Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

For this article, I concentrate on the most common type of eczema, atopic eczema. However, the treatment of atopic and non-atopic eczema is similar. The Greek word atopy means “out of place” and describes the group of disorders including eczema, asthma and allergic rhinitis and which are genetically linked. Triggers include specific allergies to foods, overheating, secondary infection, wool next to the skin, cat and dog fur, soaps, detergents, house dust mites and pollen.  Extreme hot and cold, humidity, and hormonal changes in women (caused by the menstrual cycle and pregnancy) can also cause flare-ups.

Prevention

Initial approach to treatment of atopic eczema involves the avoidance of exacerbating factors and hydrating the skin. Exacerbating factors include excessive bathing, low humidity environments, dry skin, exposure to solvents and detergents and emotional stress. A sleeping environment with minimal dust and upholstery reduces house dust mites and can reduce the severity of eczema.

Diet

In adults, food allergies do not appear to be a factor in eczema according to studies. In infants, avoidance of certain foods can help. Food triggers include eggs, nuts, peanut butter, chocolate, milk, seafoods, and soya.

Maintaining adequate skin hydration

Skin hydration is a key component of their overall management. Lotions, which have a high water and low oil content, can worsen dry skin via evaporation and trigger a flare up. However, thick creams (eg, Eucerin^®, Diprobase^®) which have a low water content, or ointments (eg, petroleum jelly, Emulsifying Ointment), which have zero water content will better protect against dry skin.

A study in infants with atopic dermatitis who required topical steroids (see more details next week) found that infants treated with emollients had significantly decreased requirements for topical steroids (prescription only creams and ointments) compared with the group of infants not treated with emollients.  Emollients are best applied immediately after bathing when skin is well hydrated. Hydration can be improved by soaking in a bath containing a bath additive such as Oilatum^® for 10 to 20 minutes. Bath additives leave the skin and bath very slippy so take particular care when bathing.

Urea

Urea is a hydrating agent found in many emollients sold over the counter in pharmacies including Calmurid^® and Eucerin^® cream. Urea is strongly hygroscopic (water-loving) and draws and retains water within skin cells. Urea softens the skin. Urea can be beneficial in dry skin conditions where scaling and flaking occur. Whelehans Intensive Moisturising Cream was developed by our pharmacist because brands such as Calmurid^® Cream, while effective, are very expensive. Our cream contains 10% urea and is over half the price of brands such as Calmurid^® Cream.

Itch

Efficacy of preparations containing crotamiton (Eurax^®) for itch is uncertain so are best avoided in Eczema. Similarly, calamine lotion is best avoided. Oral antihistamines are widely used for itch in patients with atopic eczema. Sedating antihistamines appear to be most affective. Chlorphenamine (Piriton^®) is the only sedating antihistamine available over the counter in Ireland. Although not as effective as sedating antihistamines, non-sedating antihistamines such as cetirizine (Zirtek^®, Cetrine^®) and loratadine (Clarityn^®, Lorat^®) can be useful where sedation will be an issue. Thry are available over the counter in pharmacies. Tepid baths to hydrate and cool the skin can also temporarily relieve itching.

Free Eczema skincare consultation at our Eczema Clinic

Whelehans Pharmacy offer free Eczema skincare consultations at our Eczema Clinic on Saturday July 16^th with skincare expert Trish Wallace. Learn how to reduce redness and irritation and how to reduce frequency of flare-ups. Whelehans offer a range of effective products that give clearer skin in a safe and effective way without the need for stronger and potentially damaging prescription medicines like steroid creams. Book your free appointment; call Whelehans at 04493 34591.

Type 2 Diabetes: Risk Factors, Diagnosis and Myths

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

This is the last of three articles in the Examiner on Diabetes

Risk Factors

The more risk factors that apply to you, the greater your risk of having diabetes. Risk factors are:

Your age

Risk of diabetes increases if over 40 or you’re over 25 and Afro-Caribbean, Asian or from a minority ethnic group. The risk also rises with age.

Your family and ethnicity

Having diabetes in the family increases risk. The closer the relative is, the greater the risk. So if your mother or father has diabetes, rather than your aunt or uncle, it’s more likely you will develop the condition too. People of Afro-Caribbean or South Asian origin are at least five times more likely to develop diabetes.

Your weight

Over 80 per cent of people diagnosed with Type 2 diabetes are overweight. The more overweight and the more inactive you are the greater your risk.

Your waist

Women – if your waist measures 31.5in (80cm) or more you’ve got an increased risk.
Men – if your waist is 37in (94cm) or more means increased risk of developing diabetes

The other risk factors

If you’ve been diagnosed with any problems with your circulation, had a heart attack or stroke, or if you’ve got high blood pressure you may be at an increased risk of diabetes. Pregnant women can develop a temporary type of diabetes; this is known as gestational diabetes.  Having this – or giving birth to a large baby – can increase the risk of a woman going on to develop diabetes in the future. Women with polycystic ovary syndrome who are overweight are at an increased risk of developing diabetes. If you’ve been told you have either impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT) it means the level of glucose (sugar) in your blood is higher than normal but you don’t have diabetes and you should follow a healthy diet, lose weight (if needed) and keep active to help prevent diabetes. But make sure you’re regularly tested for diabetes. Certain antipsychotic medicines such as olanzapine used for certain mental health conditions (eg. Schizophrenia) can increase diabetes risk.

Diagnosis

People without diabetes have fasting blood glucose no higher than 6.0 mmol/l; after a meal blood glucose does not exceed 7.8 mmol/l. If fasting blood glucose is 7.0 mmol/l or above, and /or it rises to more than 11.1 mmol/l after a meal, you could be diabetic. A further blood test called a HbA1c can then be used to monitor diabetes control over a three-month period.

Myths about diabetes

There are myths about diabetes which are not true. For example, you cannot catch diabetes from someone. You can eat sweets and chocolates if you are diabetic (moderation and a balanced diet is the key). You can drink alcohol if you are diabetic (again moderation is key, no more than two or three units per day and definitely no binge drinking). Eating too much sugar does not cause diabetes (there are many other factors such as genetic factors, excess weight). There is no need to eat “special” diabetic foods (a healthy and balanced low fat diet is fine). People with diabetes are no more likely to catch colds or other illnesses. Insulin does not cause weight gain.

Free Diabetes Talk and information event See Resources Here 

Whelehans Pharmacy is hosting a free talk on Diabetes this week (Thursday May 30^th) at 7pm in the Greville Arms Hotel. Pharmacist Eamonn Brady will speak about the medication used with Diabetes while experts including local HSE dieticians, eye screening specialists and other professionals will discuss diabetes management as well as experts from Diabetes Ireland. There will be free foot checks, diabetes checks and alot more. This is expected to be a popular event so we advise booking in advance by calling Whelehans at 04493 34591 or e-mail info@whelehans or message us on facebook.

Free Diabetes Test

Whelehans provide free Diabetes checks in store, no appointment is needed so simply call in for your two minute simple finger prick glucose test today (or any day) for your quick and free check.

To be continued....next week I will discuss more about diabetes

Disclaimer: Consult your healthcare professional before making any changes recommended. Whelehans Diabetes Check is not a substitute for your full assessment by your GP

Eamonn Brady is a pharmacist and the owner of Whelehans Pharmacy, Pearse St, Mullingar. If you have any health questions e-mail them to info@whelehans.ie

Last week I discussed types, symptoms, risks and complications of diabetes; this week I summarise treatment options.

Diabetes treatment

Aim of treatment

The aim of diabetes treatment is to do what your body once did automatically which is to mimic the insulin pattern you had before diabetes and to keep blood sugar under control.

Treatment of Type 1 Diabetes

There is no cure for type 1 diabetes but it can be kept under control. Type 1 diabetes is controlled by giving your body insulin. This allows glucose to be absorbed into cells and converted into energy, stopping it building up in the blood.

You may use one or more types of insulin depending on the control required. You may be on a combination of slow, medium and fast acting insulin. Modern insulin such as Lantus^® provide far better control than older types, meaning less injections and less chance of hypoglycaemic attacks (ie) dangerous low blood sugar.

There are two main methods of taking insulin.

• Insulin injections are the most common form of treatment, where insulin administration is by subcutaneous injection which means injecting under the skin (usually in the stomach). You will usually give these to yourself two to four times a day, using a pen-type syringe with refillable cartridges.
• Portable insulin pumps may be used if control of blood glucose with regular injections is difficult. Insulin pumps can be programmed to inject insulin at a rate that you can control.

Treatment of type 2 diabetes

Many people with type 2 diabetes can manage to control their condition simply by changing their lifestyle (eg) managing diet better, more exercise.

Medicines                                                                                                                            

If lifestyle changes alone don't reduce your glucose levels, you may be prescribed medicines to increase insulin production and strengthen its effect.

Examples include:

• Metformin improves the effectiveness of insulin by reducing the amount of glucose released from the liver and improving the way glucose is used by muscles. It causes less weight gain than other diabetic medication.
• Sulphonylureas encourage your pancreas to produce more insulin, and include gliclazide (Diamicron).
• DPP-4 inhibitors, such as sitagliptin (Januvia), help your body to produce more insulin in response to meals. They don't cause weight gain and only rarely cause hypos (low blood sugar). They are usually used in combination with metformin or sulphonylureas.
• Thiazolidine-diones reduce body's resistance to insulin and are sometimes used with metformin and sulphonylureas if other standard treatments aren't working or aren't tolerated. An example is pioglitazone (Actos). They are used less often nowadays due to increased risk of heart problems. Rosiglitazone (Avandia) was taken off the market a few years ago due to heart risk.
• Acarbose (Glucobay) lowers blood glucose by slowing the breakdown of some carbohydrates. It is rarely used nowadays due to gastrointestinal side effects such as flatulence, nausea, vomiting and stomach pain.

Two or more of the medicines listed here can be given in combination as they may give better control than one on its own. All diabetics, regardless of means, are entitled to all medication related to diabetes for free in Ireland under the Long Term Illness Scheme (including heart related meds)

Free Diabetes Talk and information event

Whelehans Pharmacy is hosting a free talk on Diabetes on Thursday May 30^th at 7pm in the Greville Arms Hotel. Pharmacist Eamonn Brady will speak about the medication used with Diabetes while experts including local HSE dieticians, eye screening specialists and other professionals will discuss diabetes management as well as experts from Diabetes Ireland. There will be free foot checks, diabetes checks and alot more. This is expected to be a popular event so we advise booking in advance by calling Whelehans at 04493 34591 or e-mail info@whelehans or message us on facebook.

Free Diabetes Test

Whelehans provide free Diabetes checks in store, no appointment is needed so simply call in for your two minute simple finger prick glucose test today (or any day) for your quick and free check.

To be continued....next week I will discuss more about diabetes

Disclaimer: Consult your healthcare professional before making any changes recommended. Whelehans Diabetes Check is not a substitute for your full assessment by your GP

Next week, June 13^th to June 19^th, is Men’s Health Week, this International Initiative raises awareness of men’s health issues. With the Euro’s starting this week, the theme this year is “Men United-for Health and Wellbeing”. Pharmacist Eamonn Brady of Whelehans Pharmacy, explains the fact that “men in general do not take as much interest in their health as women is one of the major reasons men die younger than women as proven by men’s lower life expectancy statistics”

What are the aims of Men’s Health Week?

• Heighten awareness of preventable health problems for males of all ages.
• Support men and boys to engage in healthier lifestyle choices / activities.
• Encourage the early detection and treatment of health difficulties in males

Boys…Don’t make a balls of your Health!

The Whelehans Pharmacy theme for their men’s health initiative this year is “Boys…don’t make a balls of your health” with their focus this year on testicular cancer. Pharmacist Eamonn Brady explains “while our slogan is a little tongue in cheek, it has a serious message. We hope our message will highlight the risk of testicular cancer in men. A sad fact is that while 1 in 4 women are diagnosed with cancer in their lifetime; the rate for men is 1 in 3. It is time for men to take their health seriously”. Eamonn explains “evidence shows that men are 70% less likely than women to visit their GP or get a medical checkup when something is wrong. Men will get their car serviced annually, but many will not get the more important checkup, a checkup from their GP”. Testicular cancer is one of the most common cancers in men and rates have doubled since the 1970s. Simple regular self-checks can detect potential problems early and will save lives.

How to self-check for testicular cancer

Pharmacist Eamonn Brady explains “Most testicular cancers are found by men themselves or their partner, very few are found by a doctor. This is why it is so important to be familiar with what is normal and if you do notice any changes then see a doctor immediately.” All men should to a monthly check. The check only takes a minute. Best practice is to “hold your penis out of the way and check one testicle at a time. Hold the testicle between your thumbs and fingers of both hands and roll it gently between your fingers. Look and feel for any hard lumps or smooth rounded bumps or any change in the size, shape, or consistency of the testicles” 

Boys…now is the time to get a check up

To highlight this problem, Whelehans are holding reduced price health checkups this Thursday June 16^th and Friday June 17^th for men only to encourage men take the first step and get their health checked. “Men Checkups” available in Whelehans this week includes Blood Pressure, Cholesterol, Diabetes and Haemoglobin Checks. Whelehans are offering these four checks at a discounted price of only €15. Ann McNelis from Whelehans Pharmacy explains “men die younger from heart related conditions than women so our health check initiative this week is all heart related, hence BP, cholesterol and diabetes checks”. While it is important that men then go to their GP to get a full checkup; Whelehans hope that their checks may be the first step for many. If there is a health issue bugging you, this could be a chance to discuss it with a pharmacist. Staff of Whelehans will have fun events and goodies and vouchers for all men who call in on June 16^th and 17^th, so while the message is serious checkups don’t have to be daunting. Your check up only takes 30 minutes and involves a single finger prick (so no big needles!!). So ladies, get your men down to Whelehans this week. There is no excuse!! Call Whelehans at 04493 34591 to book our check www.whelehans.ie  or like us on facebook

For more information on Men’s Health Intiative check out www.mhfi.org