DR ELLIE CANNON: I have type 2 diabetes that gives me cold feet… how can I keep them warm?

I am 85 years old and have type 2 diabetes. I have suffered from cold feet for years, which get worse in the winter. I have tried bathing my feet in warm water, giving massages and emulsifying creams, but nothing seems to work. Can you help?

Having cold feet is often associated with circulatory problems. And poor circulation can be an essential part of living with type 2 diabetes. It is also a common complaint in old age.

In diabetes, high blood sugar levels can damage the smaller blood vessels in the feet and toes, restricting blood flow to the area and making the feet cold. The skin is also at risk of damage as it cannot heal without proper blood supply.

Using a rich moisturizer is a good idea to prevent breaks in the skin. Annual foot checks – at diabetes clinics or GP practices – are essential. Consult your doctor if this does not happen.

The team may also use a test called ABPI to check the blood flow of the arteries in the feet. This indicates the extent of damage to the blood vessels.

Circulation will be at its best when diabetes is well controlled. This means taking the optimal medication and regular blood tests. Keep cholesterol low and blood pressure normal to prevent further damage to the arteries.

Regular exercise is also crucial as it improves circulation – studies suggest it can improve circulation and blood vessel health by 20 percent. Regular bursts of relatively intense aerobic exercise are more beneficial than occasional prolonged episodes.

In the meantime, it may be worth investing in a pair of diabetes socks, which are specifically designed to keep feet warm and dry while slightly improving blood flow in the area.

I often suffer from unexplained hives – I expect them to be stress related. In recent weeks I have noticed that the tips of my fingers have become red and swollen. They are painful to the touch. Are the two issues linked and is there anything that can be done? I am a 44 year old woman.

Hives, also called urticaria, appear as an itchy, blotchy rash. Usually the problem is caused by contact with things you may be allergic to, such as food or pollen. It can also happen at certain temperatures. For example, some people get cold hives from the wind, while others have a heat-related problem that can crop up after eating spicy foods.

Hives often appear with other symptoms such as swelling of the hands, feet, and face. When this happens, doctors call it angioedema. The hives and swelling may feel burning.

Headaches, joint pain and swelling are not uncommon.

It’s not always clear what’s causing patients’ symptoms, but it’s a sign that the immune system is in overdrive — specifically, that mast cells are overactive.

These cells release the chemical histamine, which is responsible for the rash and swelling. Sometimes hives are associated with an autoimmune disease in which the body reacts to its own cells.

These types of conditions, such as rheumatoid arthritis, can also cause joint swelling and swollen fingers, so it is important that this combination of symptoms is investigated by a doctor.

Hives should be treated with daily antihistamines. Sometimes a doctor may advise taking a more frequent dose. Other medications include steroids and a drug called montelukast, but this is a short-term solution. In some severe cases, specialist rheumatologists may prescribe potent immunosuppressants.

Stress-related hives can be particularly troublesome. It results in a vicious cycle: the physical problem brings stress, which makes the hives worse. Any stress-relieving activity, such as exercise or relaxation methods, will help break the cycle.

I can’t sleep because I have constant breathing problems. Every night I have to get up for half an hour, drink a hot drink to breathe and then go back to bed. My doctor prescribed several nasal drops, without results. A consultant has confirmed that my nasal passages are clear. Is there anything you can suggest? i am 84.

If someone has trouble breathing at night, doctors usually recommend taking part in a special sleep study.

This includes monitoring breathing, oxygen levels, and heart rate throughout the night.

A GP can refer patients for this examination, which usually takes place in a hospital sleep clinic.

Difficulty breathing at night can be a problem called obstructive sleep apnea. Usually, parts of the airway, such as the trachea, narrow when you sleep with this condition, but it can also happen when the nasal passages or sinuses are blocked.

This is not always seen when a patient is examined. If you lie horizontally at night, the nasal passages may swell with fluid or become inflamed. You won’t necessarily get the same problem during the day if you stand up straight.

An easy way to tell if this is the case is to try sleeping with a pillow. It may also be worth trying a nasal dilator – these are soft, plastic devices that sit in the nose at night and increase airflow.

If the sleep study shows sleep apnea, it means you stop breathing at night. Patients are offered a treatment known as CPAP – a pressurized face mask that keeps the airways open at night and prevents them from collapsing.

Although the device looks pretty scary and takes some getting used to, many patients find it life-changing.

Refused the details of a loved one? let me know

Have you had any problems obtaining medical records?

I recently heard of a case where the son of a lady who died in a care home was told he couldn’t see his mother’s notes due to privacy. This seems crazy.

The privacy laws set by the General Data Protection Regulation (GDPR) prohibit companies and public entities from sharing any personal information about us that they may have. But it only applies to the living.

The son tried to find out what happened to his mother, as the circumstances – during the pandemic when visits were impossible – are not clear.

It is important for people to have access to this kind of information to understand what happened to loved ones. It is also a legal right.

The care home appears to be misinterpreting the law to block the son’s request, adding frustration and confusion to grief.

I would like to know if anyone else has been told not to see the medical records of a loved one who has passed away. Write me at DrEllie@mailonsunday.co.uk – I’d like to investigate.

People over 74 can still have a bowel test

Many readers got in touch with my comments about colon cancer screening last week – asking why the tests stop when you turn 74.

It seems like an arbitrary limit, but in fact it’s based on evidence showing that the tests are more likely to have false positives in older adults.

This means patients are likely to be told they have a problem when they don’t, causing unnecessary worry and pointless, invasive testing.

That said, anyone over the age of 74 can request a free screening kit by calling 0800 707 60 60.

It is crucial that you see your GP immediately if you notice any symptoms – blood in the toilet, bloating or a change in bowel habits.