Author: Editor

Advice for parents of Type 1 diabetic kids

From Facebook (Diabetic South Africans):

Belinda wants to know if there are any parents of Type 1 diabetic kids out there… Want to share advice?

Some advice: the treatment of diabetes is not a perfect science. What works for one person may not work for the next. You need to make notes of what works for your child. This will take much of the guess work out of controlling your child’s blood sugar.
Wayne

Allow your kids to have a say and let them see the effects. Never wrap them in cottonwool! Let them live, learn and experiment!
Isabella

Hi. I’m also new to this. My little girl was diagnosed in May. She’s 2 and a half. Very scary and completely heart breaking often.
Kerry

Hi Belinda – join Kids Powered by Insulin if you haven’t yet. You’ll get good advice and support there. My son is 15 – diagnosed when he was 13. A good endo and educator, healthy diet and an understanding of how much insulin is needed and how each insulin works has helped us a lot so far. Take care x
Natasia

Hi there my daughter is 3 years old and Type 1 diabetic, she was diagnosed last year two weeks before her 2nd birthday.
Anthea

Belinda there are LOTS of us – join the Facebook group Kids Powered by Insulin.
Tiffany

Never tell them they can’t do something because of diabetes. As a child, I was told that I can’t do many things because of my diabetes – I missed out on a lot.
Elmarie

My daughter is 9 years old now and was diagnosed when she was 4. I would love to help anyone who has had to endure diagnosis – it was 3 months of pure hell and would have loved a shoulder to cry on or some tips to help.
Georgina

Thank you everybody for the reply. I am feeling much better that there are so many parents that are prepared to give me advice!
Belinda

Spreading the word about diabetes

Neville Pillay is one of Durban’s favourite DJs and comedians… Who just happens to be a Type 2 diabetic. We speak to him about keeping up with the Morning Rush on Lotus FM, with diabetes.

How long have you been diabetic?

I was diagnosed well over 12 years ago, when I was 28 years old. But I remember my doctor telling me at 24 that I was at higher risk for diabetes because of my family history, and that I should change my diet… If only I had listened then!

Was your diagnosis a surprise?

To be perfectly honest, I knew all the symptoms – frequent urination, constant thirst, itchy skin, the sweats – but I chose to ignore them. By the time I was diagnosed I wasn’t surprised at all.

Are any of your family members diabetic?

My dad was and my mom is – she’s a Type 1 diabetic. You would think that would have made me more aware of diabetes, but the way we were brought up, we were ignorant about it – it was just something that my mom had. Type 2, or adult-onset diabetes, is also a very different condition to Type 1.

Do you ever talk about diabetes on air?

Absolutely: every chance I get to relate my story, I do. Many of my listeners on Lotus FM are affected by diabetes in one way or another, so it helps to be able to share our stories.

Do you ever tell jokes about diabetes in your comedy shows?

Oh yes, for sure. My comedy is based on my life, so of course I do! For example, I’ve got a lot of friends whose dads have passed away and left them things: cars and houses, even a Jaguar – all kinds of things. What did my dad leave me? Diabetes. I also like pointing out the irony of the fact that Indians came to South Africa as indentured labourers to cut sugar cane… And what disease do we all get? The sugars! Diabetes.

How do you balance a busy lifestyle with eating right and exercise?

It’s so difficult to do, so difficult. I’m not a pro at it and yes, I lapse every now and then. But for the most part I’m on point with eating well, staying away from sugary drinks and sweets and taking my medication. I’ve been a DJ since 1997 and I love it, but if you want any kind of stability or comfort zone, radio isn’t it. Every day is different and the landscape is constantly changing. So that’s an added challenge.

What do you think the biggest challenge of living with diabetes is?

To constantly monitor your blood sugar and make the right choices. The difficulty is in making those daily healthy choices, even when you’re around other people who can eat anything they like. That said, I know that there are terrible side effects, so it’s well worth making the effort. I was diabetic for a long time before I was diagnosed, and I know there have been some debilitating effects on my body, so I’m very careful to take good care now.

What advice would you offer to diabetics who are struggling?

Make one small change at a time and eventually you will have changed your lifestyle to effectively manage your condition.

What makes your life sweet

My girls, Jordan and Skylar, and my job. I love to entertain and it drives me daily.

Get in touch with Neville: @topdan on Twitter or Neville Pillay on Facebook.

Your insulin pump questions, answered

If there’s one question we get all the time, it’s about the insulin pump: what is it, how it works and how to get it covered by medical aid. So we’ve gathered together all your Frequently Asked Questions, and found the answers.

Meet the expert

Name: Imke Kruger
How long have you been diabetic? 25 years
How long have you been on the pump? 5 years

What made you decide to get an insulin pump?
I battled to get my blood glucose under control on multiple daily injections, especially when doing sports. It was before my first 94.7 cycle challenge that my doctor suggested insulin pump therapy. It has changed my life! I can’t imagine life without my Accu-Chek Combo pump.

What do you love about the pump?
Everything! It helps me to live life the way I want to. I love the discreetness of it – I can give a bolus in a meeting or when going out with my friends, without anyone noticing.

What are some of the challenges?
The first two months were difficult to get used to sleeping with the pump, but now I don’t even realize that I’m wearing it. The challenge is more with diabetes – not the pump. It’s important to realise that insulin pump therapy is not taking the condition away. There are so many variables in diabetes, and that will always be a challenge.

When should someone consider getting an insulin pump?

  • If they are experiencing severe hypoglycaemic (low blood sugar) episodes despite careful management.
  • If they are on multiple daily injections, following a meal plan, testing their blood glucose levels 4 times a day, and still not getting target HbA1c results.
  • If they have irregular eating, working and resting times.

Insulin pump therapy won’t work for those who aren’t committed to it, and there isn’t enough evidence to recommend it for Type 2 diabetics.

A more comprehensive description of the Indications and Contra-Indications to Pump therapy can be found in the SA Guidelines for Insulin Pump Therapy. A Amod, M Carrihill, JA Dave, LA Distiller, W May, I Paruk, FJ Pirie, D Segal, Association of Clinical Endocrinologists of South Africa (ACE-SA) JEMDSA 2013;18(1):15-19.

 

FAQ about the insulin pump from our community:

 

  1. What is an insulin pump?

  • Insulin pumps are portable devices attached to the body that deliver constant amounts of rapid or short acting insulin via an infusion set.
  • The pump tries to mimic the release of insulin from a normal pancreas, but you have to tell it how much insulin to inject.
  • It delivers insulin in two ways: a basal rate which is a continuous, small trickle of insulin that keeps blood glucose stable between meals and overnight; and a bolus rate, which is a much higher rate of insulin taken before eating to “cover” the food you plan to eat or to correct a high blood glucose level.
  • Because the insulin pump stays connected to the body, it allows the wearer to change the amount of insulin they take with the press of a few buttons at any time of day. You can also program in a higher or lower rate of insulin delivery at a chosen time – when sleeping or doing sports, for instance.
  1. Where do you buy an insulin pump and how much does it cost?

You need to be a patient at one of the accredited pump centres in South Africa. Your doctor will decide if you are a pump candidate according to the Association of Clinical Endocrinologists of South Africa (ACE-SA) guidelines. If you are, you will need a script to claim the pump through your medical aid, or buy it cash from one of the supplying pharmacies.

  1. What are the advantages and disadvantages of using an insulin pump?

Insulin pump therapy improves metabolic control while giving you greater freedom and a better quality of life.

  • Your metabolism stays more stable, with better HbA1c values and fewer low blood sugar episodes.
  • You can be more flexible in your eating, if you understand the concept of carbohydrate counting.
  • You can participate in sports whenever you feel like it — without having to plan in advance

Disadvantages are that you have too much freedom in making food choices, and that there is a risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems.

Remember: Deciding on insulin pump therapy is not a simple decision and should be carefully discussed with your healthcare team.

  1. Will my blood sugar control be better if I use an insulin pump?

It all depends on you. You can wear a pump and it can have no impact on your blood sugar. Or you can use a pump, and with the right settings, motivation and help from your healthcare team, you can have better blood sugar control.

  1. Will I still have to test my blood sugar as much?

A pump patient needs to be a motivated patient who tests regularly, around 4 times a day.

  1. Are there insulin pumps that have a Continuous Glucose Meter attached?

Yes there are – it’s a good idea to discuss with your healthcare team which pump would best suit your needs

  1. How would the insulin pump be used for sports? Are there special casings made or will I have to play without it?

You can engage in any kind of physical activity while wearing an insulin pump. But for sports with intensive body contact and water sports we recommend temporarily disconnecting the insulin pump (not for longer than 1 hour). Special cases and pouches can protect the pump, but it’s always a good idea to insure it as well.

  1. At what age can you put a child on the insulin pump and how easy is it for them to adapt?

I would say at any age, but it’s best to get advice from your pediatric endocrinologist. Children often adapt the easiest of all age groups to insulin pump therapy.

  1. What is the risk of infection?

If you follow the right hygiene steps, the risks are low. You should always disinfect the pump site before inserting the infusion set. It is also critical to replace the infusion set every three days.

  1. How much is an insulin pump with and without medical aid?

That depends on the type of medical aid plan and whether the medical aid covers the costs fully or partly. It would be best to discuss this with your healthcare team or your medical aid. If your doctor agrees that pump therapy is the best option for you, they will send an application to the medical aid.

Ask the expert: Dr Claudine Lee, GP

“Pump therapy is a beautiful and practical way of delivering insulin that tries to fit in with you, the patient, in terms of meals, exercise and illness, as well as just living a normal life.”

 

10 FAQ about the diabetic diet

Ask the dietician: Cheryl Meyer

We asked our community what they most wanted to know about diabetes and food – here are 10 frequently asked questions, answered by our expert dietician.

  1. Must I cut sugar out of my diet completely?

Small amounts of sugar can be included in your diet, but too much sugar or sweet food is not recommended as part of a healthy eating pattern.

  1. What can I eat when I feel like chocolate?

Treats like chocolate can fit into a healthy diet, as long as you keep these points in mind:

  • Try to have treats with a meal, e.g. as a dessert.
  • Watch your portion size: choose a small portion or share.
  • Put a healthy twist on treats – check out these great recipes for ideas
  1. Do I have to buy special sugar replacements, or can I just use less sugar?

Small amounts of sugar, jam, and honey have little effect on blood glucose levels, so small amounts of sugar can be included in your diet, e.g. a scrape of jam on wholewheat bread.

  1. How important is fibre in a diabetic’s diet?

Fibre keeps your digestive tract working well, can help lower your cholesterol level and can improve blood glucose control if eaten in large amounts. Another benefit of fibre is that it adds bulk to help make you feel full. Given these benefits, fibre is important to include in a diabetic’s daily diet – and in the diets of those who don’t have diabetes!

  1. How many vegetables should I be eating in a day?

The amount of vegetables you need depends on your age, gender and level of physical activity. On average, an adult woman will need 2½ cups a day, while an adult man will need 3 cups, and children will need between 1 to 2 cups a day.

  1. How much protein do I need to balance out carbohydrate?

Protein should account for about 15 to 20% of the total calories you eat each day – roughly a fist-sized portion at each meal.

  1. Is too much fruit bad for diabetics? And grapefruit?

Fruit (any kind, grapefruit included) can be included as part of your diet, but controlling portion size is vital. Limit your portions to a fist-sized or tennis-ball sized portion at a time.

  1. How do I manage food for my diabetic child?

Provide structured, nutritious meals and snacks for your child and make healthy eating and lifestyle changes as a family (don’t single out one family member). Remember that they are a child first and a diabetic second. Work with your child’s diabetes health care team to help your little one grow up healthy and happy!

  1. My sugar is always high – am I eating wrong?

Diabetes is managed with diet, exercise, tablets and/or injections. Check in with your doctor to make sure your food choices, exercise levels and medication are on track to keep your sugar within your target range.

  1. How can a diabetic lose weight in a healthy way?

The best way to lose weight for good is to find an approach to eating that makes sense, doesn’t cut out whole food groups and has you eating regularly and feeling well.

 

10 Fast facts about neuropathy

One of the most common complications of uncontrolled diabetes is diabetic neuropathy – but do you know what it is? Here are the basics of what it is, how to avoid it, and how to treat it if necessary.

  1. Diabetic neuropathy is the most common complication of diabetes.
  2. Neuropathy is short for “peripheral neuropathy” which means nerve damage in the peripheral nervous system.
  3. The peripheral nervous system includes all the nerves outside the brain and spinal cord, and connects the central nervous system to the hands, legs and organs.
  4. Diabetic neuropathy is caused from damage to the small blood vessels that supply the nerves.
  5. Blood vessels are damaged by high blood glucose levels, having diabetes for many years and abnormal blood fat levels.
  6. Smoking and excessive alcohol use can also cause diabetic neuropathy, as can mechanical injury to the nerves (like carpal tunnel syndrome).
  7. Symptoms can include numbness and tingling in the hands and feet, erectile dysfunction, dizziness, muscle weakness and changes in vision.
  8. Some common signs of peripheral neuropathy are sharp, jabbing pain that may get worse at night, and pain when walking.
  9. Diabetic neuropathy can’t be cured, but there are treatments to help the symptoms.
  10. The best treatment for neuropathy is good blood sugar control, which will prevent the condition from getting any worse.

10 ways to relax (phew!)

Do you struggle to let loose? Here are 10 great ideas from Claire Barnardo that show you how to really relax…

When did life get so busy? Sometimes it can be hard to find time to unwind, but with a little imagination (and forward planning!) there’s really no excuse not to. Here are our top 10 ways to chill out:

  1. Give a foot massage

Getting a foot massage might sound more relaxing, but giving one not only makes someone else happy, but helps you to relax as well. Don’t forget to use some soothing lotion, and check out our top tips for giving foot massages below.

  1. Go for a walk

Exercise is one of the best ways you can loosen up. It’s not only fun and gets you moving, it also has tons of physical benefits. Plus your mood improves because of all the feel-good hormones. So get moving – even if it’s only a short stroll around the block…

  1. Run a bath

There’s nothing more relaxing than lying in a hot bubble bath (with a scented candle burning). It’s the perfect way to de-stress and let your mind wander and unwind from the day’s activities. Try lavender drops in the water for a good night’s rest.

  1. Have an (unlimited) coffee date with a friend

Make a date to meet a friend for a lengthy cup of coffee (or a pot of tea). Chatting things over without any time limits is a great way to chill out (and share worries). Especially if it includes a few laughs!

  1. Play a board game with your family

Get everyone together and play your favourite board game. Whether it’s 30 Seconds, Charades or a game of cards, games are an ideal way to check out of the day-to-day drill and enjoy each other’s company.

  1. Read a book

Escape into another world through the pages of your favourite novel. You’ll not only be using your imagination, but exercising your mind too. There’s no better way to relax than a good book on a comfortable chair (or bed!)

  1. Meditate

Research shows that people who meditate greatly reduce their stress levels. Plus it results in improved memory, decreased anxiety and generally makes you feel much more positive. Even a short five-minute meditation can have a good effect on your mood and your stress levels – and if you start with a guided meditation it won’t be too difficult to switch off. The easiest meditation of all? Find a quiet spot where you won’t be disturbed, sit comfortably and focus on your breathing – in and out, in and out.

  1. Pay it forward

Try being kind as a form of relaxation. Whether it’s smiling at a stranger, letting a car go before you in traffic or planning a special treat for a friend, being nice can make you feel good too. Remember that charity begins at home, so try starting with your family.

  1. Go gardening

You don’t need flowerbeds to enjoy the relaxation of green fingers. Even trimming a houseplant or potting a new pot plant will take the edge off. Studies show that the sensory experience of gardening is what really calms the mind and puts you back in touch with yourself.

  1. Close your eyes

Instead of pushing yourself from one deadline to the next, try taking a short nap to recharge. Even a 20-minute sleep can help to refocus your brain and energy. What are you waiting for? Time for some zzz…..

Telling a new partner about diabetes

Hi. This may seem like a silly question, but I want to know how do you tell a new partner that you have diabetes? Or should I say nothing and see how things go between us (I’ve been dating this guy for 6 weeks).” Bongani Nobuhle

Dear Bongani,

It can be a real challenge to tell someone you have diabetes. Sometimes people who do not understand diabetes have bizarre ideas about the condition and may react in an unwanted or hurtful way. Of course, some people will be more open-minded than others.

It’s normal for people with diabetes to worry about what their date will make of their diabetes. So when is the right time to talk about it?

Telling a new partner about your diabetes will be influenced by your personal preference and also by your medication. It’s a good idea to let your partner know about your diabetes early on in your relationship if you are on insulin, or at risk for hypoglycaemia. It will make the first episode of going low or having to inject less of a surprise to him. It is also a good idea to explain your need to inject at a convenient time as some people may feel funny about needles. If you are on oral medication, you could wait longer and see how you go.

When you do decide to tell him, be your brave and bold self. I do believe he has a right to know. If it scares him away, then he wasn’t the one for you. If he doesn’t know what it is about, all your secret long trips to the bathroom to check your sugar and inject insulin might alarm him. What if you can’t get up to go somewhere private to check your blood sugar? You don’t want to sacrifice your health just to keep a secret.

When you do tell him, don’t be a drama queen: just state the facts. Give your partner a chance to take in the news and be patient. Everyone reacts differently and at different speeds. But remember: if he doesn’t support you or take your diabetes seriously, don’t waste your time or his.

– Jeannie Berg, Diabetes Educator

 

 

Take to the trail

Tired of pounding the pavement or looking for a fun way to get active? Trail running may be the sport for you. More and more people are heading to the mountains, the veld and the forests to get away from the city, spend time in nature and run free.

More than just a work-out

Trail running is good for the body, mind and soul. It’s also good for the wallet – except for the price of running shoes, it doesn’t cost a thing. Trail running is different to road running because the ground you’re running on changes all the time and isn’t flat and hard like a road. It helps “proprioception”, our sense of balance and body awareness. It also develops strength in muscles and joints, and gives you stronger ankles and hip joints. Softer surfaces like grass, sand, and gravel are easier on the joints than tar. Trail running will help you burn more calories and shed fat faster as your body uses a greater amount of energy to use more muscles to move on the uneven surface. Paying attention to each step you take will also distract your mind from your everyday To Do list (always a good thing!) Don’t forget to stop for a moment, breathe in the fresh air, and give thanks for where you are.

Heading off-road

Although there is less risk of injury with trail running than road running, it’s a good idea in the beginning to include some exercises in your routine to strengthen your core, pelvic muscles, legs, knees and ankles to cope with the impact to these parts of the body. Follow a careful training programme where you can gradually build up your distance and speed. It’s important to be aware of your diabetic needs while you’re trail running, too. Don’t push yourself too hard in the beginning, and make sure you snack before you start running so that your blood sugar doesn’t go low while you’re on the trail.

When you’re trail running, it’s important to look where you’re going – vehicle tracks, puddles, logs and rocks are all obstacles that can trip you up, and low-hanging tree branches need to be ducked in time.

Here are some tips for different types of terrain:

Sand is difficult to run on, especially when it’s loose. Don’t run in a straight line, rather search for the firmest footing. The harder sand can usually be found on the very edge of the trail.

Muddy surfaces can be slippery, be careful!

Rocky trails mean you need to lift your legs higher to avoid tripping. Try to step lightly with a flat foot, so that if it’s not stable or you slip, you can quickly move your foot.

Forest paths can hide rocks and roots. Be on the lookout and avoid stepping on them if you you can.

Looking for runs in you area? Take a look at www.nightjartravel.com/trail-running

Want to see more of our favourite trails? Visit www.sweetlifemag.co.za/community

Expert tip: Get the right shoes.

Ask the expert: Nelfrie Kemp, Podiatry Association of South Africa

The most important tip when taking up any running is to buy the right shoes and make sure they fit properly. Foot care is vital if you have diabetes. When fitting a running shoe, choose a pair one size larger than your normal shoe size as your feet swell when you exercise. It’s a good idea to use sport socks that are thick from toe to heel and fit you perfectly. This will help prevent pins and needles or a burning sensation in the feet. Preferably wear ankle-height socks as secret socks can move and curl up under your foot, which can cause blisters. Always tie your laces, but make sure that it they are not tied too loosely or tightly.

Get more diabetic foot tips at www.podiatrist.co.za

Expert tip: Be aware

Ask the expert: Sarah Hall, Biokineticist

  • As well as the trail running, do some balance training either at home or in the gym by doing single leg exercises or balancing on wobble boards.
  • Use your whole body while you are trail running: your arms for balance and support, your core to help draw your legs up for climbing the rocky parts, and a mid-foot to front-of-foot strike with shorter, quicker strides for more control and adjustment.
  • Pay close attention to what you eat and drink before and during the run, especially on longer runs. Always have something sweet on you in case your blood sugar goes low, and never run alone.
  • Know the route you are running by mapping the route on GPS. It will give you a good idea of the height you may be climbing and the exact distance you will be covering. Remember to start with shorter routes and slowly build up distance.

Advice for a newly diagnosed diabetic

From Facebook (Diabetic South Africans):
What advice would you give a newly diagnosed diabetic?

Get as much info as you can. Prepare to make lifestyle change. Respect the illness and it won’t control you

Heidi

Don’t think you are any different from any other human. Carry on and enjoy yourself: everything in moderation. Exercise a lot and eat well – no problem!

Craig

Vat een dag op ‘n slag. eet gesond en doen oefeninge. en als wat ‘n nie-diabeet doen kan diabete ook doen!

Magrietha

Cut out anything white (sugar, flour, bread, chips, etc) and start an exercise program.

Brenda

Don’t dwell on it too much. My Type 1 diabetic son of 8 understands his illness yet just gets on with life. He is a happy child and a true inspiration to the people around him.

Wayne

Relax – it’s not the end of the world. It can be so overwhelming at first, but remember you have a manageable condition (note, not disease) God bless you!

Jashika

Keeping diabetics inspired

We chatted to community inspiration Veronica Vember about how she changes lives, one step at a time.

What got you interested in diabetes at first?

It all started whilst working in the vascular unit at Kingsbury Hospital. I realised that most people are not informed about managing diabetes after being diagnosed. So I became passionate in the control of potential complications, and Kingsbury management identified my passion and allowed me to do the vascular course in London as it’s not offered here. On my return, I did two presentations at the doctors academic meetings. At the time my husband had a myocardial infarction and had been diagnosed with hypertension and diabetes. The entire experience stimulated me to get involved with my community. Now my husband is one of the volunteers. I then started doing motivational talks at schools, groups, on radio and at our nursing college.

How did you start your community group?

I joined the Strandfontein Health Forum and offered to do the diabetes awareness events as there was no project as such. With the awareness held at the Strandfontein Clinic I handed out questionnaires and a suggestion box. The community asked for a diabetic support group: that’s what started it.

What keeps you inspired?

The positive attitude and enthusiasm of the volunteers, and noticing the excitement of the attendees. When we take a break, people want to know when we’ll be starting again. The continuous support of ‘diabetes life’ (a diabetic clinic at Kingsbury hospital) under the management of endocrinologist Dr May, Dr Tracy van Rensburg and nurse educator Sr. Dee Ferguson (my mentor). Positive feedback from the doctors at the day hospitals where the clients attend also keeps me going.

You were voted one of the Western Cape’s Lead SA heroes – how did this make you feel?

Surprised, shocked, emotional, confused and thankful towards the responsible person for the recognition. I’m very proud of the team of dedicated volunteer attendees as I can’t do this alone. It’s a team effort – unity is strength.

What advice do you offer your support group members when they are struggling?

To persevere, not to give up, not to give in, to be compliant, to attend the support group regularly. We do individual counselling and have a communication box available for constructive comments and replies.

How do you make diabetes inspiring?

We create a harmonious atmosphere: a safe environment with easy accessibility, clean, functional equipment and competent staff. We vary programs, presentations, literature, topics and menus (soup in winter and tea and a snack in summer). We also combine our decision making with the volunteers.

What makes your life sweet?

Carrying out our mission, vision and outcome.

S – be sensitive towards all

W – warn people about the consequences of not being compliant

E – educate people regarding a healthy lifestyle and change of mindset

E – be empathetic and empower people with knowledge

T – to be trained, to train others

Outcome:

To ensure that all community members are well informed, and reach and maintain normal glucose levels.

Get in touch with Veronica: Strandfontein Diabetic Support Group on Facebook

Diabetes across South Africa

We all know that more and more people are now living with Type 2 diabetes. It used to be seen as a condition for the wealthy, but today it’s increasingly common in every community – rich and poor. Nicole McCreedy takes a look.

Diabetes in South Africa is often associated with the Indian community among whom – compared with other cultures – it is more widespread. According to a study by the Human Sciences Research Council and Medical Research Council, 61% of South African Indians over the age of 45 have pre-diabetes, and are more likely, with age, to develop Type 2 diabetes.

But the Indian community is no longer the only group facing the diabetes challenge. It is now being reported as one of the leading causes of death in areas where diabetes was once unheard of.

The rapid rise in diabetes

There are a number of factors that put a person at risk for developing Type 2 diabetes. A family history of the condition, your lifestyle – what you eat, whether you smoke and how often you exercise – as well as your environment all play a role.

In the past, the Indian and white population in South Africa were more likely to be urbanised and wealthier, while Africans lived in the rural areas. Living in an urban environment often means longer hours at work, commuting and easy access to cheap fast foods. This type of lifestyle is linked to higher levels of overweight and obesity, and in turn diabetes. A study from 2005 found South African Indians ticked all the boxes: a diet low in fibre and high in unhealthy fats, physical inactivity, and insulin resistance.

However, in recent decades, South Africa has undergone both political and economic change. As a result, many people living in rural areas, especially Africans, have moved to cities for work and better opportunities. Being less physically active and eating a more Western diet (high in carbs and fats) is contributing to the growing diabetes burden in the African and coloured communities.

South Africans are fat

The relationship between overweight/obesity and Type 2 diabetes is critical. An unhealthy diet and not enough exercise can lead to being overweight or obese. Carrying extra weight, especially belly fat, is bad for your health, specifically leading to insulin resistance, high cholesterol and high blood pressure. All of which are damaging to long-term health.

What’s scary is that in South Africa, 7 out of 10 women and 4 out of 10 men have significantly more body fat than is healthy. The issue of overweight and obesity is emerging as a particular health concern among black women living in urban areas where there is a high rate of HIV. Weight gain, especially among black women, has always been seen as a sign of wealth, health and success in traditional African society, while being thin is associated with being HIV-infected. But overweight and obesity is also linked to diabetes. In a study on body perception among urban-dwelling black women, as many as 90% were overweight and obese, while almost three-quarters had diabetes.

The next generation

Your lifestyle not only affects your own health; it can also impact the health of your children. High blood sugar levels in pregnancy impact the unborn baby’s genes, making them more vulnerable to Type 2 diabetes later in life. Babies exposed to high blood sugar in the womb may have a higher birth weight and this can continue into adulthood with serious effects on their long-term health. Among South African Indians, where high blood sugar has been a problem for much longer, diabetes is now showing up at a much younger age than ten years ago – as early as between 25 to 45 years old.

Ignoring the problem

For many individuals, diabetes is a problem they don’t want to acknowledge. “A big concern is that people with diabetes are not taking their condition seriously enough,” says Jenny Russell from Diabetes South Africa’s Durban branch. “They want to swallow their tablets and carry on their unhealthy lifestyles.” According to Jenny, “in the Indian community, it is almost accepted as ‘normal’ that if you have diabetes, you will have diabetes-related complications: limb amputation, blindness or needing kidney dialysis.”

Others struggle with feelings of guilt. But whatever your culture, as Jeannie Berg, a pharmacist and diabetes educator in Mpumalanga, says:

“Diabetes is the same for everyone. Don’t let it define your life: it is not who you are, it is a part of your life you need to manage.”

Proudly South African portion sizes

Ask the dietician: Cheryl Meyer

From our community: “Can anyone tell me about madumbis for diabetics – good or bad for us, and how much can we eat?” Lynette Hitchcock.

Madumbis, amadumbe, African potato or taro – call them what you will, they are delicious! They have a rich, nutty, earthy flavour and a stickier texture than potatoes. Like potatoes, they fall into the carbohydrate group of foods and can be roasted, mashed or boiled.

The key to eating proudly South African carbohydrates like madumbis, roti, pap or samp in a healthy diabetic diet is portion control! Counting the carbs in your meals and being aware of the carbs you eat can help you match your medication or activity to the food you eat. This can lead to better blood sugar control.

Remember: Everyone needs a different amount of carbohydrate at each meal and/or snack – the amount that is best for you depends on your:

  • age
  • height
  • weight
  • physical activity
  • current blood sugar
  • blood sugar targets

Not sure how many carbs you should be eating? Ask your doctor or dietician for help.

A general guide:
  Carb limits for women Carb limits for men
Meal 30 – 60g 45 – 75g
Snack 15 – 30g 15 – 30g

What does this mean? A food that has 15g carbohydrate is called “one carb serving”. One slice of bread or a small piece of fruit each have around 15g carbohydrate, so they are equal to one carb serving.

One carb portions of Proudly South African foods:

1 carb serving 50g madumbi
1 small roti (35g)
⅓ cup pap (60g)
⅓ cup samp (75g)
½ cup sweet potato (100g)
1 medium mielie (140g )
½ cup rice (50g)
1 x 15cm tortilla or wrap (35g)
½ cup pasta (100g)
1 slice bread (30g)
1 small apple (115g)

As much as possible, try to stick to this portion size, with a serving of protein (meat, fish, chicken, eggs, beans) and half a plate of vegetables or salad.

How to cook amadumbe: Scrub them clean and steam or boil until soft. Drain and cool slightly before removing the skins. Serve dusted with black pepper, a dash of salt and a drizzle of olive oil. Yum!

Amadumbe in numbers:
100g portion boiled amadumbe has: *

  • 600 kJ
  • 5g plant protein
  • 1g fat
  • 5g of carbohydrate
  • 1g fibre

* According to The SA Food Tables

10 Fast facts about foot ulcers

All diabetics know that foot care is really important, but do you know why? Preventing foot ulcers is an essential part of keeping your feet healthy. Here are some great tips.

  1. Foot ulcers are skin ulcers where the skin has broken down under the foot and you can see the tissue underneath it.
  2. Diabetics are at greater risk of foot ulcers because high blood sugar for a long period of time can damage the nerves in the feet, which means you won’t be able to feel pain and might not notice a foot injury.
  3. A diabetic foot ulcer can develop after even the smallest injury, like stepping on a little stone with bare feet. Ulcers are easily infected and can take weeks or even months to heal.
  4. 15% of people with diabetes may develop a foot ulcer.
  5. More than half of all diabetic foot ulcers become infected.
  6. Foot ulcers are the most common reason for diabetics needing to go to hospital.
  7. Luckily, they are also easily prevented: by carefully controlling blood sugar levels to prevent nerve damage.
  8. It is very important to check the feet, including the areas between the toes, for cuts and sores – every day.
  9. Keeping the feet clean and dry is essential – but do not soak them.
  10. Be sure to have your feet checked once a year by a doctor or podiatrist.

 

Free ways to have fun with family

Need to make more time for your family this year? Why not do it in style and have some fun too? Claire Barnardo leads the way… 

4 Top tips:

  1. Time it
    One of the greatest gifts you can give your family and friends is your time. Simply add it to your schedule: an hour or two over the weekend to make memories together.
  1. Plan it
    Don’t leave finding a child-friendly, cost-effective play option till the last minute. Do your research and plan ahead of time so play time is actually spent playing!
  1. Price it
    There are lots of cheap and free ways to have fun. Using your creativity can turn a simple picnic into a magical adventure for the kids.
  1. Weather it
    Always check what’s in store weather-wise if you are heading outdoors for the day so you don’t get any nasty surprises.

Old school

Do you remember how much fun games were when you were young? They still are! All you need is your imagination and a few bits and pieces to make staying at home together an absolute treat. Try out these old favourites:

  1. Hide-and-seek
  2. Colouring-in
  3. Story-telling
  4. Play dough
  5. Tent building

Picnic perfect

If you’re in town, then look no further than these gems for a free and fun outing:

Green Point Park, Cape Town

If you haven’t already been, then you are missing out on one of the most fantastic parks in the country. It’s the perfect place for a good stroll, whether you’re pushing a pram or riding a bicycle. Or plan a family picnic and take along your own games – there’s plenty of space. There’s also an outdoor gym and play parks with top equipment, so all you need to do is get there and play time is yours!

  • At: Granger Bay Boulevard, Green Point

Emmarentia Dam, Joburg

If  you’re looking for the urban version of outdoor fun then head to Emmarentia Dam for the day. Right next to the Joburg Botanical Gardens, the dam is not only a dog’s best find for a walk and a swim, but also the perfect place for families to picnic, braai and relax. Or just sit and watch the windsurfers and canoeists on the water.

  • At: Olifants Road, Emmarentia

Durban Botanic Gardens, Durban

If you haven’t been to the Botanic Gardens for a while, you’re due a visit! The park has always been the perfect spot for a family picnic, with its lake full of ducks for the kids to feed and the orchid house for the older kids to explore. And as always, the tea garden is perfect for an afternoon cuppa or a toasted sarmie.

  • At John Zikhale (Sydenham) Road

Don’t forget to pack!

  • Hat
  • Sunscreen
  • Snacks and juice
  • Books for the car ride
  • Change of clothing (you just never know!)
  • Camera: for those priceless moments

Diabetic tips for teachers

“This year I have a diabetic child in my class and I don’t really know what to do. I want to make him feel supported but I also don’t want to make a big fuss about the fact that he’s diabetic – he seems to be managing it very well… What do you suggest?” Linda Nkosi.

Dear Linda,

I think it’s great that you want to lend support to your learner who has diabetes. However, being in charge of children with diabetes can be a challenge unless you know about the condition – it’s a good start for you to get more information on diabetes.

Children with diabetes often feel isolated and alone. Having to test your blood sugar several times a day, keep tabs on what you eat, and give yourself insulin shots or other medicine is enough to make anyone feel self-conscious and different.

If he is willing to do an awareness project with you, it could be very helpful for the whole class. It’s very important to first talk this idea through with him and his parents, though – some people prefer to hide their diabetes and pretend that it doesn’t exist. If you tackle this project in an exciting way, the child will feel involved and the other children in his class will enjoy the topic and then, like children do, just move on to something else. Children are like that. They soon move on, but the message of hypos, testing and shots will be stored in their memory banks.

Remember that this child must always be treated like his classmates. Don’t make exceptions. Always remember, he is a child first. He has diabetes, but that doesn’t give him more or less rights than the child next to him.

Like everyone else, kids with diabetes get along better with a little help from their friends. What a lucky person he is to have a supportive teacher like you!

– Jeannie Berg, Diabetes Educator