I am a 48 year old who has had gout for about two years, I am treated with antiinflammatory pills, and now I have noticed that my toenails are starting to fall off. I have a strong family history of diabetes. Could I have diabetes?

Your family history of diabetes is enough to have your physician screen you with a fasting glucose level annually. Elevated uric acid levels, which cause gout, can be hereditary. They can also be related to insulin resistance.

Many activities can make gout worse. These include the use of some medications and alcohol. Anti-inflammatory medications are appropriate to treat gout, as it is the inflammation from the uric acid crystal deposition which initiates the pain. There are medications which can be used to prevent attacks before they begin. You need to speak with your physician about whether you would benefit from such a treatment strategy.

JTL