DEAR DR. DONOHUE: My husband is 6 feet 4 inches tall and weighs 170 pounds. He is a competitive distance runner. He loves Kool-Aid and calculates that he drinks in a year 150 pounds of sugar in Kool-Aid alone. A friend told him if he continues this habit, he might develop diabetes. Can a skinny, athletic person develop diabetes from consuming sugar? — S.B.

ANSWER: Although “sugar” is half the name of sugar diabetes, sugar doesn’t cause diabetes. It’s a popular belief that it does, but it doesn’t. People with diabetes are careful to watch their sugar intake, and they watch their total carbohydrate intake, but diabetics don’t have to eliminate sugar completely from their lives. Careful monitoring of sugar and carbohydrate intake is essential for their control of blood sugar.

Type 1 diabetes, the kind that requires insulin for control, often has its onset in younger years. It’s due to a destruction of the insulin-making cells of the pancreas. The destruction is believed to be the work of the immune system. Sugar has nothing to do with it. Type 1 diabetes accounts for 5 percent to 10 percent of all diabetes cases.

Type 2 diabetes, the much more common kind, comes about from a decline in insulin production along with a decline in the effectiveness of insulin. Ninety percent of type 2 diabetics are overweight, and weight loss helps them control their blood sugar. Physical inactivity also contributes to type 2 diabetes. So do genes. Again, it’s not the sugar intake that produces this common type of diabetes. But monitoring the intake of sugar is important for control of this variety of diabetes.

DEAR DR. DONOHUE: If one has genital herpes and takes acyclovir twice a day for suppression of outbreaks, should one get the shingles vaccine?

ANSWER: The shingles vaccine contains live chickenpox virus. Chickenpox, acquired most often in childhood but at other ages as well, lives in nerve cells for the rest of that person’s life. Shingles is the result of the virus coming out of hibernation in nerve cells and traveling to the skin to cause an outbreak of shingles.

Acyclovir (Zovirax) and its two close relatives famciclovir (Famvir) and valacyclovir (Valtrex) suppress recurring outbreaks of genital herpes, a different virus from the chickenpox virus of shingles. However, these same drugs also can do in the chickenpox virus. Since they have that effect, they could kill the virus in the shingles vaccine and make it ineffective in its protection against a shingles outbreak. The vaccine shouldn’t be given to a person who is taking these medicines for suppression of a herpes recurrence or for any other reason.

You can get the shingles vaccine if you stop acyclovir for a week or so. Ask your doctor if he or she agrees.

The booklet on herpes discusses this common infection and genital warts in detail. Readers can order a copy by writing: Dr. Donohue — No. 1202. 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: I am 81. When I urinate, the bowl is covered with tiny foam bubbles. Is this dangerous? What causes it? — E.K.

ANSWER: Urinated urine covered with foam that looks like a head of beer poured into a glass might be due to protein in the urine. Ordinarily, no protein should be in urine. The kidney’s filtering stations keep protein in the blood. Protein finds its way into the urine when those stations have holes in them.

Don’t let this alarm you. Foamy urine isn’t a reliable sign of trouble. You can settle the question by getting one of medicine’s cheapest, fastest and easiest tests, a urinalysis. Your doctor can arrange such a test for you.

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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