Is my diabetes down to blood pressure pills?

QI HAVE recently been diagnosed with borderline diabetes, which was a surprise. I am 82, weigh 8st 10lb and am 5ft 3in tall and so not overweight. I am also very active and eat plenty of fresh fruit and vegetables. My blood pressure is slightly high and I take medication for this. Could this be causing my blood sugar abnormalities?

ABOTH doctors and patients have a picture in their mind of the typical person who develops type 2 diabetes and it is certainly not someone who has kept slim, eats well and stays active into old age.

The current epidemic of the illness is linked very strongly with expanding waist circumferences, lack of exercise and the poor diets many have.

However, while type 2 diabetes is mostly associated with those problems, we do see it in people who don’t fit that bill.

The chances of developing the condition increase with advancing age, and you are far more likely to have it if you have a first-degree relative with the condition.

It is also more common in those with high blood pressure and at least twice as likely in people of South Asian or African-Caribbean descent. So someone who has a combination of some or all of these risk factors can develop type 2 diabetes without fitting the usual stereotype.

If someone develops type 2 and is neither the typical profile nor has the other risk factors discussed, then a doctor should really consider what else could be going on.

This is especially important to rule out pancreatic cancer. Diabetes can be due to a deficiency of the hormone insulin which is produced by the pancreas. Side effects from medication should also be considered as possible causes of disease.

In general practice, we see a lot of symptoms that occur as a result of one medication or another, and this is a particular issue in our elderly population who are using multiple medications. Blood pressure tablets however do not commonly cause changes in blood sugar control.

QCAN I get my recommended amount of Vitamin D from the sun through the glass of a single-glazed window?

AVITAMIN D is a topic I hardly ever heard about at medical school, but now I talk about with patients most days. We commonly diagnose deficiencies in clinic and find sufferers have tiredness, muscle pains or muscle weakness, or bone pain in the back or legs.

Vitamin D helps us form and maintain healthy bones. It is particularly important for anyone growing – for example pregnant women and children. Recent research has suggested it aids a healthy immune system and may be protective against certain cancers.

Some experts now suggest it could be used to fortify food and so reduce the burden of disease. The food sources of Vitamin D are mainly limited to liver, eggs and oily fish so it can be difficult to get it through diet.

Public Health England recommends we get ten micrograms a day, and that people should consider taking a supplement to assure this.

The problem with Vitamin D is that it is made by the skin in response to sun exposure, specifically, UVB radiation (the same rays that burn the skin).

During the colder months, between October and April, very little UVB radiation will reach the UK, making the amount of Vitamin D anyone can produce pretty negligible.

Most glass used for windows blocks UVB, so you are unlikely to get redness or sunburn through a window and you are also not going to make Vitamin D. And be warned: glass does not block UVA rays that cause skin ageing.