DEAR DR. DONOHUE: Today I was diagnosed with diabetes. My blood sugar was 294 (16.3), and it should be less than 100 (5.6). The doctor said I don’t need treatment yet but I should avoid fast food and sugar.

I would like to have a diet that tells me what I can eat and what I should avoid. I am also interested in checking my own blood sugar (glucose). How can I do that?

What is your opinion of my not needing treatment or a diet? – B.M.

ANSWER:
You do have diabetes – type 2 diabetes, the kind where your pancreas still makes some insulin, the hormone that allows blood sugar to enter body cells, but your insulin doesn’t work so well. Sugar remains in the blood and the level rises. A normal blood sugar, after eight hours of not eating, should be less than 100 mg/dL (5.6 mmol/L). If blood sugar is 126 (7) or higher, the person has diabetes. Values in between indicate prediabetes.

If your blood-sugar test was taken without fasting, the value should be less than 200 (11.1). There’s not much doubt that you have diabetes. Treatment of diabetes requires a change in diet, an increase in activity and, most often, medicines – sometimes insulin.

You’ve got to get moving. Even a half-hour daily walk will bring your sugar down. You have to lose weight if you’re overweight.

As little as a 10-pound weight loss can improve your blood sugar greatly. The proper diabetes diet is based on how many calories are carbohydrate calories, how many are protein calories and how many are fat.

Of the total daily calories, 50 percent to 55 percent should be carbohydrates, no more than 30 percent should be fat and the rest should be protein. You cannot master the diet on your own. You need instruction. Your doctor, a dietitian or a certified diabetes instructor can guide you through the diet. The local hospital can help you find one. It takes more than one session to master.

If a trial of diet and exercise don’t bring your sugar down, then you’ll need medicine.You can buy a blood-sugar monitor at just about any drugstore. Bug your doctor for some help. If you don’t get it, find a new doctor.

The diabetes report explains this illness in detail. To receive a copy, write: Dr. Donohue – No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address.

Please allow four weeks for delivery.

DEAR DR. DONOHUE: More than 20 years ago, my husband was struck by a car, and his right leg was shattered.

He had surgery and an exterior fixator for several months. In the next two years, he had further surgery, braces, casts and rehabilitation. The sites where the fixator pins were have broken open and seep.

He has a staph infection. The infection specialist says to put a bandage on it. It’s very difficult to accept this opinion. Is that the only answer? – J.F.

ANSWER:
It’s difficult for me to accept that opinion too. Even if your husband has a staph germ that resists many antibiotics, there are still a few antibiotics that can successfully treat such a germ.

Treatment might be prolonged and might require intravenous infusion of the antibiotic.

If your husband has any metallic screws or plates in his leg, they might have to be removed.

I’d seek two separate opinions – one from an orthopedic surgeon and one from a different infectious-disease specialist.

DEAR DR. DONOHUE: I have pain in my right buttock. It’s worse when I sit. My neighbor is a physical therapist and says it could be piriformis syndrome. Can you expand on that for me, and what I can do for it? – H.H.

ANSWER: The piriformis muscle is one of the buttock muscles. In some people, the sciatic nerve runs through it. Spasms of the muscle compress the nerve and cause pain at midbuttock level.

The usual treatments for muscle-caused pain apply here. Soaking in a tub of warm water relaxes the muscle. The standard anti-inflammatory medicines, like Aleve, can lessen pain. Stretching the muscle is effective treatment. Sit on the floor with your legs straight out in front of you.

If you want, rest your back against a chair. Bend your right knee and place the sole of your right foot on the floor outside of your left knee. The right knee is bent at a 90 degree angle. Push the right knee gently a bit farther to the left.

When you feel a stretch in your buttock muscles, hold that position for 20 seconds, then repeat five times. Don’t continue if this is painful, and if it doesn’t work, see your family doctor for confirmation of the diagnosis.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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