My friend who has diabetes frequently eats foods that I think are inappropriate (powdered sugar donuts, Pop-tarts, smoothies, etc), and when I remind her she isn’t supposed to have sugar, she says her blood sugar levels are normal. She is having arterial bypass surgery in her legs, and I can’t help but think that all that sugar may have contributed to her problem. Am I right? How can a friend deal with a situation like this? I feel that I am watching her slowly commit suicide.

You sound like a concerned friend. Unfortunately, we all take responsibility for our behavior. Bypass surgery in the lower extremities usually implies a significant smoking history, as well. If this is the case, smoking cessation is very important. I think it helps to get some other key people in your friends’s life and help to support your contention that her eating behaviors are not good. It may be true that her sugars are not bad. However, if she was eating better, she may not need to use as much medication. There is also the issue about whether she needs to lose extra weight that may make it difficult to treat her diabetes. Finally, there are support groups available in many locations. This allows her to address her issues about eating in a supportive environment. Sometimes, it is denial. Bypass surgery, unfortunately, would be a rude reminder of the problems of diabetes. It does not have to be that way, in most cases.

JTL