Heatwave Health Warning: How to Avoid Heat Stroke and Stay Safe in Hot Weather

Learn how to stay safe during hot weather, recognise the signs of heat exhaustion and heat stroke, protect vulnerable people and try refreshing cooling drink recipes.

As temperatures rise across the UK, health experts are urging people to take the risks of extreme heat seriously. While many of us welcome sunny weather, prolonged periods of high temperatures can lead to dehydration, heat exhaustion and, in severe cases, life-threatening heat stroke.

Older people, young children, pregnant women and those living with long-term health conditions are particularly vulnerable, but anyone can become seriously ill if they spend too long in the heat without taking precautions.

Understanding the Risks

When the body becomes too hot, it struggles to regulate its temperature. This can lead to heat exhaustion, which often causes symptoms such as:

Dizziness

Headaches

Excessive sweating

Muscle cramps

Feeling weak or tired

Nausea

If left untreated, heat exhaustion can develop into heat stroke, a medical emergency that can cause confusion, seizures, loss of consciousness and organ damage.

Seek urgent medical help if someone develops a high body temperature, stops sweating despite the heat, becomes confused, or loses consciousness.

Protect Yourself During Hot Weather

Simple steps can significantly reduce the risk of heat-related illness:

Drink plenty of water throughout the day.

Avoid excessive alcohol, which can contribute to dehydration.

Keep curtains and blinds closed during the hottest parts of the day.

Wear loose, light-coloured clothing.

Avoid strenuous activity between 11am and 3pm.

Use fans where possible and take cool showers.

Apply sunscreen regularly when outdoors.

Even if you do not feel thirsty, your body still needs fluids during hot weather.

Check on Vulnerable Friends, Neighbours and Relatives

A quick phone call or visit could make a real difference during a heatwave.

Make sure vulnerable people:

Have access to drinking water.

Are keeping their homes as cool as possible.

Have sufficient food and medication.

Know who to contact if they feel unwell.

Older people may not always recognise the signs of dehydration, making regular check-ins especially important.

Cooling Drinks to Help Beat the Heat

Citrus Mint Cooler

Ingredients:

500ml cold water

Juice of one lemon

Juice of one lime

Fresh mint leaves

Ice cubes

Mix together and serve chilled.

Berry Hydration Splash

Ingredients:

500ml cold water

Handful of strawberries

Handful of blueberries

Ice cubes

Lightly crush the fruit before adding it to the water for extra flavour.

Cucumber and Lemon Refresher

Ingredients:

1 litre cold water

Half a cucumber, sliced

One lemon, sliced

Ice cubes

Leave in the fridge for an hour before serving.

Homemade Electrolyte Drink

Ingredients:

500ml water

Juice of one orange

Pinch of salt

One teaspoon honey

This can help replace fluids and minerals lost through sweating.

Stay Cool, Stay Safe

Heatwaves are becoming more common in the UK, making it increasingly important to understand the risks and take sensible precautions. 

By staying hydrated, keeping cool and checking on vulnerable people around you, you can help ensure everyone remains safe during periods of extreme heat.

Enjoy the sunshine, but remember that when temperatures soar, looking after your health should always come first.

Please share this with anyone who you think would benefit from it.

Former top user of insulin tells his story of how weight loss changed it all

A man who used to be Britain’s highest individual user of insulin told delegates at a study day in Liverpool recently how specialist weight loss surgery transformed his life.

Michael Parker, 49, who weighed 34 stone and was plagued by ill-health, is among 200 people nationwide who have all undergone a complex weight loss procedure known as the duodenal switch.

40 duodenal switch patients gathered together for the first time at an event organised by leading weight loss surgery information charity WLSinfo to share their experiences.

Speakers at the event included leading surgeons, including Professor David Kerrigan, who pioneered the duodenal switch operation in the UK. Also attending were patients and dieticians.

“The study day was for anyone who has had or is thinking of having the duodenal switch operation,” said Ken Clare, founder of WLSinfo.

“As a charity, we have many members the length and breadth of the British Isles who have had this procedure. We felt it would be a great opportunity to bring them together to talk about their experience and for potential patients to find out more.”

Designed to help the seriously obese lose weight by making the stomach smaller and diverting the course of the food eaten, the duodenal switch procedure works by reducing the calories being absorbed by the body.

“Before surgery, I had to take 600 units of insulin a day – 12 times the average amount,” says Michael Parker, one of several duodenal switch patients scheduled to address the gathering,

“Since having the operation, I have lost 19 stone, no longer need insulin, my blood sugar levels are normal and my blood pressure is down. I do not have any symptoms of diabetes that plagued me for almost seven years.”

Also speaking at the event was Michael Parker’s surgeon Professor David Kerrigan, medical director of weight loss surgery specialists Gravitas.

An early pioneer of duodenal switch surgery in the UK, Professor Kerrigan is the surgeon who advised the UK government on the NICE obesity guidelines currently in use.

Over the last nine years, he has performed the duodenal switch procedure on over 150 patients, many of whom attended the event.

At the study day, Professor Kerrigan outlined the history of the operation, its results and describe how – for the right patient – the results can be excellent.

Also attending the event will be specialist dieticians who will speak on nutrition, blood monitoring and the importance of aftercare.

A new very healthy alternative to sugar? It's called Total Sweet

Sugar has been part of our diet for hundreds of years and remains a staple of our everyday lives. It has three main drawbacks however, which have caused many users to shift to sweeteners:
•Sweet, sugary foods and drinks have been linked to obesity; largely due to a high calorific and GI values
•Sugar causes dental decay and plaque
•Diabetes, especially type 2, is becoming increasingly common among the population and is linked to sugar consumption; so those living with diabetes or trying to avoid it are advised to steer clear of sugary foods and drinks.

There are now a range of different artificial sweeteners that have been created largely with the intention of creating a sweet substance with little or no calorific value

•There has however been a lot of bad press surrounding artificial sweeteners and possible links to cancer
•Whilst the cancer links are disputed, more recently claims have arisen suggesting that artificial sweeteners may actually be detrimental to dieting because they are so intensely sweet and are ‘non-nutritive’, increasing users appetites and food consumption
•Artificial sweeteners are difficult to bake with

An increasingly popular option in the face of the scares around ‘artificial’ sweeteners. Several fruit sugars have been launched, which are largely promoted on the grounds that they are natural. They also have a relatively low GI value compared to sucrose
•Fruit sugars are worse for your teeth than ordinary sugar
•Fructose has been linked to obesity as it is more readily laid down as fat than sugar
•Many of these sweeteners come in syrup form which is hard to replace sugar with in cooking
Fructose (Fruit Sugar) Alternatives
Sugar - fructose

Total Sweet is the world’s first ‘total sugar alternative’ and ticks all the boxes:
A solution for dieters that allows them to enjoy sweet food whilst encouraging weight loss
A natural alternative to sugar
A solution suitable for diabetics
An alternative that actively promotes healthy teeth
An option offering health benefits not health scares
Can be used exactly like sugar in baking or otherwise
It has no taste difference to ordinary sugar
A product that is good for the environment as well as your body
Total Sweet Introduction

Total Sweet is a ‘nutritive’ sugar alternative, that is to say it contains calories, but these calories are healthy calories (see below)
Total Sweet has 40% less calories than sugar and 75% less available carbohydrates BUT
Total Sweet is absorbed slowly and has a GI value of just 7, meaning it keeps you feeling fuller for longer, less likely to snack and therefore much more likely to lose weight
Studies have confirmed xylitol aids with weight loss:
A study published in the American Journal of Clinical Nutrition showed those who had 25g of xylitol, compared with nothing, glucose, fructose, or sucrose (sugar), ate 230 less calories at their next meal
This suppression of appetite was also observed in a study carried out at Leeds University and published in the British Journal of Nutrition showing those who ate yoghurts for breakfast that were sweetened with xylitol rather than sugar went on to eat 10% less for lunch

Weight Watchers have given xylitol a Pro Points value of “0”. This is because whilst xylitol contains calories they appreciate it can aid with weight loss

“We would rather people didn’t add sugar to what they eat, but xylitol used sensibly could reduce dependence on conventional sugars” Dr David Haslam – Chairman of the National Obesity Forum

An Effective Dieting Aid
A Natural Solution
Xylitol is derived from the Greek word ‘xyl’ meaning wood as it was first discovered in Birch Wood after the Second World War. Birch wood xylitol remains the highest quality xylitol
Xylitol is found in various plants and is even made by our own bodies
The xylitol used in Total Sweet is extracted from a sustainable source of European birch wood With a Great Taste
Total Sweet looks and tastes just like sugar ,has the same sweetness and can be used in just the same way as sugar

A Diabetic Solution
Around 3 million people in the UK are diabetic, 90% of these have type 2 diabetes
Cutting down on sugar intake is advised in the treatment of diabetes, an increasing number of Type 2 diabetes is being attributed to bad diets and being overweight (often due to too many sugary and fatty foods). Not only does Total Sweet provide a sugar alternative that has a very minimal impact on blood sugar levels – making it ideal for diabetics – it also allows type 2 diabetics to diet, but still enjoy sweet foods
Diabetes is often linked to poor dental health, making Total Sweet even more advisable
Total Sweet is recommended by many nutritionists, medical and diabetes experts

Actively promotes healthy teeth
Total Sweet doesn’t help teeth just because users cut out sugar, rather it actively prevents and reverses numerous dental conditions
It has been observed over several decades that xylitol produces an alkaline environment within the mouth – this is seen to dramatically reduce the number of Streptoccocus bacteria, which are the main cause of dental caries. The number of studies in this area now run into the hundreds
Further studies have now shown xylitol also has an ability to reduce plaque
Current studies are now showing that xylitol has an ability to remineralise damaged teeth
Xylitol is recommended by dentists around the world

Other health benefits
Xylitol can be used to help prevent ear infections
Studies have shown that xylitol reduces the adherence of thrush to cells and can not only reduce its numbers, but also the amount of carcinogenic chemicals it produces
Osteoporosis – studies have shown that xylitol can help strengthen bones – it is thought xylitol may help the body absorb more calcium

Easy to use
Total Sweet can be used exactly as sugar (except in bread as it can’t feed yeast)
In can be used to replace sugar, like for like, in any recipes
It is used by top chefs
It can be used in hot drinks or sprinkled over fruit or cereals just like sugar

Healthy for the planet
Total Sweet is made from sustainable birch wood from Finland not to be confused with lower quality Chinese corn sourced xylitol
For every tree used two are planted in its place
Uses a recyclable, reseable pouch
Through ‘Trees For The Future’ they have planted over 50,000 trees in third world countries to date

To learn more visit them at www.totalsweet.co.uk.

Testing... Testing...

When times change, we must change with them. Now we have easy to use, portable blood test machines to help us control our diabetes. But more than the actual mechanics of just doing a test, there is little point unless we know what to do with the information you gain as a result.

It can be hard to remember sometimes, but you are more than just a number! With the arrival of the capacity for people with diabetes to do daily blood testing, it might seem that you spend your life looking at little screens with numbers on that seem to judge you on a small but often stressful way.

Be in no doubt, the ability to do your own tests (to self-monitor your blood glucose levels) is a very important tool in your own self-management. But as machines get cleverer and do more things for you, it's possible to feel a little left behind. More to the point, if all you see are 'bad numbers', then it's very hard to keep up the motivation to keep testing.

Not all diabetics are encouraged to test, but there are some clear guidelines laid down. Put simply, diabetics on insulin should be testing daily, while Type 2 diabetics need not test unless they want to or there is a good reason for them to do so. Some people are encouraged not to test, and I even hear stories about (and have experienced myself) doctors suggesting that someone with diabetes reduce how often they test order to save the NHS some money.

In March 2010 NHS Diabetes published a report on self-monitoring of blood glucose (SMBG) for people with Type 2 diabetes which stated, "The data from clinical trials show that in patients treated by lifestyle modification or oral agents, SMBG with appropriate education and clear objectives leads to an improvement in blood glucose control. The improvements in blood glucose control when SMBG is used without education and clear objectives are so small as to be of doubtful clinical benefit."

In keeping with the recommendations contained within NICE Clinical Guideline, it was suggested that SMBG should only be provided routinely to people with Type 2 diabetes not treated with insulin or sulphonylureas (pill meditation such as Metformin) where there is an agreed purpose or goal to testing and that "Individuals with non-insulin treated diabetes who are motivated by SMBG activity and use the information to maximise the effect of lifestyle and medication should be encouraged to continue to monitor."

NICE also recommended that people with Type 2 diabetes should expect to have their long-term glucose control checked every 2-6 months - this HbA1c result will give an indication of the overall blood glucose level over previous months [see additional info on HbA1c on p.11].

The report also acknowledged that patients should be shown how to interpret their results and how to use these results to make any appropriate lifestyle changes, "This has the potential to improve both the quality and the efficiency of blood glucose self-monitoring." By Sue Marshal.

Dr William Polonksy was the principal investigator of the Structured Testing Program study (STeP) the results of which were published in February 2011 in Diabetes Care.

He comments, "The HbA1c has been perceived as the gold standard for monitoring glycaemic control for a long time, but it does not provide information about the peaks and troughs in blood glucose levels during the day."

The STeP study used 12 months of data based on using SMBG (the self-monitoring of blood glucose), which is an established part of therapy for diabetics on insulin but in this case was applied to people with Type 2 not on insulin (but who may have been on other medications). They were asked to test several times a day for three days only. Then they repeated this activity each month, with a review with their doctor of the results every three months.

ONE STEP AHEAD "Diabetes and its resulting secondary complications are a significant and growing burden on individuals, society and national healthcare system," says Polonsky, "At the same time, healthcare budgets for individual care are being continually eroded. We must therefore redefine our strategies for management diabetes and use the available resources more effectively."

He points out that one of the best ways is more blood testing with well-designed data capture, "Blood glucose data should provide immediate feedback about the effects of food choices, activity, and medication on glycaemic control. It is crucial for people with diabetes to understand the close link between their lifestyles and behaviour and their metabolic responses. Most of the participants in the STeP study agreed that seeing how their behaviour actually affected their blood sugars motivated them to take on more responsibility for their condition and to change their lifestyle."

The other side of the fence is the experience of the healthcare professionals (HCPs, whether doctors or nurses). It's known that 90% of doctors do not download blood test data. Clearly, blood testing needs to be easy to do and to review, for both patients and HCPs. The STeP study showed that most of the physicians welcomed these changes in patient behaviour and found that their patients were more willing to participate in managing their condition. Says Polonsky, "As patients became more acquainted with using the meters they found that the tool actually reduced consultation time. Most of the physicians found that the detailed profiles gave them a better sense of how and what medication to prescribe."

Dr Satish Garg, also involved in the study, notes that, "the global diabetes epidemic requires immediate action. At present, some 50% of those people currently diagnosed with Type 2 diabetes fail to effectively manage their blood glucose levels. Looking at HbA1c is not enough as it shows only long-term glycaemic control over three months and doesn't reflect the important daily (and hourly) fluctuations.

It does not demonstrate to people with diabetes when and they their blood glucose values rise or fall, and it does not tell them how to react in order to correct them." For the healthcare system he says, "Structured SMBG also gives healthcare professionals the accurate data they need to recommend effective therapy changes.

Whereas a high HbA1c value merely indicates that a change in therapy is needed, structured SMBG instructs HCPs exactly what changes to make." Lat est result s Speaking on behalf of Roche, which sponsored the study, Franz Walt says, "For the patient, the focus must be on individual diabetes management; for the doctor, on the effective therapy management based on accurate information and data.

“Taking responsibility for their own therapy is a cornerstone in modern diabetes therapy, and blood glucose values obtained by the patient according to the structured testing concept form the foundation for the essential and information doctor-patient dialogue." Being able to discuss data might also help you address what could be termed 'clinical inertia' - when it's agreed, 'let's not do anything at the moment'. It's not just the testing, but the quality of what you DO with it.

If you can see the impact of behaviour or medication on your blood test results then you're more likely to keep to the programme.

LIVING › seeing how their behaviour actually affected their blood sugars motivated them to take on more responsibility for their condition and to change their lifestyle Dr. W. Polonsky There are two issues regarding blood testing for people with type 2 diabetes.

First is access to strips on prescription.

Because strips are seen as costly, and with the NHS facing cuts (as always), strips for Type 2s have been targeted as a way of cutting back. That means that people who want to test are being held back from doing so.

Second is a bizarre belief that because blood testing can be unpleasant (apparently) and that people might find it hard to do, that they need not bother.

OK, so not many people WANT to stab themselves in the finger, no matter what the reason, so Type 2s can be forgiven for not 'wanting' to, but that does not mean that they shouldn't.

There's several pharmaceutical companies looking to help Type 2s test more, and a few online pharmacies that have spotted the trend who are offering simple, cost-effective meters and strips so that you can buy them if you want them and forego the hassle of dealing with an unyielding GP.

Among the many blood test meters out there, some are aimed at those with Type 2 diabetes with some added features for those who test infrequently or who do not have to use carb-counting to help control their condition.

For example, the OneTouch VITA from Lifescan (http://bit.ly/Lifescan_Vita) can help users link the effects of food to their blood glucose level. It is particularly recommended for Type 2 diabetics on insulin as it can also help to show how food choices affect their blood glucose levels. Increased awareness of this on the part of the patient should lead to greater control of their diabetes.

Among the meters and strips that are more easily available online are those for the Wavesense Jazz (www.arcticmedical.co.uk) and IME-DC meter (http://bit.ly/Desang_IME-DC). Other meters are widely available from chemists - you can chat to your pharmacist about costs per pot of sensors. A very rough guide is about 70p per strip. Yes, that adds up if you're testing five times a day, seven days a week - that's two pots of 25 strips every two weeks. But if you're testing once a day for three days a week, then you might think it a seriously good investment in your longterm health.

● People don't blood test because they (often understandably) don't see the point of doing it. As Polonsky explains the results, "We not only saw improvements in blood glucose control but in well-being too. Those who tested understood the numbers, felt their interaction with their GP was useful and generally felt less stressed about having diabetes. They could perceive the usefulness of treatment as they saw evidence that the changes were making a difference." That's the point.

● CONTRIBUTORS

Dr. William Polonsky, Associate Clinical Professor in Psychiatry, University of California. Author of Diabetes Burnout: What to do when you can't take it anymore. Founder of the Behavioral Diabetes Institute www.behavioraldiabetes.org STeP study was sponsored by Roche and utilised the Accu-Chek 360 view tool.

Dr. Satish Garg, Professor of Medicine and Paediatrics, Young Adult Clinic Barbara Davis Centre for Diabetes, University of Colorado School of Medicine. Editor-in-chief of Diabetes Technology and Therapeutics.