Author: __Sweet Life__

What is diabetes?

If you’re newly diagnosed or looking to explain diabetes to friends and family, it can be helpful to have a breakdown of what exactly diabetes is, and how it affects the body. Pick n Pay dietician, Leanne Kiezer, breaks it down for us.

Understanding diabetes

Want to know how diabetes works in the body? Here’s a simple explanation.

It all starts with food.  The carbohydrates you eat get broken down into glucose, a type of sugar. This glucose is absorbed into the bloodstream, and becomes known as blood glucose. The release of the hormone insulin from your pancreas allows the glucose to pass from your blood stream into your cells to produce energy for the body. In this way, the insulin helps to regulate your blood glucose levels and allows your body to use the energy from carbohydrates.

In people with diabetes, the body produces too little or no insulin or the body is not able to use its insulin properly. This means that the process of allowing glucose to pass from your bloodstream to your cells for energy is hindered. As a result, glucose accumulates in the blood, causing blood glucose levels to rise. Over time, high blood glucose levels can cause damage to kidneys, eyes, nerves and the heart.

The good news is that with the right treatment plan, diabetes can be managed, allowing you to live a long, healthy, active life. The first step is to develop a treatment plan with your lifestyle in mind. Consulting with a team of healthcare providers, such as a doctor, diabetes educator and dietitian will help you to master the four key areas for managing your health and diabetes: Exercise, Healthy Eating, Medication and Monitoring.

Pick n Pay dietician explains diabetesInformation provided by Pick n Pay dietician, Leanne Kiezer

Types of diabetes

There are three types of diabetes:

Type 1 Diabetes

Accounting for 5 – 10% of diabetes cases, this is an autoimmune condition, in which the body turns on itself and destroys the cells of the pancreas that produce insulin.  A combination of daily insulin and a carefully developed eating plan is required for its management.

Type 2 Diabetes

Accounting for 90 – 95% of cases, this is a complex and progressive disorder where a relative lack of insulin occurs together with resistance to insulin action. Occurring most often in people who are overweight, the first step to managing this type of diabetes is lifestyle change, through exercising, healthy eating and promotion of weight loss. As the condition progresses, oral tablets and insulin injections may be required.

Gestational diabetes (GDM)

GDM is a form of diabetes first diagnosed during pregnancy. GDM usually disappears after pregnancy, but women with GDM and their children are at an increased risk of developing Type 2 diabetes later in life.

Get screened

Early detection of diabetes is important, as the longer your body is exposed to high blood glucose levels, the more damage it could do. Some people with Type 2 diabetes have no outward signs associated with high blood glucose levels, so testing your blood glucose level is the only way to be sure. To screen for diabetes, a finger-prick blood test is used – go to your nearest clinic or pharmacy for this quick, painless test.

This information was brought to you by www.picknpay.co.za

Pick n Pay is committed to promoting health and wellbeing among South Africans and employs the services of a registered dietician to provide food and nutrition related advice to the public. For your nutrition and health related queries, contact healthhotline@pnp.co.za or toll free on 0800 11 22 88

For more fantastic information on diabetes and nutrition, visit Pick n Pay’s Health Corner.

A community of diabetics who understand diabetes

Earlier today, a mom messaged me on our diabetes community Facebook page, Diabetic South Africans, to say that she desperately needed strips for her Type 1 diabetic son. Their local clinic had run out and they didn’t have money to buy strips, and she didn’t know where else to turn.

I put the request out on our page to see if anyone living near her could help.

facebook diabetes communityWithin 15 minutes, someone in her town had offered extra strips, and someone in nearby Joburg had offered to courier her spare strips and a spare meter. A few minutes later, someone else had offered more strips and insulin if necessary, and someone else had offered to buy a month’s supply of strips.

I actually feel quite emotional about it – I am in awe at people’s generosity.

And this couldn’t have happened anywhere else, because only fellow diabetics would understand the panic of not having test strips and not being able to test your blood sugar, and not knowing when you would get strips. It’s the absolute worst feeling, and now this boy doesn’t have it because of the Diabetic South Africans community.

Thank you, from the bottom of my heart, thank you. And if you haven’t joined us yet, please do.

Dealing with a diabetes diagnosis in later life

Jane Sandwood, one of our regular contributors, tackles the issue of diabetes diagnosis in the elderly.

diabetes in the elderly

In a recent study of South Africans over the age of 50, 9% reported having diabetes and this percentage rose with age. With the proportion of elderly people over 60 growing fast in South Africa, having reached 4.6 million in 2017, this means that a chronic disease like Type 2 diabetes is on the rise too. As an older person, dealing with a new diagnosis can be challenging and as well as changes in diet and lifestyle, support from family and friends can be very helpful in managing the disease.

Changing habits to be diabetes-friendly

In a country where the demands of other health challenges take precedent, the needs of older people can be overlooked. Even with the best health care, a diagnosis of diabetes can be difficult for older patients. They need to change deep-rooted habits when they may already be facing symptoms and illnesses associated with the condition.

Nearly a third of people with diabetes have diabetic retinopathy which causes gradual deterioration to sight, and yet with early and regular treatment, the risk of blindness is reduced by 90%. This highlights how, by attending routine regular check-ups and creating new healthy habits, many of the symptoms of diabetes can be controlled.

Managing sugar levels

Older people are particularly vulnerable to hyperglycemia caused by very high blood sugar levels. Complications from a hyperglycemic crisis are dangerous. This is a very real risk in the elderly who may have trouble getting used to a new diagnosis and forget to follow health and diet guidelines strictly. Daily reminders about diet, keeping hydrated, careful monitoring of blood sugar levels and, in case of collapse, a system to ensure treatment is provided promptly can all help the patient feel more in control and less vulnerable.

Coping with stress – and diabetes

Adjusting to a new regime can be very demanding but it’s important to learn to relax (easier said than done!) Stress affects metabolic control and can lead to increased HbA1c, a term for glucose in the blood. HbA1c levels are almost double in diabetics experiencing extreme stress, increasing the risk of long-term complications. Tempting as it might be, it’s crucial not to rely on habits like smoking to relieve stress. One of the many consequences of smoking is hardening of the arteries, leading to an increase in cardiovascular complications. In a recent study of adult South Africans with diabetes, 73% were dealing with other cardiovascular illnesses such as angina or hypertension. In order to alleviate stress and improve circulation, an increase in exercise can be very helpful

A diagnosis of diabetes in later life can be a lot to cope with. However, small changes in lifestyle and regular check-ups and treatment can make a big difference.

Type 2 Diabetes Chat on Expresso

Bridget McNulty, editor of Sweet Life diabetes community, was recently interviewed on the Expresso show on SABC3.

The segment was about what Type 2 diabetes is, how it is caused, what to do to prevent Type 2 diabetes and how to live a healthy, happy life with diabetes.

Take a look at what Bridget had to say about how to live well with Type 2 diabetes – what would you add?

 

 

Prefer reading to watching? Here’s a breakdown of the information in the video.

 

What is diabetes?

There are three types of diabetes: Type 1, Type 2 and gestational diabetes. They are all related to how insulin is used in the body. In people without diabetes, when you eat your pancreas releases the perfect amount of insulin to match the food you’ve eaten. In Type 1 diabetes, the pancreas releases very little (or no) insulin so insulin injections are necessary. In Type 2 diabetes, either not enough insulin is being produced or the insulin that is being produced isn’t being used properly – the body is insulin resistant.

Insulin is so important because it acts as a key that unlocks the cells. When you eat, food is broken down into glucose, which is absorbed into your bloodstream. Insulin transports the glucose from the blood to the cells of the body, where they are used as fuel – as energy. People with diabetes have impaired insulin function, which means that if they are not in good control. their blood glucose gets higher and higher – this can lead to complications like blindness, amputation and kidney failure. But only if you don’t look after yourself! It is possible to live a perfectly happy, healthy life with diabetes.

What causes Type 2 Diabetes?

There is a strong genetic component, but Type 2 is often called a lifestyle disease because it is strongly linked to a poor lifestyle – being overweight (particularly around the belly), eating the wrong kind of food (junk food, lots of refined carbohydrates, fizzy drinks etc) and not exercising. If caught early enough, Type 2 can be reversed with a healthy diet, weight loss (if necessary) and exercise. (Type 1 can never be reversed). If lifestyle modifications don’t help, the treatment is generally insulin pills and eventually insulin injections. But the earlier you are diagnosed the better it is, because your body has not been damaged – that’s why we always promote getting your blood sugar checked. It’s a simple, fingerprick blood test at your local clinic or pharmacy.

Is stress a contributing factor – and how?

We all know that stress is bad for us. When it comes to diabetes and how the hormones function in the body, stress releases stress hormones like cortisol which raise blood sugar to give you an energy boost in times of danger (I’m not a doctor, but I’ve experienced this a lot myself). There are a lot of studies being done at the moment about prolonged stress, anger, anxiety, depression, poor sleep and how they relate to diabetes, but nothing has been proven yet.

What diet and lifestyle changes need to be made to fight diabetes?

Funnily enough, the kind of diet and lifestyle changes we should all be making – whether or not we have diabetes. A balanced diet with lots of fresh food and no refined carbohydrates (white bread, white rice, cakes, biscuits, etc), no juice or fizzy drinks, no fast food. Plenty of water, little alcohol, no smoking. Regular exercise – the recommendation is 30 mins 5 times a week, and it doesn’t have to be anything hectic, it can just be walking around the block and getting faster as you get fitter. And losing weight if necessary. Also regular sleep and keeping your stress down. It’s a recipe for health for anyone!

Diabetes and diet is a hot topic at the moment because of Banting and the wonderful results many people with Type 2 diabetes have had on it. At Sweet Life we don’t recommend a particular diet, we give everyone the facts so that they can decide for themselves. What works for one person may not work for others.

Study looks at diabetes and gum disease

Diabetes changes oral microbiome that promotes gum disease

diabetes and gum disease

In a fascinating study on the relationship between diabetes and periodontal (or gum) disease, Janet Southerland and colleagues note that hyperglycemia leads to the formation of specific proteins and fats that promote inflammatory responses in the mouth. “Diabetes is an important risk factor for more severe and progressive periodontitis, infection or lesions resulting in the destruction of tissues and supporting bone that form the attachment around the tooth.” A new study, however, has discovered the reason why. It’s all got to do with the way that diabetes changes the oral microbiome – the community of microbial residents that lives in the mouth. Therefore, regular brushing and flossing, attention to one’s diet, and dental visits are key.

Shifting oral biomes

The study, published in the journal Cell Host & Microbe, compared the gum health of mice with and without diabetes, finding that the microbiome of hyperglycemic mice changed. Bacteria diversity became lower, and the result was gum disease, including a loss of bone supporting the teeth. These mice also had higher levels of IL-17, a molecule involved in the immune response and inflammation. The researchers were able to reduce bone loss in affected mice through the use of an IL-17 antibody. Currently, however, this treatment is not likely to be useful for humans. Researchers therefore insisted on blood sugar control and good oral hygiene for human beings with diabetes.

Your dentist can save your oral health

An interesting study involving 2.5 million people found that adults with diabetes are less likely to visit the dentist than those with pre-diabetes or those who don’t have diabetes. Why is that? Part of the problem is undoubtedly cost, as unlike countries like the USA, where those with lower earnings can rely on Medicaid to cover emergency and preventive oral health care, few medical aid schemes in South Africa cover dental health. The report also found ethnic disparities and concluded that single people and men were less likely to visit dentists than those in relationships and women, respectively.


How often should diabetics visit their dentist?

Diabetics are advised to visit their dentist at least once a year Preventive care ensure that teeth are clean and plaque does not cause gum tissue to separate, form pockets, and eventually lead to tooth and bone loss. It’s a good idea to see your dentist right away if you have any signs of gum disease or dry mouth… Be on the alert if your gums are inflamed and bleed, which happens with gingivitus.

Because microbiomes are different for people with diabetes, inflammation and gum disease can be more likely. It is important to take proactive measures to battle gum disease and tooth decay through daily hygiene and regular dental visits. Also be on the lookout for signs and symptoms of the beginning stages of gum disease.

When last did you go to the dentist?

 

The best diabetes specialists in South Africa

We get one question on our Diabetic South Africans Facebook page every week: please can you recommend a diabetes specialist in (a certain city)?

And then we ask the diabetes community, and get amazing answers. So I thought it would be helpful to compile all of those answers in one place. If you’re looking for a diabetes specialist, take a look at the list below. I’ve included comments in italics when people had something specific to say. And if you have a diabetes specialist to recommend, please share! You can either comment on this page or on the Diabetic South Africans Facebook page.

These are all diabetic specialists recommended by the diabetes community – endocrinologists, doctors and a few diabetes educators.

Gauteng

 

Joburg diabetes specialists:

 

Dr Zaheer Bayat

Dr Sundeep Ruder

Dr Segal at Donald Gordon (Wits University Donald Gordon Medical Centre)

Prof Wing at Donald Gorden Institute – (011) 356-6000‬. Amazing. He changed my life 4 years ago!

Dr Adri Kok, Union Hospital, Alberton

CDE in Houghton – 011 712 6000‬
Fantastic facility! I’m under the superb control and guidance of Dr. Stanley Landau.
1) Doctors and endocrinologists.
2) Gym
3) Dieticians
4) Lancet Laboratory
5) Chemist
Doesn’t get much better than this!

Dr Mayet at CDE Houghton is a diabetologist, Dr David Segal specializes in paediatric diabetes.
Depends on whether you have medical aid or not. As a private patient the fees are less than for medical aids.
Dr Segal is a pediatric diabetic endocrinologist and excellent with children.

Dr Debbie Gordon at the Centre for Diabetes – 011 356 6040. She is absolutely amazing.

Dr Brian Kramer or Prof Larry Distiller.

Tabitha Hume is a really helpful registered dietician.

Dr Erasmus and associates in Benoni: Dr Erasmus is the best

Diabetic Clinic at Charlotte Maxeke Hospital 👏👌👌
Johannesburg Hospital (Charlotte Maxeke) has the best diabetic specialist in SA

Diabetic Educator Charlotte Meschede at Parkmore Medical Centre

Dr Reyneke at Life Springs Parkland

Dr Chiba at Clinton Hospital Alberton

 

Pretoria diabetes specialists:

 

Dr Jacobus van Dyk in Pretoria – the best ever

Dr Betsie Klopper in Pretoria/Hatfield.

Dr. Smit at Pretoria East Hospital

Dr Helena Oosthuizen at Pretoria East Hospital

 

Boksburg diabetes specialist:

 

Dr Coenie Venter, Healthworx in Boksburg

 

Mpumalanga

 

Secunda diabetes specialists:

 

Jeannie Berg is a diabetes educator at Kosmos Pharmacy

Dr Bahadur – 0176381253

 

Witbank diabetes specialists:

 

Dr Lombard and Kate Ratcliff at the Diabetic Clinic in Witbank – 013 697 2407

I have been with them for almost 8 years now and have got my HBA1C from 10.8 to 6.0. They arrange all your yearly appointments with Kate, the diabetic educator, the podiatrist, eye specialist and dietitian. You also see Dr Lombard every time you see the previously mentioned people. They have received awards with the medical association and are all just awesome!

 

KwaZulu/Natal

 

Durban diabetes specialists:

 

Dr Diab in the Kloof area (Highway Diabetes Centre – 031 7658741). Fantastic!

Dr Randeree at Parklands is an endocrinologist

Dr Pillay in Westville. He is a paediatric endocrinologist.

Dr Govender, Sedeshan Soobramoneyvery good specialist

Dr Jairam at Kingsway Hospital in Amanzimtoti. Very happy with him.

Dr Jo Skelton (endocrinologist) is incredible

Fiona Prins is a diabetic specialist par excellence

Dr Govender in Umhlunga

Julie Peacock is a Registered Dietitian practising in the Durban North, KZN area. She has lived with Type 1 diabetes for the last 43 years!

 

Pietermaritzburg diabetes specialists:

 

Dr Devan Gounder based at Netcare St Anne’s Medical Centre

Dr A.Y.D. Moosa – 033 3456222. He is also the MD of Midlands Medical Hospital in Pietermaritzburg. He is brilliant!

Dr Russel Kirkby

Kate Bristow is an excellent diabetes educator

 

Hilton diabetes specialist:

 

Dr Claudine Lee in Hilton

 

Free State

Welkom diabetes specialist:

Dr. Colyn: Internist at MediClinic Welkom

Eastern Cape

 

Port Elizabeth diabetes specialist:

 

Dr Greg Hough

 

East London diabetes specialist:

 

Dr Sean Murray

 

Western Cape

 

Cape Town diabetes specialists:

 

Prof Joel Dave

Dr Neville Wellington

Dr Hennie Nortje – N1 City Medical Chambers – 021 595 0922/3

 

 

A Diabetes Selfie to raise awareness

I received this message from the Blue Circle Voices team, who are part of the International Diabetes Federation. Please help them to raise awareness for diabetes by sending them a diabetes selfie.

We would like to ask your support for a very important initiative: the IDF campaign on the occasion of the UN High Level Meeting (HLM) on NCDs.

As we have explained previously, the HLM will take place on September 27, and will be the most important political meeting for the diabetes community of the last four years. During this meeting, global and national progress on diabetes and NCDs will be assessed, and the countries will decide which actions they will develop over the next four years.

Commit your selfie for diabetes

We would like to ask you for the following diabetes selfie:

1. Write your HLM message on a piece of paper:

o   On the first line, write: #HLM2018

o   On the second line, write what you think is more important for people with diabetes in the coming 4 years, choosing one of the following options:

  • Improve prevention of diabetes complications
  • Conduct T2D prevention initiatives
  • Improve diabetes education and awareness
  • Ensure access to affordable essential diabetes medicines and supplies
  • Improve access to quality diabetes care
  • Guarantee Universal Health Coverage
  • End discrimination against people with diabetes
  • Defend the rights of people with diabetes
  • Increase investment in diabetes care
  • Increase budget for diabetes care and medicines
  • Develop new funding mechanisms for diabetes care
  • Engage and empower people with diabetes

2. Take a nice picture of yourself with the paper.

3. Send it to Blue Circle Voices as soon as possible.

We will use your pictures in the coming months on the IDF social media channels.

As much as possible, please share this action with your networks. The more support we can gather, the more likely governments are to listen and take action!

Running with Type 1 diabetes

Are you a runner? Do you have Type 1 diabetes? Share your advice, tips and lessons learned below…

Hi,

I have been a Type 1 diabetic since 1984.  I have been running fairly regularly, but recently decided I need a new challenge.  I have done half marathons with no significant problems and managed my sugar levels throughout without gu or syrups. I used regular sips of Coke and mini energy bars.

My new challenge is a full marathon.  I need advice on carbs or gu while running, without rocking my blood sugars too much.  I am not on a pump, which I suppose makes it slightly more challenging.

Anyone who has done this before and can offer advice?

Much appreciated!

– Charlene

Psst! Have a question for the South African diabetes community? Email us and we’ll get it answered.

Read more about trail running with diabetes and a few fun trail runs in South Africa for diabetics to try.

Lifestyle changes to manage Type 2 diabetes

It’s one of the questions we get asked at Sweet Life all the time. Do I have to change my lifestyle – and my diet – to manage Type 2 diabetes?

diabetes diet

Lifestyle disease

Well, that depends. Most of the time, Type 2 diabetes is caused directly or indirectly by issues of diet and lifestyle – it’s sometimes called a ‘lifestyle disease’. That said, there is a strong genetic component, so it’s not helpful to think that you ‘gave yourself diabetes’. That kind of attitude isn’t going to help you live a healthy, happy life with diabetes.

Take a close look at your lifestyle. Do you think it’s one of the reasons you were diagnosed with Type 2 diabetes? Do you eat a lot of fried, fatty food? Is there enough fresh fruit and vegetables in your diet? Do you eat a lot of processed food or refined carbohydrates? Do you eat large portions, even if you’re no longer hungry? If so, it might be time for a lifestyle revamp. Take a look at Sweet Life’s Ask the Dietician articles for advice on a healthy diabetes diet.

Family with diabetes

One of the hardest things for newly diagnosed diabetics is making the changes necessary for their health, while still being part of the family. For many people, family meals are an important part of the day, and having to either eat a different variety of a meal or eat at different times or in a different way (a plate of food instead of sharing from communal plates, for example) is a difficult adjustment. Some families are fantastic at supporting the newly diagnosed, others find it too much of a challenge. Sweet Life has written about the challenges of family life with diabetes in our Partner’s Corner articles – you can find out more about families with diabetes here.

Remember that it’s important to sit down and explain to your family why you need to make certain changes, and how they can benefit from them too. Those who have adopted a healthier lifestyle – one that’s rich in fresh food and regular exercise – not only see the effects in their blood sugar results, but in their overall wellbeing.

Have you had to change your lifestyle because of diabetes?

Photo by Dan Gold on Unsplash

 

Diabetes dinner recipes

Not sure what to make for dinner? Let us help! Check out our delicious free diabetes-friendly recipes to get ideas for dinner that are tasty, healthy and good for people with diabetes (and all those without diabetes!)

healthy diabetes dinner

You’ll find recipes for:

  • Spinach and Leek Pie
  • Grilled Boerie, Cauli Mash and Relish
  • Korean Beef Lettuce Wraps
  • Baba Ganoush with Tortilla Crisps
  • Guilt-free Baked Chicken
  • Hearty Beef and Bean Soup
  • Delicious Chicken Barley Salad

Download your diabetes-friendly recipes here.

All with nutritional information to ensure you know the carbohydrate count, protein and fibre in each dish.

Looking for a specific diabetes recipe? Let us know!

And don’t forget to check out our free diabetes cookbook, which you can read online or download and print out.

Here’s to healthy, delicious, diabetes-friendly meals!

 

An honest take on Type 1 diabetes

I’d like to introduce a new contributor to Sweet Life: one of my favourite Instagram feeds, Tracy Sanders. Also known as @type1tracy. Tracy has Type 1 diabetes, but that doesn’t stop her from doing anything in life… Check out what she has to say, below, on a solo trip to Italy.

type 1 diabetes tracy

H O N E S T Y 💭H O U R: Firstly, I just want to say whatever you want to do, whatever you dream of, or whatever adventure you seek. You can do it. With diabetes. Without diabetes.


Secondly, this isn’t an inspirational “Diabetes can’t stop you from living your dreams” message, let’s be potently honest, it sure as hell can. If you choose to passively sweep through this life ignoring diabetes, your body, it’s messages, type one will create walls and obstacles.


You have to be practical💪. You have to take charge💥. You have to apply yourself and take responsibility. Take on responsibility WITHOUT resentment. 🙏Without wishing otherwise, “I wish I didn’t have diabetes, I wish I could be lucky like my friends who don’t have to inject”. It is important to acknowledge these thoughts💭, be intensely curious about them and their origins, and let them go.

Taking responsibility does not mean aiming for perfection (it does not exist). It’s about refusing to let numbers define you🚫, putting effort 💪🏼into working FOR your numbers and looking after your mental health too: patience, self-love and kindness, forgiveness, gratitude.

Being alone in Italy, it dawned on me the kind of responsibility that I was carrying with me.🙈 If I had a low, the only person I could rely on was myself.

The thoughts of mid-sleep hypoglycemia developing into seizures did creep into my mind. 🤔I have never had such before, but this does not mean it’s not possible. It just means I better make 100% sure it doesn’t happen as there will be no one to run into my room to help me. Careful bolusing, dinner well before I sleep, glucose sweets🍬 always on hand & at my bedside. Small practicalities that make all the difference. But I had gelato🍦, I had pasta🍝, I skipped dinner, and ate until my tummy was bursting😂 I had some nasty BGs and a lot of good ones

Yes you can be free, you can explore, you can run that event, you can lower your HBA1C, you can have a beautiful healthy pregnancy. But you first need to have a RAW and HONEST conversation with yourself. How can you make a change, take charge and free yourself of any little bits of a victim mentality that can lurk in the setting of chronic disease?

Have a diabetes question? Ask us here!

There are some questions that only diabetics know how to ask – and answer… This is your space to ask any diabetes questions you like – and give answers to the rest of the community. After all, we’re all in this diabetes journey together!

Share your experience, your tips and advice, and your challenges with diabetes on this page.

diabetes question

Please bear in mind that any information shared here is from the diabetic community, and has not been supplied by a medical doctor. Don’t make any changes to your medication without first consulting a medical professional. That said, diabetes is a social condition, and we can all learn from each other as we strive towards better control.

Have a question?

Write an email, attach a photo (if you want to) and we’ll publish it here! Give as much information as you can about the issue and we’ll work through it together!

Diabetes question (an example!)

Subject: Eating curry sends my blood sugar up
Email: Every time I eat curry my blood sugar goes through the roof… Has anyone else experienced this? I’m eating chicken curry with naan and taking what I think is the right amount of insulin. By Joe Blog (www.yourwebsite.com)
Pics: If you want to add photos to your post, simply add them as an attachment in the email and we’ll put them up as part of your blog post.

Once your blog post is live, we’ll invite the rest of the community (particularly from Facebook) to join us in sharing advice.

Have a diabetes question? Let’s answer it!

The carbs-fat-protein debate

Ask the dietician: Genevieve Jardine

From the community: “I don’t understand the whole ‘low carbs high fat or high protein’ idea – how do carbs, fat and protein work together? Is there a happy middle ground, or does it need to be all or nothing?” Wessel Jones

To understand what all the fuss is about, we need to look at the history of diabetes treatment. Treating diabetes (both Type 1 and Type 2) by lowering carbohydrates (carbs) has come and gone out of fashion over the last century. This debate is not a new one and it is probably not going to go away.

Before the invention of insulin, the only way for a diabetic to survive was to cut out the foods (carbs) affecting blood glucose. With the advent of insulin, the focus switched from lowering carbs to lowering fat to help reduce heart disease. Fast forward a couple of decades and we can see that we have failed in reducing obesity, diabetes or heart disease. It’s not as simple as just diet: it’s about physical activity, stress, diet and environment.

How do carbs work in the body?

What is quite simple is that carbs cause blood sugar to rise and the more carbs you eat, the higher the blood sugar goes. If a person wants to control their blood sugar, it’s a very good idea to reduce carbs. The big question is: how low do you go? A “low carbohydrate diet” can have anything from 20g to 130g of carbohydrate per day.

Remember: One portion of carb (a medium apple, a slice of bread) = 15g carb

The amount of carbs depends on the individual, their control, their medication and their weight. There is a growing amount of scientific evidence that low carb diets improve glucose control and help with weight loss.

Where do fat and protein fit in?

When carbs are cut, the amount of protein or fat (or both) go up. And this is where the debate heats up. The concern is not the low carb, but the increase in saturated fat or fat in general. Remember that not all fat is the enemy and there are good fats that play a very important role in the body.

A benefit of protein and fat is that in the immediate, they do not cause the same spikes in blood sugar. When you lower carb intake you have an immediate blood sugar lowering effect. When this happens, and you have fewer spikes and dips in blood sugar, your appetite is better controlled. The fuller you feel, the less likely you are to snack and the fewer kilojoules you consume. The fewer kilojoules you consume, the more likely you are to lose weight.

The problem with the low carb approach is that, like everything else, it needs to be a lifestyle. When you add carbs back into your diet you will put on weight, especially if you have increased your fat and/or protein. You can’t have it all: full fat products and also carbs. The most important goal is to increase your vegetable intake and try to eat as close to nature as possible. Eat foods in their most original form.

When it comes to deciding on the right ratio of carbs : fat : protein, work with a dietician. It may take time to find your correct balance and you need to be monitored properly with blood tests and possible medication adjustments.

‘Being diabetic is a gift’

I got this amazing email from one of our community members last week and had to share it. Would you like to share your story with the Sweet Life community? Email me – we’d love to hear it.

————————————————————–

What an absolute treat to read your magazine and continually refer to it.

I have been Type 1 diabetic for 14 years. As much of a roller coaster ride as it has been, I would not swop being diabetic for anything in the world.

The people you meet along this journey, the knowledge you gain about how your body functions and responds, the prior knowledge you get from high glucose readings before you get ill and a complete understanding of the people I meet who possibly battle with elevated glucose levels or hypoglycemia.

Being Type 1 diabetic makes you aware on every level – spirit, body, mind, soul, feelings, thoughts, allows for wise choices (although if not wise then the consequences that accompany these – you have actually just got to smile, knowing that this is within your control), tolerant and respectful of others.

It is without a doubt, a gift.

It is amazing how when you change your mindset and adopt an attitude of gratitude, how life truly shines in its full form.
Make no error, there are days when I sit on my kitchen floor and weep in frustration – as ‘for no reason’ my sugar levels are astronomically high (21.0) or scarily low (1.8) and then I do adopt the ‘oh woe is me’ and sob. Then when I’m done I get up and reconsider things with fresh eyes and chances are good I know what I have done wrong, or that my insulin pens are not working as they should or my change in hormones as I get older has added a new spin.
I have a diabetic friend who is wise, a mind blowingly phenomenal psychologist who practices the Demartini approach. At one of my ‘I can’t do this’ moments, she told me to get myself a journal and write down 200 reasons why I am grateful for the gift of having diabetes. Initially I balked at the mere thought – then when you get started you just keep going and smile as you write or nod like a lunatic. I am on 150 reasons and it’s been a couple of months – but I look back and reread these and then put one foot in front of the other again, with purpose.
– Lara

Diabetes treatment update

Diabetes treatment update

The International Diabetes Federation reports an average of three and a half million people in South Africa are living with diabetes. Three and a half million of us struggling with the insufficient production of insulin by our bodies – and many more undiagnosed. There is no question that diabetes is one of the most common healthcare concerns of South Africa and its citizens. So what diabetes treatment updates are there?

Well, there are reasons to hope and possibly celebrate. Recent years have seen great advancements in the diagnosis and treatment of diabetes globally. Scientists and medical professionals alike continue to work tirelessly in pursuit of a clinically tested and dependable way to improve the lives of those living with diabetes and possibly prevent the diagnosis of further cases. That work is beginning to show with some great breakthroughs in the treatment of diabetes. Here are some treatment advancements coming to the forefront and what it may mean for diabetes patients across South Africa.

Diabetes treatment options are changing

In 2016, the world received word of the first artificial pancreas being brought to the market for the first time. Although distribution and availability of the system remain fully explored, it is certainly garnering attention for its ability to help patients living with Type 1 diabetes by reducing the chances of hypoglycemia. The development has been cited by many studies as having the ability to transform diabetes by offering improved glycemic control. It responds to either low or high glucose levels and automatically adjusts the insulin levels accordingly.

With overwhelming success rates, South Africans saw the first version launch in 2009 along with Europe before later being expanded upon and eventually approved by the FDA in the United States of America. New drugs such as empagliflozin have also shown a great deal of promise in reducing cardiovascular risk. South Africa’s senior population has one of the highest cardiovascular risks in the world and this is directly linked to diabetes. The most common causes of death in diabetic patients have been shown to be either stroke or heart disease.

New development in insulin treatment for diabetes

For those living with diabetes, insulin is a key part of their daily lives. Diabetes means the body is unable to process glucose which in turn affects blood sugar. This is caused by the body either producing too little insulin or the insulin produced not working properly. Another exciting development in recent years is the development of longer lasting and more efficient medication for those having to do regular injections of insulin. Technological inventions such as the insulin pen by Timesulin are especially aimed at the senior population. The pen tells you when you last took an insulin dose. The device is now widely available from distributors in South Africa and has been largely welcomed.

Diabetes awareness is shifting

Public awareness around South Africa and amongst South Africans about diabetes is changing. Organisations such as SEMDSA (the Society for Endocrinology, Metabolism and Diabetes of South Africa) have released updated guidelines alluding to dietary guidelines for those with diabetes. The government is playing its part as well with an announced sugar tax taking effect in April 2018.

The Sugar Beverage Levy dictates that for beverages with sugar content exceeding 4g per 100ml is taxed at 2.1 cents per gram of sugar content. The tax is apart of the Healthy Living initiative being pursued by the government and saw information roadshows being held across South Africa to educate the public about the tax. Introduction of a sugar tax is hoped to deter the consumption of sugary beverages, a large trigger for patients and also a contributing factor for being diagnosed with diabetes in the first place.

Diabetes awareness in the workplace

Corporate wellness programs are now being offered by employers and more food establishments and canteens across South Africa are offering healthier options. More and more online resources and publications are promoting the need and tips for healthy eating on a budget. With over 37 percent of the population not being able to afford an adequate healthy diet thanks to food prices, the timing of these promotions is perfect.

Although these steps are certainly in the right direction, there remains a long way to go in fighting the spread of diabetes in South Africa. Better education along with an increased priority on healthcare lists are among some of the pressing options. By preventing and treating diabetes early, it is not only the country’s population that stands to benefit greatly, but also its economic standing.