 unit reduction the following month and so on. However, if your start day is less predictable, then adjustment of your food intake, such as eating extra carbohydrate at the beginning of the day on the first day of your period, may be simpler.

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High blood glucose levels is termed HYPER if you feel well and your blood glucose is high. The fact that you do not feel unwell may be due to your levels being regularly high and therefore your body has got used to high blood glucose levels and so you do not feel unwell.

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Answer: Medi-tag is available from Hoopers Medi-tag Department, Tel: 0121 200 1616 or e-mail info@medi-tag.co.uk

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To counter this problem, Diabetes UK have a mortgage desk and financial services to help with the mortgage process, including critical illness insurance. Call freephone 0800 731 7431. The Association of British Insurers (020 7600 3333 or www.abi.org.uk) or the Council of Mortgage Lenders (020 7440 2255 or www.cml.org.uk) will also be able to point you in the right direction. Good Luck.

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Waxing causes trauma to the skin and could be a source of infection. DVT socks should only be used under the instruction of your GP if there is a possibility of problems with the circulation.

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Some people with diabetes have problems with circulation in their legs and feet and because of this you may be advised not to use DVT socks, as they could restrict circulation more. But there are other things you can do to help. Moving around the cabin during a long flight will help to reduce any period of prolonged immobility. Many airlines also provide helpful advice on exercises that can be carried out in the seat during flight. It is thought that exercise of the calf muscles can stimulate the circulation, reduce discomfort, fatigue and stiffness and it may reduce the risk for developing DVT. You can take your own food or pre-order food suitable for people with diabetes, and flights will also have bread rolls etc, if you feel you need more carbohydrates. You just need to ask.

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It is worth shopping around, but did you know that Diabetes UK Insurance Services has a travel insurance policy for people with diabetes and families and friends travelling with them. No referrals for medical screening are required and there is no age limit on single trip policies. Buy online at www.diabetes.org.uk or call 0800 731 7431.

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There is no interaction with travel injections or malaria therapy with your insulin and it is highly recommended that you have them. The best way to keep your insulin cool is to use a travel bag such as the FRIO bag, which works by using cold water and keeps insulin cool for up to 45 hours.

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You should carry your insulin and testing equipment with you in your hand luggage and inform security that you have insulin in your bag. There is no problem with carrying this but to be on the safe side it is recommended that you have a letter from your GP stating that you have diabetes.  I would also recommend that you carry with you a repeat prescription list in case you lose or run out of your medication.

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Make an appointment with your Specialist Diabetes Nurse either at the GP practice or through your local hospital. They will be able to give you specific tailored advice, as you may need to reduce your dose whilst travelling, test more frequently and have written information on how to cope if you are unwell. You may want to consider wearing diabetes ID.

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