Author: Editor

How to lower high blood sugar?

From our community blog:

Hi all,

Petunia has a question for us about lowering high blood sugar:

“I would like to know what can I do to bring down my sugar. I have Type 2 diabetes, I’m on Actraphane 30/70 and I don’t have a proper diabetes diet.”

What do you suggest?

The obvious ones that spring to mind are:

  1. Eat lots of fresh vegetables, wholegrains, lean protein and no refined carbohydrates.
  2. Steer clear of sweet treats.
  3. Drink lots of water.
  4. Exercise a little every day – even if it’s just a walk around the block.
  5. Lose weight if necessary.

What do you have to add? Let’s help Petunia out!

Comments:

Hi,

I am also Type 2 – I find the best thing is exercise. Sometimes you can’t avoid the carbs, but if you walk, run or cycle 30 min per day – you can reduce your sugar levels significantly.
Victor

Dear Petunia,
Diabetes is not an easy quick fix ever. It is important to manage this condition in the best way always and this means getting a lot of HELP! I suggest you find a dietician or a diabetes educator in your area and schedule an appointment a soon as possible. In order to understand this condition it’s important to understand how food and your medication impact on your glucose levels. It becomes so easy with this help!
Fiona

Extreme sport and diabetes

Richard English has Type 1 diabetes – but that hasn’t stopped him from embarking on all kinds of adventures, including a seven day, 1000km cycle across England and Scotland. We ask him for his secrets to a healthy life with diabetes.

When did you find out you were diabetic?

Eight years ago, when I was 25. I had been feeling incredibly under the weather and stressed, but I blamed work and too much partying – I just thought I was run down. Then I started getting all the symptoms: extreme thirst, dramatic weight loss, drinking 2 litres of water a night and needing to pee every hour.

How has diabetes changed your daily life?

Obviously I have to inject insulin before I eat anything, and I test my blood sugar more or less before every meal. Exercise is also more of a need than a want – I always used to exercise, but now I can see the effect on my blood sugar results, immediately. That’s very motivating.

I went cold turkey on a lot of things when I was diagnosed, and I haven’t kept any bad habits. I’m 20kg lighter than I used to be, and I don’t over-indulge any more. I suppose, in my case, diabetes could be seen as a positive thing. I wasn’t living a healthy life before I was diagnosed, and I have a better quality of life now.

I don’t think I could have adapted so well to life with diabetes if it weren’t for my wife, Casey. She never left my side, and all the dietary changes I adopted she did too. She also helped a lot in the early stages, when there was just too much information for me to absorb. She got behind the science of it and now knows more about low GI and its effect on blood sugar than I do!

Have you always been a cyclist?

I got my first bike when I was 5 years old, and I’ve almost always had a bike. Cycling is a big part of my life, and I really love it. I stopped exercising for about 6 months after my diagnosis, because I was uncertain about what it would do to my blood sugar, and every so often I have to cut a ride short because I’m going low. But most of the time diabetes doesn’t get in the way of my cycling at all.

Can you tell us about the Ubunye Challenge?

The Ubunye Challenge is a triathlon event organised by an old Rhodes friend of mine, Cameron Bellamy in 2012. He decided to raise funds for the Angus Gillis Foundation by doing an extreme cycle, swim and rowing challenge. I joined him for the cycle – I rode for seven consecutive days and covered 1000km through howling gales, rain, sleet and snow. It was in April, which was supposed to be spring, but it was shockingly cold. By the third day, we outran the weather and I saw my shadow for the first time. That was a good moment! 1000km seems like an unbelievable distance, but if you do it in 120km chunks it’s not that bad.

What advice would you offer to other diabetics?

To me, the most important thing is that you have to stay positive and optimistic, because diabetes is not going to go away. As soon as you can smile at it and look it in the eye, you’re on your way to living a happy life with diabetes. The sooner you can get positive about it, the better.

What makes your life sweet?

My wife Casey, my wonderful son Robbie, weekends with friends, good food, my bike, and exploring my new home city of London.

Get in touch with Richard: molorich@gmail.com

Diabetes breakthroughs

From the artificial pancreas to new ways of testing blood sugar and more, we take a look at the future for those with diabetes.

Diabetes is a rollercoaster ride of blood sugar ups and downs, and tight control can be hard work. But there’s good news: while some researchers are working on a cure, others are making life easier for those with diabetes right now, through technology.

Carine Visagie brings you a roundup of the top new technologies out there.

Glucose-monitoring devices

 

Continuous glucose monitoring (CGM) devices are soon going to take blood sugar control to another level.

With the help of tiny electrodes stuck beneath the skin, CGM devices allow for real-time glucose readings throughout the day. The results are sent wirelessly to a monitor you can clip onto your belt and access on the go, and some devices can even send results to your doctor. Normal finger prick testing is still required (for a double check and to calibrate the CGM sensor), but you can rest assured that a CGM device will alert you if your sugar spikes or drops below your limits.

Examples include the Flash Glucose Monitoring System (Abbott) and the Guardian REAL-Time Continuous Glucose Monitoring System (Medtronic).

Ask the expert: Dr Joel Dave, endocrinologist
“24-hour glucose monitoring is going to be very helpful in patients that have difficulty controlling their blood glucose levels, as it will provide a 24-hour 360-degree view of their diabetes control.”

Ask the expert: Dr Wayne May, endocrinologist
“I’m looking forward to the Abbotts Flash Monitor, as it will stay on for 14 days and doesn’t require calibrating with a second machine.”


Insulin pumps

Insulin pumps keep getting smarter: some of the latest ones sync with CGM devices, while others are incredibly accurate at giving just the right insulin dose at the right time.

One example is the touch-screen Tandem t:slim insulin pump, which shows the date, time, how much insulin is ‘on board’ (seeing this before you bolus can help you avoid stacking your insulin*), duration of insulin action, and the amount of insulin in the reservoir. It looks like a smartphone and data is easily transferrable via a USB port. Plus, it can deliver insulin in very small doses.
*Insulin stacking is injecting a second dose too soon after a first, without taking into account the insulin already in your system. This can result in low blood sugar.

Another insulin pump to watch is the MiniMed530G by Medtronic – the first pump to shut off when blood sugar goes below a predetermined level.

Ask the expert: Dr Joel Dave, endocrinologist
“Although an insulin pump isn’t the ideal way of administering insulin for everyone, many diabetics find a pump improves their diabetes control and quality of life. Since the addition of CGM, the use of this technology has improved even more, especially in children and patients with very erratic blood sugar.”


Bionic pancreas


Bionic (artificial) pancreas systems are the next big thing in diabetes management. These systems, the first of which is still being tested, combine the latest CGM tech with the most advanced insulin pump tech and add a sophisticated computer programme to simulate the function of the pancreas.

The system constantly checks blood sugar levels by means of a CGM, and responds automatically by administering either insulin (to lower blood sugar) or glucagon (to raise blood sugar levels quickly) via two separate pumps. The system hooks up to a programme on your smartphone that makes decisions every few minutes, telling the pumps via Bluetooth how much hormone to deliver.

The bionic pancreas should be available in the next 5 years.

Ask the expert: Dr Joel Dave, endocrinologist
“The artificial pancreas has been the ‘holy grail’ for diabetes care for many years. The system has been vastly improved and early studies are showing great promise. Although not for routine clinical use at the moment, in the near future it will be a life-changing addition to the diabetes care of many patients.”

What about now? Smartphone apps for diabetes

If the future of diabetes tech seems too far away, keep an eye out for apps that can help you deal with diabetes right now, on your smartphone. We like:
Glucose Buddy: to track blood sugar readings, insulin doses, carb intake, exercise, blood pressure and weight, and
Diabetic Connect:
helping you tap into trusted advice, friends, support and tips.

But be warned: many international apps use mg/dL, the US blood glucose standard, instead of mmol/l, the South African standard.

To snack or not to snack?

Ask the dietician: Genevieve Jardine

From our community: “My average blood sugar over the past few months was higher than it should have been, so I’m trying really hard not to eat the wrong foods. Any tips for healthy snacks?” Lynnae Daniel

Getting creative with your snacks can really help make your daily meal plan more exciting. We all get into a rut with our meal choices, and adding different (healthy) snacks can improve variety, colour, flavour and even add valuable nutrients to your daily intake.

Not every person with diabetes needs to snack. Some people are happy with three square meals a day, while others prefer small snacks throughout the day. Your unique eating style largely depends on your own natural eating patterns, medication, blood sugar control, and how active you are.

Remember: If you go for more than 4 or 5 hours between meals you may need to snack in order to prevent your blood sugar from dropping too low. But snacking on the wrong kind of food can cause blood sugar levels to rise and also cause unwanted weight gain.

So what does a healthy snack look like?

  • A snack should be between 300 to 600 kilojoules otherwise it is more like a meal.
  • Snacking is a good chance to increase your vegetable or fruit intake (remember, the aim is 5 servings of vegetables a day).
  • Plate your snack to help control portion size: don’t eat straight out of a bag, box or packet – or straight from the fridge!
  • Portion your snacks into snack-size packets, or buy suitable snack portions.

Ask yourself: are you actually hungry? Don’t snack because you’re bored, stressed or worried.

Healthy snack ideas:

  • One piece of fruit (carb 15g, fat 0g, 300kj)
  • 100ml low-fat flavoured yogurt (carb 16g, fat 2g, 400kj)
  • 2 cups popped popcorn sprinkled with fat-free parmesan cheese (carb 15g, fat 7g, 636kj)
  • 30g lean biltong (carb 0.7 g, fat 2g, 346kj)
  • 3 Provitas or 2 Ryvitas with cottage cheese, tomato and gherkin (carb 20g, fat 2g, 382kj)
  • ½ an apple with 20g sliced low-fat cheese (carb 8g, fat 5g, 430kj)
  • Raw veggies (carrot sticks, cucumber, baby tomatoes, gherkins, baby corn, snap peas) with cottage cheese, hummus or avocado dip (carb 8g, fat 7g, 540kj)
  • 30g nuts/seeds (carb 3g, fat 14g, 735kj)
    Tip: Nuts and seeds are high in fat and kilojoules. However, the type of fat is much healthier than that found in a chocolate bar.

Unhealthy snack choices:

  • 50g bar of chocolate (carb 30g, fat 12g and 1120kj)
  • 30g packet of potato crisps (carb 24g, fat 12g, 766kj)
  • 300ml bottle of drinking yoghurt (carb 45g, fat 5.6g, 1140kj)
  • 25g packet of sweets (carb 18g, fat 0g, 316kj)
    Tip: It might seem like this snack is within the recommended carb, fat and kilojoule allowance, but they are empty kilojoules with no fibre and very little vitamins and minerals.

Snacking for exercise:

Remember that exercise can also cause low blood glucose. It is important to check blood glucose before and after you exercise. People react differently to exercise depending on the type, duration and intensity: some people see a rapid drop and others an increase in blood sugar levels, so it is important to test and see what your individual response is.

As always, you should see a dietician to help you plan suitable snacks for different situations. Fresh snack ideas can bring a sense of fun into your daily eating plan.

Puppies, baby goats, hedgehogs and pre-diabetes

You might not think puppies, baby goats, hedgehogs and pre-diabetes have anything in common… But you’d be mistaken! This brilliant campaign highlights the risks of pre-diabetes, a condition that indicates a person is on the path to developing Type 2 diabetes.

Here’s the explanation:

More than one in three adults have pre-diabetes and are at a high risk of developing Type 2 diabetes. Of those individuals, 90% don’t even know they have pre-diabetes.

A first-of-its-kind PSA campaign from the Ad Council brings together the American Diabetes Association, American Medical Association and the Centers for Disease Control and Prevention with the ultimate goal of reducing the incidence of Type 2 diabetes. Anyone can find out where they stand with pre-diabetes in just one minute by taking a quick pre-diabetes risk test.

The spots offer viewers a “perfect way to spend a minute” where they can learn where they stand by taking the one-minute pre-diabetes risk test while also doing something everyone loves — watching adorable animal videos.

So here are those videos… They are amazing.

Puppies:

Baby goats:

Hedgehogs:

10 Fast facts about foot care

Foot problems are one of the things that those of us with diabetes need to watch out for. We’ve got some top tips to keep a healthy spring in your step.

  1. People with diabetes should have their feet examined by their doctor or podiatrist at least once a year, with thorough washing and daily inspections a part of everyone’s diabetes management plan. Be careful to wash and dry properly between the toes, and at the first sign of any sores, blisters and cracks see a podiatrist immediately.
  2. When cutting your toenails, be sure to cut straight across, without following the curve, and file the edges to smooth them. Be careful not to cut your nails too short. This will prevent ingrown toenails.
  3. Avoid walking barefoot and have any corns or calluses cut by a medical professional – don’t do it yourself.
  4. Don’t use hot water bottles or heaters near your feet.
  5. Moisturize daily to avoid any dryness. Even mild cracking can lead to ulceration. Avoid putting cream between the toes, as this encourages fungal infections.
  6. Nerve damage caused by high blood sugar levels can cause numbness in the feet. Together with lower production of sweat and oils that lubricate the feet, this can cause increased pressure on the skin, joints and bones of the feet, which in turn causes pain, redness, swelling, sores and ulcers to develop.
  7. Foot ulcers are reported to affect 1 in 4 people with diabetes in their lifetime. Constant foot care is vital in preventing and treating complications like these.
  8. Foot ulcers can be stubborn to heal and, in the worst cases, lead to serious lower body infection, disability and even amputation. Contact your podiatrist at the first sign of any problem.
  9. How do you recognize a foot ulcer? They are often not very painful, and can occur just about anywhere on the foot. When calluses are not removed correctly and often enough, it causes bleeding under the callus, which is how the ulcer begins.
  10. When it comes to footwear, choose comfort above all else. A good pair of shoes will go miles towards keeping your feet in their best condition.

How to start a kitchen garden

Always wanted to grow your own greens? Claire Barnardo gets you started this season.

How often have you wished you could simply pick vegetables from your own garden, instead of having to go to the shops? Well that’s entirely possible, no matter what size space you have. Not only is growing your own veggies a good health choice, it’s also more affordable and very satisfying as well. We’ve decided to get started with growing your own salad. Get into action with our starter guide!

Sun, soil and seeds:

  • Find your spot

Vegetables grow best in a sunny position. Start by preparing your soil, digging it up, mixing in compost and keeping the soil moist.

  • Know your space

You can go green whether you’ve got a garden or not. Here’s how to match your space to the right vegetable choice:

–       If you have a garden…

If you’re lucky enough to have a spacious garden then you can look at growing more rambling types of vegetables. Try cucumber, courgettes, patty pans and watermelon.

–       If you have a small patch…

For a more compact garden area, try lettuce, spinach, leeks, beetroot, bush beans and aubergine. These veggies also make good borders as they grow in a contained space.

–       If you have a window box or pot…

Chillies make beautiful pot plants, as do small cherry tomatoes. It’s also a good idea to grow tomatoes in large pots (20 litres) and train them up a trellis, or try other runner plants that do well in pots with frames, like peas and beans.

  • Sowing seeds

Planting from seed is far more affordable than seedlings. The gardener’s secret is to use about three seeds at a time. Make sure that the soil is moist enough at germination (when the seed is sprouting) and sort seedlings when they are big and strong enough to be separated. You can store leftover seeds in a packet in a dark space.

 Summer salads

  • Lettuce and rocket

Sow: September

Harvest: November

With many wonderful types to choose from, growing your own lettuce is the way to go. Find a sunny spot and prepare the soil. Sow seeds in short rows and cover with netting to protect from birds. When the seedlings are about 2cm big you may need to space them out more. Lettuce is also ideal to grow in window boxes – try variations like iceberg, cos or wild rocket for a more vibrant taste.

Hot tips:

– Continue to sow seeds each week for four weeks to have a constant supply throughout the summer.

– Make sure that you choose a spot that gets afternoon shade: full sun in the summer is too hot for lettuce.

  • Tomatoes

Sow: September

Harvest: December

Reliable and quite easy to grow, tomatoes enjoy warm and sheltered spots. Make sure you match the variety you choose to your space and location. They need good soil, regular sun, compost and water.

Hot tips:

– Sow seeds thinly as most start sprouting within two weeks.

– To keep tomatoes at a contained size, pinch out the growing tips so that the plant produces fruit.

  • Peppers and chillies

Sow: September

Harvest: January

Peppers and chillies love to grow in sunny pots. Sow seeds thinly on top of a composted soil pot, water and wait a week. You may need to transfer smaller seedlings to bigger pots as they grow.

Hot tips:

– Support larger plants with a stalk and some twine.

– Water often, especially in hot weather, as these veggies get thirsty often.

And why not make your own compost!

The best compost comes from organic waste – things that are found right in your home.

  • Save vegetable and fruit cuttings from your kitchen (everything except citrus, which is too acidic for compost).
  • Also set aside used tea bags and eggshells.
  • Add it all to your compost heap.
  • Turn the compost heap regularly.
  • Make sure it gets a lot of sun.

How to deal with a diabetes diagnosis

“My son has just been diagnosed with Type 1 diabetes and we all feel like our world has been turned upside down. But he’s really struggling to talk to us (and his extended family) about his diagnosis. Any tips on how to begin?” Razan Naransamy

Dear Razan,

When a child is diagnosed with diabetes, both parent and child feel different emotions. In the beginning, parents are inclined to spend time worrying about the physical effects and the day to day management of a condition they don’t yet know anything about. The child goes through different feelings, like sadness and hopelessness, even anger and frustration.

It might help to find someone your son will confide in – even if it’s just to find out why he doesn’t want to talk about his diagnosis. It could be a diabetes nurse he trusts or a psychologist or even a family member or friend. Don’t feel bad about getting help. There are many reasons he might not want to share: he might feel isolated, depressed, afraid or even angry at you. Because you are the one in charge of the tests and shots and the policeman of what he eats or does, it might be easier to blame you. He could even be feeling embarrassed because of the sudden overload of attention.

Helping your child involves acknowledging his feelings and listening to what he says. This communication does not always have to be verbal. Writing or drawing or even making music can get your child to share his feelings.

Encourage him to actively participate in his health care management. Help him to be independent. Once he starts feeling more confident and independent, he will be more likely to share his feelings of living with diabetes. Encourage him to have fun with friends and if he starts going on outings and camps with friends and other children with diabetes he will learn from them that it is okay to talk about it.

  • Tell your son that he did nothing to deserve diabetes – it just happens. If he feels that the condition is troublesome for you or your family, reassure him that there’s no reason to feel guilty.
  • Remember that children are likely to copy the way that their parents cope with something.   Also remember that expecting a child to deal with things quickly and practically isn’t helpful to you or him. You need to set the example.
  • Build a support network that you and your family can fall back on. Be informed parents.
  • Make the most out of every day.

You and your son are on a lifelong journey with diabetes.

A good journey requires lots of planning, flexibility, curiosity, frequent course corrections, and an occasional attitude adjustment.

Make it a good one.

– Jeannie Berg, Diabetes Educator

 

Exercise made easy

Who said getting fit has to be a big project? With these five 20-minute workouts, you’ll be on your way to getting active in minutes! Daniel Sher shows us how. 

Let’s be honest: most of us have a lot of things on our To Do Lists, and exercising is not the one we want to do most! Our busy lifestyles often get in the way of our health, but how hard is it, really, to get active? Exercising can be easier than you think – there’s no need to run marathons or spend hours at the gym. In fact, a recent study* showed that just twenty minutes of daily exercise is enough to lose weight and control your diabetes better. Here are five simple ways to get active that only take twenty minutes to complete. We all have twenty minutes every day… Why not use them to feel great?

  1. Before (or after!) work

It might be a part of everyday life, but walking is also a great way to exercise. Taking a walk is a simple and relaxing way to get your heart rate up. Beaches, forests, parks and rivers are all great for a refreshing twenty minute walk, but a quick stroll through your neighbourhood can be just as enjoyable. Choose a time for your daily walk – twenty minutes before work, for example – and try to do this every day. Walk quickly and keep things interesting by changing which way you go from time to time. Join up with a few friends and it will make your walk even more fun.

Ask the expert: Sarah Hall, Biokineticist

“It’s important to practise correct posture when you walk. Follow these tips: walk tall, imagine a piece of string pulling you from the top of your head, lengthening your spine, and use your arms so that you have more power.”

  1. On your way to work

Most people sit in a taxi, bus or car to get to work. Believe it or not, this is a great opportunity to get some exercise! If you live close to your workplace, choose to walk, jog or cycle instead. And if your home is too far away, get out of the taxi a few stops early, or park further away than usual. Using your morning commute to exercise can help you save time, and also make you feel refreshed for the day ahead. Choosing to walk home (or part of the way home) after work can help to burn away the day’s stress and clear your mind.

Ask the expert: Sarah Hall, Biokineticist

“Buy a pedometer and track how many steps you take and the time it takes you to get from home to work. This is a great way to figure out how active you are during the day, and to encourage you to work on beating your own time and setting your own goals.”

  1. In the office

Quiet times at work are ideal for a quick workout: you can do an easy muscle-toning routine while sitting at your desk. Start by tightening your three main muscle groups, one at a time (legs, stomach and arms). Begin with a deep breath and clench your legs for five seconds; then take a breather for ten seconds before tightening up your stomach muscles for five seconds. Take another breather, and finish by clenching your arms and chest, which you tighten by pressing your palms together as if you’re praying. Repeat this routine until twenty minutes are up for a quick and easy muscle workout!

Ask the expert: Sarah Hall, Biokineticist

“Add a few arm and neck stretches as well! Hold your drawer, roll your shoulders back and down, and lengthen your spine whilst you sit.”

  1. At home

We all make excuses to stay inside: it might be raining, you might have a lot of chores to do, or the TV might be calling your name. Don’t let this stop you from getting your twenty minutes of exercise – you can easily transform your household routines into a workout. When you’re talking on the phone, pace around the house or climb up and down stairs, rather than sitting down. What about your errands? Sweeping, mopping, scrubbing and washing can give you a great workout and a clean house at the same time. Feel like watching your favourite TV show? No problem – use this time to jog lightly on the spot, whilst gently punching your arms in front of you like you’re boxing. Just be sure to pull the curtains so your neighbours don’t think you’re crazy!

Ask the expert: Sarah Hall, Biokineticist

“Treat this just like any other exercise session. Start with the easy tasks first, then stretch. Follow this with the activities that get your heart rate up, and then end with the chores that involve lifting things. Remember: if you are treating it as a workout, don’t forget to cool down and stretch at the end.”

  1. On the weekend

If you’re looking for a simple way to exercise and to have fun at the same time, dancing might be the answer. And what better time to dance than on the weekend? Listen to your favourite playlist, focus on letting loose and try to enjoy yourself – before you know it you’ll have worked up a sweat. If you know any ballroom steps ask a partner to join you for twenty minutes – fast-paced dances like the swing, salsa or tango are all great for increasing your heart rate. If you don’t know any dance moves, make up your own! Nobody’s watching…

Ask the expert: Sarah Hall, Biokineticist

“Dancing can be a great way to challenge your balance and a useful way to become aware of any imbalances between the left and right side of the body.”

How does exercise help diabetes? Exercise is recommended for most people, but an active lifestyle is especially helpful for diabetics. Why? Exercise can:

–       Help your body to use insulin better.

–       Prevent cardiovascular (heart) disease and other diabetes-related complications.

–       Reduce stress and anxiety, which makes it easier to manage your condition.

–       Improve your blood sugar control.

* In the September 2012 issue of The Journal of the American Medical Association.

South Africa’s most (and least) obese city

Last week I was lucky enough to spend a morning at Discovery learning about The Vitality ObeCity Index 2017 (check out #VitalityObeCity to read all about it.)

It was a fascinating morning. The Vitality ObeCity Index analysed data from Discovery Vitality members in six cities in South Africa (Bloemfontein, Cape Town, Durban, Johannesburg, Port Elizabeth and Pretoria) to see which city is the most obese and how their buying habits influence that.

A few interesting (and terrifying) facts:

  • Half of South African adults are overweight or obese. What that means is increased risk of heart disease, Type 2 diabetes, certain cancers and premature death.
  • Our eating habits have changed so much that South Africans now spend more money on beer than on vegetables and fruit combined. What?!
  • 45% of South African women are obese, as opposed to only 15% men. In 2013, South African women were the most obese in sub-Saharan Africa. So South African women are the most at risk for obesity.

I asked why that was and apparently there are three reasons:

  1. Women who were nutritionally deprived as children are more likely to be obese as adults (men who were deprived as children are not).
  2. Women of higher adult socioeconomic status (which is income, education and occupation) are more likely to be obese, which is not true for men.
  3. And possibly: in South Africa, women’s perceptions of an ‘ideal’ female body are larger than men’s perceptions of the ‘ideal’ male body – it’s seen as a status symbol to be a heavier woman.

Are you a South African woman? I am… Let’s make sure we’re informed and don’t let obesity happen to us and our sisters, mothers, daughters, friends.

The results

Vitality gathered data from half a million Discovery members to give us these results:

  1. Their weight status (BMI and waist circumference)
  2. Their food purchasing score (healthy vs unhealthy items)
  3. How many fruit and vegetable portions they purchased
  4. How many teaspoons of sugar and salt in the food they purchased

Weight status

Cape Town scores highest, with 53.5% of Capetonians in a normal weight range. Cape Town also topped the healthy purchasing score (which shows a positive relation between what you buy and whether your weight is in range or not.)

Fruit and vegetables

Cape Town purchased the most portions of fruit and vegetables compared to other cities – see the ranking above. In general, though, South Africans are only eating 3 servings of fruit and vegetables a day, as opposed to the 5 servings we should be eating.

Salt

Durban purchased the least amount of salt in SA, with Cape Town purchasing the most. We are eating twice as much salt as we should be in a day: it should only be 5g (1 teaspoon).

Sugar

Durban came out top of this test too, with the lowest average number of teaspoons of sugar purchased – Bloemfontein purchased the most sugar. And again, we’re eating twice as much sugar as we should be – a staggering 100g a day! (That’s 24 teaspoons – in the food and drink we consume.)

There are a number of factors that play into this, of course. The way we buy our food – the impulse buys, the treats, emotional eating. Fast food is also a huge problem, because it’s loaded with salt, sugar and bad fats. Cooking at home with whole foods (not convenience foods or ready-made meals) has been proven to have an enormous impact on health and weight.

So what should we be eating? Here are some excellent guidelines.

What do you think? This information made me take a closer look at how I shop and what we eat… Not even because I’m diabetic, but just because I want my family to be as healthy as we possibly can.

Living well with diabetes

From Facebook (Diabetic South Africans):

What does living well with diabetes look like for you?


Tried changing my way of eating, lost weight and still had to go on tablets. My levels are stable though – between 5.3 and 6.1 – enjoying my new way of life.
Sharon

Well… Sharon, that’s living well with diabetes, the rest is history! Well done.
Clint

I am Type 2 and lost 40kg from 110kg, gained muscle, full of energy and feeling 10 years younger! What I eat is part of living well with diabetes.
Phillip

It sucks big time. But taking it day by day. Some days are cool, but some are just hell.
Phumzile

Totally sucks. Got neuropathy from my ankles to my toes! Sugar down from mid 16s to between 8 and 12. Doc wants to put me on insulin but I don’t want to. Staying positive and fighting hard!
Anton

After taking control of my diabetes myself, i.e. testing throughout the day and increasing my insulin to where I needed it, I’m happy to report I tend to stay between 4 and 8 with a couple of hiccups here and there when I hit 12 or 9 – but nowhere close to 16 as before… Anton, I fought insulin injections too. But it works and I feel so much better. The fight against insulin is not worth it if you are damaging your body…
Elrica

The challenge of gestational diabetes

Celeste Smith is no stranger to gestational diabetes: she’s had it twice, including during her pregnancy with now-five-year-old twins Connor and Adam. We find out what she wishes she’d known before she fell pregnant.

Is there a reason you’re so happy to share this very personal story?

I want to educate, encourage and motivate women with gestational diabetes, and prevent other women from having to go through what I and many others had to endure.

How did you find out you had gestational diabetes?

My first pregnancy was stillborn: Noah was born at 38 weeks. I didn’t know I had gestational diabetes until after Noah was born. We suspected with my family having diabetes that I could get it, but my doctor at the time never picked it up. When I wanted to fall pregnant again, my new doctor Dr Jansen immediately tested for glucose tolerance before I fell pregnant, and then again after I fell pregnant. That’s how we found out I had gestational diabetes again.

What were your symptoms?

What’s tricky about gestational diabetes is that it goes from nothing to full-blown diabetes very quickly. It’s only when you’re pregnant, so there’s no warning beforehand. The symptoms I had were swollen hands and feet, bad circulation, pins and needles in the hands, and constant thirst – I was drinking a lot of water.

Does diabetes run in the family?

Yes – my late mother had Type 2 diabetes, and three of my sisters and my brother have diabetes (half of my eight siblings, in fact!) None of my family recognised my symptoms, but none of us were looking for them: you put your faith in the doctor, that’s what doctors are there for.

What did you do to manage your gestational diabetes?

During my pregnancy with the twins, I was put on Metformin and later insulin. I also had to have monthly HbA1c tests and test my blood sugar seven times a day: when I woke up, before each meal, after each meal and before I went to bed. My fingers had so many holes in them; I didn’t know where to prick myself! I went to a dietician, which was helpful, we discussed good eating habits and made a lot of changes – we started eating more steamed foods and not so much starch (like potatoes, bread and pasta). And I started exercising. My diabetes doctor, Dr Dave, told me I had to exercise every day, even when I was tired after working all day.

What advice would you offer to women with gestational diabetes?

Listen to your doctors, stick to your eating plan and exercise a little bit every day. Stay focused: this is for the health of your babies. It helps that you just have to stay focused for nine months, and then the reward at the end is breathtaking. My boys were big for twins (2.8kg/each at 35 weeks) and healthy. I’ll never forget how relieved I was to hear both babies crying in the delivery room. They were both crying at the same time, and the doctor said: “Wow, they sound like a choir!”

What makes your life sweet?

I could say sunsets and sunrises, I could say my religion or even cupcakes and chocolates. But my husband and three boys are the light of my life, and sharing everything with them makes my life so sweet.

Do or Don’t: Diabetic dietary supplements

Are dietary supplements really necessary if you have diabetes? Nicole McCreedy asks the experts.

Like many other people with diabetes, you may be wondering whether you need to take supplements to help manage your condition. Dietary supplements can be vitamins, minerals, herbs or other plants, amino acids (the building blocks of protein) or a combination of the above. They can be in pill, capsule, powder or liquid form.

Despite some of the claims being made, there is not enough scientific evidence to suggest that any dietary supplements can help prevent or manage Type 2 diabetes. That said, dietary supplements may provide extra nutritional benefit to people with special health problems, including diabetes. In such cases, they are usually recommended when there is a specific lack of something in the body.

Do: Eat correctly

It’s important to try and get the nutrition your body needs from a balanced diet. Making healthy food choices and choosing fruit, vegetables and whole grains over carbohydrates, refined sugars and foods high in saturated fats can make a big difference. Compared with supplements, whole foods provide a variety of different nutrients for health in one package, whereas single vitamin supplements are most often for a single purpose. An apple, for example, contains vitamin C, fibre, and antioxidants – all in one crunchy package!

Dr Claudine Lee, a GP from Hilton, says that following a balanced and healthy diet is essential. “If you think you’re not getting the vitamins and minerals you need from your diet, consult with your GP whether it is necessary to take a supplement,” she advises. Eating correctly, being physically active and taking your prescribed medication is vital for maintaining good control of blood sugar levels to avoid serious complications like strokes, heart and kidney disease, limb amputation and blindness.

Don’t: Go it alone

Talk with your doctor. That is the first step in deciding whether or not to use a dietary supplement. He or she can discuss the possible benefits of dietary supplements, and check that any supplements you take will not interact dangerously with your medications.

Be sure to list any dietary supplements you take whenever you tell your doctor or any other healthcare professional about your medications. Most importantly, keep in mind that a dietary supplement is not a replacement for the diabetes treatment and care advised by your doctor.

So who could benefit from a vitamin supplement?

  • Those on low calorie diets, who do not eat a variety of foods.
  • Those following vegan diets.
  • Those with certain food allergies, kidney disease or diseases of the gastrointestinal tract that interfere with nutrient digestion or absorption.
  • Pregnant women.

An A to Z of supplements and their benefits

 

Ask the expert: Andrea Jenkins, nutritionist.

“The following supplements have been shown to improve blood sugar control or limit diabetic damage.”

Amino Acids/Protein

Carnitine (L-carnitine), a nutrient made from amino acids that helps the body turn fat into energy, has been found to be deficient in people with diabetes. Almonds, egg and cottage cheese are rich in this nutrient.

Antioxidants

Antioxidants can help reduce oxidative stress and lower the risk of diabetic complications. Choose brightly coloured fruits and vegetables in smoothies, salads and soups to ensure a variety of antioxidants.

Enzymes

Digestive enzymes help ensure that mineral uptake is strong and can aid the management of diabetes. Pre- and probiotics are also helpful to maintain digestion and immunity.

Lipids and essential fatty acids

Omega-3 fatty acids lower blood pressure and triglyceride levels, and can help to relieve many of the complications associated with diabetes.

Minerals

Magnesium, common in leafy green vegetables, is frequently lacking in people with Type 2 diabetes, as is chromium. Brewers yeast, mushrooms and non-refined grains all contain chromium. Zinc improves insulin function, and potassium (found in all fruits and vegetables), can improve insulin sensitivity.

Vitamins

A vitamin B complex improves the metabolism of glucose, and vitamins C and E can improve eye health.

Remember that dietary changes are important to treat diabetes successfully. Many foods can have a positive impact on blood sugar, for example artichokes, garlic, nuts, onions, olives, cinnamon, blueberries, avocado and fenugreek. Try to include some (or all!) of these in your next meal…

Ask the expert: Faaiza Paruk, dietician
“Some people believe that by taking a supplement they won’t need to exercise or take any medication. 
This is untrue. You need a balanced diet as well as exercise to help control your sugar levels. 
A balanced diet includes five servings of fruit and vegetables a day, a low intake of salt and fat, lean meat and complex carbohydrates found in foods such as brown rice, potatoes, beans and lentils.”

What does this food label mean?

Ask the dietician: Genevieve Jardine

From the community: “I would like to understand the nutritional information printed on food labels – I’m new to it all and don’t know what I should and shouldn’t be looking for.” Lynnette Hitchcock.

Food labels are certainly not the simple list of ingredients they used to be – they’ve evolved into complicated beasts that don’t make sense to most people. So what information is actually useful? What makes you decide to put a product into your trolley?

Let’s take a look at an example: Jungle Energy Bar (Yoghurt)

At the top of the label is the nutritional breakdown for 100g/ml and the breakdown per serving size. Make sure that you read the label clearly and understand the difference – this example is clear because it gives the nutrients for 100g and for the 40g bar.

There should also be a list of ingredients with the highest ingredient by weight listed first. You can then check the nutritional value of a particular ingredient by referring to the nutrition information panel.

Energy

When it comes to Energy, look at the serving size. This energy bar contains 760kj per bar. People with diabetes who are trying to manage their weight should compare total energy of a few products to get perspective. For example, this energy bar is a snack, but when you compare it to the energy content of an apple (273Kj) or low-fat yoghurt (425Kj) you will notice that it contains twice the amount of kilojoules. There is no reference for energy content because you have to take into account your total energy intake across the day.

Protein

The Protein content per serving may come with a percentage next to it (not found on this example). This is merely to indicate how much of the product contributes to the recommended daily allowance of the average individual: about 55g protein per day.

Carbohydrate

This is important for diabetics, especially those who are carbohydrate counting or watching their carbohydrate intake. On most labels you will see two categories “Total Carbohydrates” and “of which are sugar”. This information can be tricky to interpret: the total amount of carb is more important than how much sugar and starch there is, as all sugar and starch eventually ends up as glucose in your blood stream. The “sugar” indicated on the food label could mean added sugar or natural sugars found in the food. If we look at the list of ingredients, we see that oats appear first (highest in weight) followed by sugar and golden syrup. This would indicate that oats make up most of the carbohydrate amount, with a smaller contribution made from sugar and golden syrup. The sugar is therefore added sugar.

If you look at the label, there are 25g of total carbohydrate in the energy bar. 15g of carb is one portion, so this energy bar is closer to two servings (30g) of carbohydrate. The bar therefore has a much higher carb content than an apple, 3 Provitas or 100ml low-fat flavoured yoghurt – all 1 carb.

Fat

When looking at the fat content, take a look at the values per 100g/ml. Take note of the total fat content and then the saturated fat and trans fatty acid.

For a product to be labeled “low-fat” there needs to be less than 3g of total fat per 100g (solids) or 1,5g per 100ml (liquids). Fat-free means less than 0,5 g total fat per 100 g/ml.

Saturated fat is part of total fat and is a key player in raising cholesterol. Low saturated fat is less than 1.5g per 100g (solids) or 0.75g per 100ml (liquids). This energy bar is not low in fat or saturated fat.

Trans fatty acids have a similarly harmful affect and also lower your HDL (good) cholesterol. For a product to be called “trans fat free” there should be less than 0,1g per 100g/ml.

Fibre

Fibre is very important to help improve gastro-intestinal health, prevent cancers, help lower cholesterol and delay the release of glucose into the blood stream. It also helps you feel fuller for longer. These are all very positive benefits which make a high fibre product very desirable. The recommended daily intake for fibre is 25g per day (for women) and 30 to 45g per day (for men). As a general estimate, a high fibre product would be more than 5g of fibre per 100g. This energy bar just makes the grade.

Sodium

Sodium comes from salt: a high salt intake has been linked to raised blood pressure in some people. The recommended daily intake of salt is 240 to 300mg per day. A low sodium product should contain less than 120mg per 100g. A sodium free product should contain less than 5mg per 100g. This energy bar is not too bad.

Results:

So overall how does the energy bar fair? The energy and total carbohydrate content of the energy bar are similar to that of a Bar One chocolate, with slightly less total fat. On the plus side the fibre content is good and the sodium content is low. I would suggest this energy bar as a treat.