I have intense itchy skin that spreads from my scalp, back, face and arms to under my breasts.

ALTHOUGH it is a largely preventable condition, around 13.6 million of us are at risk of developing type 2 diabetes.

Closely linked to obesity, it can lead to problems such as heart disease, stroke, erectile dysfunction and tooth loss.

But carrying excess body weight is not the only risk factor.

The same goes for having a family member diagnosed with diabetes or hypertension.

People of South Asian, Afro-Caribbean or Black African descent are up to four times more likely to be diagnosed.

Smoking, PCOS, mental health problems, and gestational diabetes (during pregnancy) also increase your chances.

This is Type 2 Diabetes Prevention Week, so grab a tape measure to check your risk.

A healthy waist size in most men is 94 cm (37 in) or less, or 90 cm (35 in) for those of South Asian descent.

For women of all ethnicities, a healthy waist size is less than 80 cm (31.5 in).

If you’re above these limits, it’s worth taking steps to get healthier.

You could take a look at the NHS’s free 12-week weight loss program or, if you’ve tried this sort of thing before, speak to your GP to see what support is available to you.

MY ENDLESS ITCH

Q: I’ve been suffering from itchy skin for months.

It started on my scalp and the back of my neck.

It then spread down my back, the sides of my face, shoulders, arms and under my breasts.

It’s serious and keeps me up at night. I am so tired.

I was given antihistamines and Eurax cream, but the itching and rash are getting worse.

I only saw a nurse and was advised to see a pharmacist.

I am a 70 year old woman.

Please, can you help me?

A: The generalized nature of your itching, along with the fact that it does not improve with prescriptions, suggests that there may be an underlying medical condition.

This may be a condition that originates in the skin itself – such as eczema, psoriasis or a fungal skin infection – or it may be a systemic disease.

Allergies, hormonal imbalances, or medication side effects may also be causing or contributing to your symptoms.

Which came first – the itch that caused the rash or the rash that caused the itch?

Either way, it’s important to evaluate him properly and probably do some blood tests as well.

GP practices are stressed at the moment and the truth is that most practices are struggling to provide the excellent quality of care they want.

This means patients need to advocate for themselves more than ever.

In your case, the fact that your itching is intense and affects your quality of life so much makes this important, so I definitely recommend scheduling an appointment with your family doctor.

In the meantime, there is no harm in consulting a pharmacist, who can help.

Pharmacists train for four years and gain a lot of knowledge in treating patients with mild illnesses, in addition to their experience in medicines.

The pharmacist may be able to identify a fungal skin infection and advise appropriate antifungal treatments, or may suggest mild corticosteroids if they suspect an inflammatory skin condition such as eczema.

The good news is that most itchy skin problems will improve once the cause is known and treated appropriately.

DO I NEED LONG-TERM ANTIBIOTICS?

Q: I have had ankylosing spondylitis for 50 years and was under control with anti-inflammatory medications.

Then I was told to stop taking it because it was affecting my kidneys.

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Tramadol and co-codamol gave little relief, and prednisolone left me with insomnia after a few weeks.

I am about to start taking adalimumab (Imraldi) and I would like to know if my doctor should prescribe antibiotics as my immune system will be compromised.

A: Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine, causing pain, stiffness and potentially leading to fusion of the vertebrae over time.

It’s a shame that his kidneys were affected by the anti-inflammatories, as they seem to have helped a lot.

Imraldi is a biologic medicine that helps reduce inflammation by blocking a specific protein.

You are right that it can also affect the functioning of your immune system.

However, prophylactic antibiotics (to prevent rather than treat infections) are generally not needed or prescribed with Imraldi.

It is important, however, to be alert for signs of infection, and if you think you have an infection at any time, inform your medical team immediately.

It is important not to take antibiotics unless necessary.

Overuse can cause bacteria to change and become resistant to the antibiotics designed to kill them, making the antibiotics less effective – this is known as antibiotic resistance.

This can limit the antibiotics we can use to treat people and results in more serious, sometimes life-threatening infections.

When you need antibiotics, it is also important to complete the prescribed treatment, even if you start to feel better.

This ensures that all bacteria are killed and prevents the development of resistant strains.

My advice is to talk to your specialist medical team – the specialist nurse is usually more accessible.

Find out the exact advice regarding any future infections and antibiotic use.

HOPE FOR ALZHEIMER

A COMMON hormone already produced by the body could stop the early stages of Alzheimer’s.

Leptin is released by fat cells and is involved in regulating appetite.

Researchers at the University of Dundee found that a small part of the hormone can reduce the effects of toxic proteins called amyloid and tau, which build up in the brain and lead to memory loss and Alzheimer’s disease.

Professor Jenni Harvey said: “We are working at the level of synapses, which are the communication points in the brain, because synapses are affected early in the disease process, when Alzheimer’s disease is still reversible.

“We found that applying leptin can block the ability of amyloid and tau to interfere with synapses and memory loss, and can prevent the unwanted effects of these cellular changes.”

Researchers discovered six amino acid fragments of the hormone’s 167 that slow or stop the disease.

This allowed scientists to design a potential drug model. But it could be a few years before any new leptin-based drugs are available.

Professor Harvey said: “Drug development is not a quick process, most medicines take around ten years.”

There are 900,000 people in the UK with dementia and this number is predicted to rise to 1.6 million by 2050.

NIGHTMARE IN LUPUS

NIGHTMARE and “daytime nightmares” can be an early warning sign of lupus.

A study by the University of Cambridge and King’s College London looked at people with lupus, a disease that causes the immune system to attack tissues and organs, as well as other chronic inflammatory autoimmune diseases.

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Researchers asked nearly 700 patients to list the order in which 29 neurological and mental health symptoms usually occurred, including depression, hallucinations and loss of balance.

The research found that three in five patients with lupus and one in three with other rheumatology-related conditions experienced an increase in vivid, distressing nightmares before they experienced hallucinations.

They added that they thought this happened when they were “overworked” and “the more stress my body was under, the more vivid and bad the dream would be.”

Experts said it had long been suspected that nightmares and hallucinations were linked to the disease, which counts US pop singer Selena Gomez among its patients.

Angie Davidson, from the Lupus Trust, said: “Many patients have spoken about having these types of symptoms without knowing it was part of their illness.

“It’s a fantastic step forward in recognizing another area of ​​lupus.”

Q: I have been taking an estrogen-blocking medication for three years after being diagnosed with breast cancer.

I have terrible pain in my muscles and back and I have also noticed that my scalp has become very flaky and red around my hairline.

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Could this be caused by the drug?

A: The short answer is yes, it certainly could be.

Estrogen blockade can affect any and all organs and systems in the body because estrogen plays a role in the functioning of every part of the body.

Estrogen-blocking medications, such as Tamoxifen, help lower the risk of breast cancer coming back in people who have a hormone receptor-positive type of breast cancer.

They do this by blocking estrogen receptors, which stops estrogen from telling cancer cells to grow.

Tamoxifen can reduce the risk of breast cancer recurrence by 40 to 50 percent in postmenopausal women and by 30 to 50 percent in premenopausal women.

It can reduce the risk of developing new cancer in the other breast by around 50%.

The downside, however, is that it also blocks estrogen receptors in other tissues, and this can cause a number of negative side effects, many of which are the same as menopause.

It can lead to changes in muscles and joints, causing pain and stiffness.

Estrogen also helps keep skin healthy, so dry, inflamed skin can certainly be a side effect of using this medication.

That said, it’s important not to ignore other potential causes, like psoriasis, which can cause red, scaly skin (and sometimes joint pain) but is very treatable.

Your pharmacist can advise you on over-the-counter treatments for psoriasis and I recommend making a routine appointment with your family doctor to discuss your symptoms in more detail.

If the symptoms are side effects of medication, it can be very helpful to consider the duration of treatment.