Dr Thomas Stuttaford's next online forum (live on February 6, after 1pm) is: How to cope with food intolerance and allergies? To ask the doctor your question on this topic and to read other recent topics he has answered click here

Q1: I am a 42 year old female, and I have been diabetic for almost 15 years. Within the last year I have had pains in my lower legs, and occasional cramps when I walk uphill. My practice nurse did a "dopper" test I believe, which revealed that the blood pressure in my leg was higher than my general blood pressure. The nurse then booked an appointment for me to see my GP, who subsequently dismissed the pains as nothing to worry about since my age was on my side and my weight, my HbA1c and my cholesterol level was satisfactory. I don't smoke and I have had three healthy children (10, 8 and 5 yrs) and no problems since diagnosis. Is there any form of screening that would be useful for me? Name and address withheld.

A1: Only the reader's doctor will be fully conversant with the patient's history so it is his or her opinion that is obviously the one to be relied upon. We can only talk in general terms.

It is wonderful to see how well the reader's diabetes is being controlled so that the HbA1c, a measure of how high and low the blood glucose level has been over the last month or two, remains at acceptable levels and her cholesterol readings are satisfactory. Even so after fifteen years of diabetes any patient's likelihood to develop complications, especially vascular ones, is increased. Peripheral arterial disease both of the larger and smaller arteries is common even if not always expected. It is therefore important to check the cardiovascular system, especially the coronary arteries, the arteries in the neck leading to the brain, and the main artery of the body, the aorta regularly. In men one of the first signs of arterial disease is increasing impotence and in both sexes intermittent claudication is another warning. Intermittent claudication is pain in the legs when taking brisk exercise, particularly in cold weather or when climbing a hill. One of the characteristics of the pain is that it disappears as soon as the patient stops for a moment or two. As peripheral arterial disease is rather surprisingly an even more important warning symptom of trouble ahead it is important to exclude more generalised arterial disease if there is any suggestion of it. Relatively expensive tests are available that give the doctors a view of all the relevant arteries in the body. This involves CT scanning and so there is a small dose of radiation to be taken into consideration. This may not be available on the NHS but can be obtained privately. I sent my patients to the Euro Scanning Centre or Prescan, both in Harley Street. Any patient who wanted this would be well advised to discuss it with their GP.

It is important that the serum fats, not only the overall cholesterol but the amount of the good cholesterol - the HDL the amount of the pernicious cholesterol - the LDL, and the blood levels of the triglycerides should all be measured every time. Obviously blood sugars must be estimated regularly and the HbA1c. Blood tests to estimate glucose levels is more efficient than merely testing the urine.

When blood tests are done routinely it is now common practice to include the eGFR a kidney function test. Routine urine tests will also look for micro albuminaria as well as the sugar, kidney problems are a common complication in diabetic patients. Eyes should be examined annually, I always found it very useful to have photographs of the retina taken so that changes in the retina can be compared. Naturally patients with diabetes will need their blood pressure more often monitored than patients without it and likewise their weight should be checked regularly. The skin should be looked at to see there is no evidence of persistent infection and any signs of sores, especially between the toes, should be excluded.

Q2: Can diabetics be organ donors? Name and address withheld.

A2: This will depend on the state of health of the patient, the organ that is needed and how great the need for the organ is. Is this, for example, a rare cross-match so that any organ might be better than no organ? Every area has someone who controls organ donorship and the reader's GP will probably know which hospital she or he works from.

Q3: When can I expect my son, aged 30, to be cured of his Type 1 diabetes? John O'Donnell.

A3: Diabetes Type 1 is an autoimmune disease that results in the complete destruction of the Islets of Langerhan in the pancreas. For several years means of transplanting pancreatic tissue have been investigated but achieving good transplants of pancreatic tissue have been more difficult than was expected. There have been advances but this is proving to be a harder nut to crack than was supposed. It is impossible to give any date when pancreatic transplants will be routine but I would have expected it to have been reached within the next fifteen years or so. In the meanwhile the treatment of diabetes improves every day even though it is a matter of living with diabetes rather than getting rid of it.

Q4: My father has just been diagnosed with diabetes Type 2 at the ripe old age of 85. He isn’t overweight, eats properly and exercises every day. My husband also had diabetes Type 2 but died at the age of 48. My mother asked if he used to have bad breath, but I can’t say I ever smelt anything. She says my father does and is it a symptom of diabetes? Also she is finding it very difficult to adjust their eating habits as they already eat healthily anyway, can you help please? Vicky O’Dowd, Felixstowe.