DEAR DR. DONOHUE: What should I eat with type 2 diabetes, high blood pressure and high cholesterol? All the advice I get tells me what I cannot eat — no potatoes, no bread, no crackers, no cereal, no fruit. Since breakfast is the most important meal of the day, I don’t know what to eat. — C.L.

ANSWER: The diet for type 1 and type 2 diabetes is not as restrictive as it once was. You can eat all the foods you mentioned. Sugar also can be eaten, something that was strictly prohibited in the past. You have to use it in moderation, and it’s best to save sugar calories for other carbohydrates by using artificial sweeteners.

Weight reduction, if applicable to you, is the best way for you to control blood sugar. A 5 percent to 10 percent weight loss is a sure way to keep blood sugar where it should be. For high blood pressure, limit salt. You ought not to eat more than 1,500 mg a day of sodium. Read the sodium content of foods on their nutrition labels. For cholesterol control, cut back on fatty meats and whole-fat dairy products. You can use low-fat dairy.

Carbohydrates are an issue with diabetes. Carbohydrates are sugars and starches. They should constitute 50 percent to 55 percent of your total daily calories. Fruits (yes, you can eat them), vegetables, cereals, breads, crackers, pastas and similar foods are carbohydrates. You have to get a book that lists the calorie content of foods and their protein, fat and carbohydrate makeup. These guides in all bookstores, and they’re cheap.

Breakfast shouldn’t be a problem. You can drink orange juice if you like it, have cereal, have toast and drink coffee or whatever.

You need a coach in the form of a dietitian. The dietitian can help you navigate through the difficulties of understanding a diabetic diet. Your doctor or the local hospital can put you in touch with one.

Advertisement

You also need to contact the American Diabetes Association, whose website is www.diabetes.org. Or call 1-800-342-2383. The association will provide you with tons of information on diet and on diabetes in general. If you don’t have a computer, you must know a friend or relative with one. That person can make a connection for you. Be there when he or she does.

DEAR DR. DONOHUE: I have a 16-year-old daughter who weighs close to 200 pounds. She is 5 feet 4 inches tall. She really doesn’t eat a lot, but she is not all that active, either. Last year she started growing a moustache and has to shave regularly. Now she’s got hairs growing from her chin. Could the two problems — weight and hairiness — be related? — K.S.

ANSWER: They could. Problems with the adrenal glands, ovaries or pituitary gland could be at the bottom of her hair growth and obesity.

Polycystic ovary syndrome, for example, features obesity and facial-hair growth. Menstrual irregularities also are a part of the picture.

That’s only one condition that leads to the same symptoms that your daughter has. Have the girl start with an examination by the family doctor. See if that doctor believes it would be wise to consult an endocrinologist. The adrenal glands, pituitary gland and ovaries are endocrine glands.

DEAR DR. DONOHUE: My son lives on the West Coast, and we live on the East Coast. He called to say he has secondary hypertension. I know what hypertension is, but I don’t know the meaning of the “secondary” modifier. — A.L.

ANSWER: Most hypertension (high blood pressure), 90 percent to 95 percent, is primary hypertension — high blood pressure that develops on its own, not from some other condition. Primary hypertension is treatable but rarely curable.

“Secondary hypertension” means the blood pressure elevation comes about from some other illness, such as adrenal gland problems, issues with the kidneys or a narrowing of the aorta. This hypertension is usually curable.

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.


Only subscribers are eligible to post comments. Please subscribe or login first for digital access. Here’s why.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.