Your health

Got a medical problem or need health advice? ask GP Dr Rosemary leonard

THIS MONTH… The foods to avoid for prediabetes Can drinking coffee prevent rosacea? Losing the strings to a Mirena coil

QI recently had an NHS health check and was told I was prediabetic. I’ve been referred for some lifestyle advice, but meanwhile, do I need to follow a special diet? And what about checking my blood sugar levels?

Ablood sugar levels can vary enormously during the day, especially before and after meals, and doctors now know that it is your average blood sugar that is really important, measured by checking the level of glycated haemoglobin (Hba1c), which is made when glucose sticks to your red blood cells. the higher the glucose level in the blood, the higher the level of glycated haemoglobin. Red blood cells last for two to three months, so levels are taken quarterly. a level of 6.5mmol/l or over means you have diabetes. a level between 6 and 6.4 means you have prediabetes, and that blood sugar levels are higher than they should be. Most people with prediabetes are overweight, so the best way of preventing diabetes developing is to lose weight – by a combination of diet and exercise. Cut out all foods high in sugar, and cut down on fatty foods that are high in calories. Don’t try to crash-diet – lose weight steadily on a healthy eating regime that you can stick to long-term.

QI’ve had rosacea for several years, and despite taking antibiotics, my cheeks still look red a lot of the time. I avoid drinking too much coffee, but I recently read that it was good for rosacea. Is this true? Is there anything new I could try?

ARosacea is a skin condition that causes facial flushing, spots and redness similar to sunburn. It is sometimes mistaken for acne and affects around 10% of people, mainly in middle age. the cause isn’t known but the underlying problem is inflammation in the skin, linked to sun damage, genes, or a tiny mite called Demodex folliculorum, which normally lives harmlessly on the skin. Eating spicy foods and drinking alcohol can make symptoms worse, and caffeine is also often on this list. Recent research, done in the us, has suggested that women who drank four or more cups of coffee a day were less likely to develop rosacea, but unfortunately there is no evidence that coffee is good for treating rosacea. standard treatment is either antibiotics, taken by mouth, or metronidazole gel, applied to the face, but more recently, cream containing ivermectin has been found to be very effective. It appears to have an anti-inflammatory action and can reduce the number of Demodex mites. It is available on prescription. w&h