DEAR DR. DONOHUE: For at least two weeks I have been taking my blood sugar three times a day. It has been above 200 (11.1) and 300 (16.7). My mom and I really want to know how to get my sugar down. My mom told me to get off sugar. What else can I do? — M.S.

ANSWER: To get your blood sugar down and to keep it down, you must see a doctor. Your blood sugar readings indicate that you have diabetes. That’s an illness you can’t handle on your own. You need the help of a doctor, a dietitian, a diabetes educator and perhaps others. You have to receive specific instructions on how to change your diet and what medicines to take. There is no other way to handle diabetes.

You didn’t say how old you are or how you are getting your blood sugar checked. I presume you’re an adult. If I am correct about your age, you most likely have type 2 diabetes, the kind that commonly occurs in adult life. The complications of untreated diabetes include heart attacks, strokes, loss of sight, kidney failure and peripheral artery disease. I’m not trying to scare you. I am trying to prod you into action for treatment of this illness.

Do you have to urinate frequently? That’s one sign of uncontrolled blood sugar. Constant thirst is another. And a third sign is losing weight in the face of eating the same amounts of food you usually do.

You have to go on a diet that takes into account the amount of carbohydrates (sugar and starches) you eat. If you’re overweight, you must diet to reach your ideal body weight.

Oral medicines often can regulate the blood sugar of type 2 diabetes. If the oral medicines don’t bring it down, then insulin injections will. All people cringe when they hear “injections.” These are not painful. They’re made with very fine needles that have to penetrate only under the skin. Get into a program right away.

The booklet on diabetes explains the different kinds and their treatment. Readers can order a copy by writing: Dr. Donohue — No. 402, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My wife’s osteoporosis has gotten progressively worse in the past year. She refuses to go to a doctor on the grounds that it cannot be cured. She is currently suffering. She has been reduced to using a cane to get around. We are both in our late 70s. — J.R.

ANSWER: Your wife has too pessimistic a view of osteoporosis. It isn’t curable. Many illnesses aren’t. However, it is treatable.

Treatment medicines include drugs called bisphosphonates; Fosamax, Boniva and Reclast are three names. The schedule for taking these medicines varies from daily to weekly to monthly to yearly. These medicines stop bone breakdown.

Forteo, an injection medicine, and Prolia, a new osteoporosis remedy, are other possibilities. She should be taking 800 IU of vitamin D and 1,200 mg of calcium daily. And she needs to be getting some exercise, like walking. Not doing anything makes matters worse.

(You mentioned another problem, but didn’t say what it was.)

DEAR DR. DONOHUE: Please find room for this small question.

Is vitamin B-12 as helpful in tablet form as it is from shots? — B.D.

ANSWER: If people have a normal digestive tract and a normal stomach, the oral vitamin B-12 is as effective as the shot. If people have pernicious anemia, they are usually treated with shots. Those people don’t make intrinsic factor, a substance produced in the stomach. It grabs hold of the vitamin and leads it into the blood. Shots bypass the need for intrinsic factor.

In some parts of the world, people without intrinsic factor are treated with large doses of the vitamin in pills.

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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