DEAR DR. DONOHUE: Having dealt with diabetes for 15 years, I thought I knew everything about it. I am a type 2 diabetic, and I am on an oral medicine for it. I am very strict about what I eat.

Someone asked me if I pay attention to the glycemic index of foods. I never heard of it, and my doctor never mentioned it to me. This person said it was essential for diabetes control — news to me. What is it? — G.R.

ANSWER: I need to give some introductory information — not for you, but for readers who don’t have diabetes. Foods are fats, carbohydrates or protein. Most are a mixture of the three, but some are predominantly one or the other. For diabetes control, carbohydrates are the main concern: They are sugars or starches. In the digestive tract, starches are broken down into sugars. Of a diabetic’s total calories, around 50 percent should come from carbohydrates — vegetables, fruits, breads, pastas and various sugars.

The glycemic index is a measure of how quickly a food raises blood sugar. A high glycemic index, one that is 70 or higher, produces sudden spikes in blood sugar and requires an outpouring of insulin. High glycemic index foods are white bread, white bagels, baked potatoes, pretzels, watermelon and honey. Low glycemic index foods are pumpernickel bread, barley products, sweet potatoes, baked beans and split peas.

I don’t know how many people with diabetes are instructed to pay attention to the glycemic index. For most, it’s impractical. If you have good control doing what you are currently doing, stick with that. If you are interested and have computer access, go to the website www.glycemicindex.com. You will find many entries with charts giving the glycemic index of foods.

The glycemic load is another measure of a food’s tendency to quickly raise blood sugar. It’s the glycemic index incorporated into the total amount of carbohydrates in each serving.

DEAR DR. DONOHUE: Which is better, a hot dog or a hamburger? I should say, which is worse? I have a 20-something son who lives on his own. His meals consist either of a hamburger or a hot dog. I try to get him to have a little more variety, but he won’t budge. Any comment?

ANSWER: The average beef hot dog has about 180 calories and 16 grams of fat, about equally divided between saturated (not good) fat and monounsaturated fat (OK). It has 35 mg of cholesterol, not a great amount. It contains 585 mg of sodium, quite a load. A beef hamburger has about 300 calories and 21 grams of fat, equally divided into saturated and monounsaturated fat. It contains 80 mg of cholesterol. It has only 60 mg of sodium, a plus when compared with the hot dog.

An exclusive diet of hot dogs and hamburgers isn’t a great idea. Having them once in a while is OK.

Salt, sodium and chloride are electrolytes, as are potassium and bicarbonate. The booklet on electrolytes explains their role in health and illness. Readers can order a copy by writing: Dr. Donohue — No. 202, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order 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 aunt was hospitalized for lingular pneumonia. Is that more dangerous than the regular kind of pneumonia? — P.J.

ANSWER: The right lung has three lobes. The left lung has two lobes and a remnant of a third lobe. It’s the lingula. Lingular pneumonia is pneumonia confined to the lingula of the left lobe. It’s not worse than other kinds of pneumonia.

Pneumonia is an inflammation of the lungs. Usually it’s from an infection, either bacterial or viral. Other causes of lung inflammation are things like toxic gases.

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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