Sweet Life diabetes community blog.
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“Diabetes…. Uugh.” That feeling pretty much sums up what diabetes burnout is all about: the feeling that it’s too exhausting / frustrating / unpredictable / impossible to manage your diabetes, so why even try? Diabetes burnout is common in people with diabetes (both Type 1 and Type 2) and for good reason – it’s a chronic condition. Chronic as in forever, never giving you a break, never giving you a holiday, never giving you a moment’s rest. Add to that the fact that diabetes is an ever-changing condition, with blood sugar fluctuating depending on everything from your diet and exercise to hormones, weather, sickness and more, and it’s no surprise that people with diabetes sometimes feel exhausted by it all.
When you need to worry about diabetes burnout
“Diabetes burnout is a normal emotion for diabetics to feel at any given time,” explains Gabi Richter, a Type 1 diabetic and counsellor in Cape Town. “It occurs when you are fed up with the routine and lifestyle that being diabetic entails, and you just want to forget it all. This is fine to feel once in a while – and can even be healthy to some point. But it needs attention when the feeling stays for a long time and your routine diabetes care stops.”
This, of course, is the warning sign. If it feels like there’s no point taking care of your diabetes because you have no control any more, that’s when you stop paying attention to food and medication and self-care. And that’s when blood sugar levels can get wildly out of control. Extended periods of high blood sugar (hyperglycemia) lead to diabetes complications, and in Type 1 diabetics, low blood sugar (hypoglycemia) can be extremely dangerous.
So what do you do if you’re experiencing diabetes burnout? Reach out. Connect. Realise you’re not alone. “Diabetes burnout is a very real issue for all the people I am privileged to educate and spend time with,” explains Kate Bristow, a diabetes specialist nurse in Pietermaritzburg, KZN. It’s a combination of the frustration of things: Never having a day off from diabetes. The guilt of not sticking to the right eating plan or forgetting to take medication or check blood sugar. The relentlessness of never being able to take time off from managing diabetes. “Burnout is often accompanied by stress and anxiety and sometimes depression or guilt – all negative emotions,” says Kate.
5 tips for diabetes burnout
Here are 5 pieces of advice Kate Bristow offers her patients.
Share your frustrations with someone – a family member, or diabetes nurse or educator. See if there are ways to decrease your burden for a while.
Try new diabetic-friendly recipes – a change is as good as a holiday.
Try practicing mindfulness – a practice based on learning to become aware of how you are feeling emotionally in a non-judgemental way. It has been found to be effective in supporting diabetes management and the general stress of everyday life. Eating mindfully has been shown to improve diabetes control.
Life is busy – stress is a way of life – defined as a state of emotional tension elicited by the pressure of everyday life. Diabetes is probably only one of those stresses. Exercise has been shown to reduce stress levels and alleviate depression as much as some medications used for the same purpose. Exercise is also good for our physical health – blood pressure, weight, cholesterol, and diabetes. So perhaps another way of dealing with burnout is to get an accountability exercise partner and start getting physical at least 3 times a week (even if it’s only for 20 minutes at a go, or at work).
If you really feel like you are not coping – ask for help. This is why you have a health care team and a diabetes community. Ask your doctor, your diabetes educator, your diabetic community. You’re not alone in this.
Diabetes burnout is a reality for many of us with diabetes, but it doesn’t have to be a long-term reality. With the right help and care, it can be a phase we move through – just another part of living with this chronic condition. How do you cope with diabetes burnout? Do you have any tips to share?
Meet Michael Marnewick, a Type 1 diabetic and active member of the Diabetic South Africans community. Michael has an inspiring take on living with diabetes, and shares some of his advice here. He’s also the author of a new book: “Coach: The life and soccer times of Clive Barker.”
“Although diabetes has the potential to be life threatening if not managed well, it also has the potential to create better awareness about our bodies and our health. I accept that I have a condition but I do (almost) everything I can to live a life free from fear. But ultimately a combination of diet (first and foremost), regular physical activity, a wonderful endocrinologist and my awesome diabetic nurse (Fiona Prins), the fear of the consequences of not managing it properly and the willpower to follow a lifestyle that works for me is what keeps me positive.”
What was your diabetes diagnosis like?
I was quite unaware of my so-called ill-health when I went for a routine test and my blood sugar was in the mid-teens. I put it down to the coke and chocolate I had enjoyed earlier. The frequent night visits to the loo were explained away with advancing age (early 40s). In short, I was in complete denial.
Do you know many other people with diabetes?
I don’t know many, but my brother was diagnosed Type 1 diabetic some years ago following a massive trauma (shrapnel through the brain while on active service duty for the SADF in 1986). So, while there might be a genetic link, both of us had trauma that may have had a hand in this. For me, it was a sedentary lifestyle, bad eating habits and the stress of divorce that led to the diagnosis in 2012 – six years ago.
When (and why) did you change your diet?
When I posted something on Facebook about it, my GP called me up and suggested I look into the low carb, high fat lifestyle. I don’t call it a diet, because it isn’t a short-term intervention. So I’ve been living the low carb lifestyle for about six years. Initially I lost about 8kgs and dropped to a low of 55kgs (I am 1.7m tall). A year ago I went for a health check and with persistently high and uncontrolled BG ranging from 6 – 18 (and a high of 27), was hospitalised. My initial diagnosis in 2012 proved to be incorrect, I was not Type II but Type 1 (Actually, Type 1.5 – LADA which is Latent autoimmune diabetes of adults). My endocrinologist gave me the diagnosis and since working with her and my diabetic nurse, my HBA1C has improved every four months since then.
Could you tell us a typical day’s food?
Typically I wake up at 5am for work and eat breakfast at 9am. Generally I’ll eat some bacon, two eggs, half an avo, cream cheese or other cheese, and some leftover cheesy roasted veg. Lunch is a smoothie at about 2pm. Double cream Greek yoghurt with added cream, chia seeds (soaked in water first), frozen strawberries, almond nut butter, cinnaon and ice. Dinner at about 6.30pm will be roast / pork rashers / chicken dish / curry / zoodles (zuccini noodles or konjac root noodles) with a creamy sauce and bacon or salami / generally with veg. If I eat out, it will be mostly chicken with veg or salad.
What exercise do you do?
I do a lot of physical exercise – when time affords. Some parkrun or else a jog, mountain biking action cricket in season, swimming, badminton, tennis, gym. I am also outside and on my feet most days, often 12-18 000 steps worth.
How is your health?
My health, despite the diabetes, is probably the best since I was an active teenager. I eat zero sugar, I exercise 3-5 times a week, and I am rarely sick with colds, etc. My TomTom sports watch gives my physical age as 25 (I am currently 49).
What advice do you have for diabetics who are struggling?
My advice is to find a reason to stay healthy. I live an active lifetsyle that I want to continue. I want to walk my daughters down the aisle one day, not from a wheel-chair. My brother has no control because he is in denial and has ended up in comas and in hospital numerous times. My inspiration is not to be like him.
What makes your life sweet?
I try to avoid sweet things as much as possible – as far as substitutes go. Sugar addiction (and it was), is what I believe made me diabetic. But I feel like diabetes has given me a new lease on life. I want to be setting sporting world records in my 80s and I feel strongly that I am in the kind of good health now that will realise that.
Any final advice?
We are all led to believe that the food pyramid is the bible on nutrition when vast numbers of studies are proving the opposite. We’re told to eat carbs for energy, when fat is a much denser fuel but isn’t stored as fat in the cells like glucose is. We’re told to “Eat “healthy” things like fruits, but when fruit juice contains more sugar than coke, something is very wrong. I’ve read the testemonies of sick people who no longer suffer from PCOS, high blood pressure, high blood glucose, and they’re winning the war on obesity.
Hippocrates wrote: “Let food be thy medicine and medicine be thy food” – how true!
Are you in Durban? Do you have diabetes, or know someone with diabetes? Then join Diabetes SA for their 2nd annual fundraising brunch for the Durban Diabetes SA office.
All the details are below – one week today till this exciting event!
Did you catch Sweet Life editor Bridget McNulty when she returned to the Expresso show on SABC3 to talk about Type 2 diabetes? Here’s an excerpt of the interview in case you didn’t… Watch Bridget try to remember everything she can about Type 2 diabetes, on air!
The interview covers the causes of Type 2 diabetes, who is most at risk and why, the symptoms of Type 2 diabetes to look out for, and what food to eat to help combat Type 2 diabetes. Check out the previous interview here.
Prefer reading? Here’s an excerpt of the interview:
1. What causes Type 2 Diabetes?
Although Type 2 diabetes is known as a lifestyle disease, which means that poor lifestyle choices cause it, there is also a strong genetic component. So if you have family with Type 2 diabetes, you’re more likely to get it – it can be hereditary. There’s not much you can do about that but there’s a lot you can do about your lifestyle.
Poor lifestyle choices like eating a lot of processed, sugary, fatty foods (junk food, essentially) and not exercising, smoking and drinking too much all elevate your risk of Type 2 diabetes developing. Being overweight is also a risk factor, especially fat around the middle. These all lead to insulin resistance, which means your body can’t process insulin properly. This is one of the main causes of Type 2 diabetes. The other cause is when your body doesn’t make enough insulin.
2. Who is most at risk and why?
People who lead a sedentary lifestyle – not exercising – and making bad food choices – too much sugary, processed food. White bread, white rice, pasta, chips, chocolates, pies, sweets, cooldrinks – all the delicious stuff that’s bad for you.
3. What are the symptoms to look out for?
There are 5 common symptoms of diabetes: extreme thirst, extreme hunger, needing to pee a lot (especially at night), exhaustion and blurry vision. If you have any of these symptoms you should get a fingerprick blood test – it takes less than 5 minutes at your local clinic or pharmacy and will tell you if you’re at risk of developing diabetes.
4. Nutrition-wise, which types of foods can help combat type 2 Diabetes?
All the healthy stuff! High fibre, whole foods. Fresh fruit in moderation, loads of vegetables, some good carbs that are low GI and high fibre, good quality protein. No junk food, no cooldrinks, no cakes, sweets, biscuits, chips. If you think of your plate as a circle, half of it should be filled with vegetables or salad, 1/4 with good quality protein (fish, chicken, meat, eggs) and 1/4 with high-fibre carbs, with some good quality fats (like olive oil or avocado). If you’re Banting, this will be a different proportion, but it’s the same idea: good quality, healthy, whole food.
I’d like to introduce Maryna Prins, a new contributor who will be sharing her thoughts on living with Type 1 diabetes every month. Would you like to contribute to the Sweet Life diabetes community blog? Send us a mail to share your thoughts with the community!
The one thing that truly bothers me about diabetes
I’ve had Type 1 diabetes for most of my life, 27 years to be exact.
I’m fortunate enough to not have any complications and I’ve never found my diabetes to be a setback or an obstacle in my life. I’ve always taken pride in myself, I’ve faced the world head on and have been quite successful – I’ve achieved many things that my small, terrified ten-year-old self would never have dreamed possible. Everything seems to be pretty good as far as things go, but are they really?
I was sitting in the waiting room at my doctor’s office, bored, and picked up one of the many old magazines that are always associated with the stuffy surroundings of a doctor’s office. It was an older issue of the CDE magazine. I hesitantly flipped through it, too stubborn to admit to myself that I have a condition that affects my life.
Then, there it was. One page that listed do’s and don’ts for parents with diabetic children.
I skimmed through the list, still not willing to fully commit to reading and understanding the words. Then I really read it, and the one thing that truly bothers me about diabetes jumped right from the page into my heart. Diabetes inadvertently destroyed my relationship with my parents, especially my mother.
Do not become obsessed with the diabetes
Sometimes a condition, a disease, whatever you want to call it, brings a family closer together; but at times, the opposite happens.
“Remember that your child is still a human, do not become obsessed with the diabetes.” The quote isn’t exact, but in my head, that’s what it said.
I can distinctly remember myself crying as a young fifteen- or sixteen-year-old, telling my mother that I have feelings, that everything is not always connected to my diabetes. I also had my heart crushed by the handsome, popular boy in class, I also felt the pressure of fitting in and being a “cool kid”, I was a normal teenager, with normal problems. To my mother though, I was a condition, the only thing she was concerned about was my blood sugar levels and why they weren’t perfect. A 6.5 blood sugar level wasn’t good enough, even a 6 wouldn’t do, she wanted a 5.8 and only then would it ever be good enough.
A rollercoaster ride of highs and lows
Now if you’ve gone through puberty as a diabetic, you will know that the war inside your body with a million hormones practically makes a perfect blood sugar reading impossible. Your body does strange things at that age, even if you don’t have a chronic condition. When you add diabetes in the mix, it’s just a rollercoaster ride of highs and lows, most of the time not explainable.
I can’t wholly blame my mother though, it was very different back then.
Diabetes was rare, Type 1 diabetes even rarer, and no-one really knew what it was. The last 30 years have seen a massive leap in our knowledge and treatment of the condition. In 1992, diabetes was practically a death sentence. There were no epipens, the glucometers were larger than bricks and cost a fortune, the tests took ages and weren’t necessarily very accurate, I used a normal syringe and vial for ages before I got my first pen to use. Sugar was the devil, and I came out of my first three months after diagnosis believing that I would go into hyperglycemic shock if I even looked at sugar.
My mother was afraid that I would die. It’s something I only came to understand many years later, and surely not something I can hold against her: she loves me. Her desire was to not let me die, but right there she lost something very valuable: we both lost our relationship as mother and daughter. My mom became my police officer and prison guard, someone that did not care for things like feelings and aspirations, she only cared about that perfect score.
We fought, a lot, and even today I often have to remind my mother that I’m not a disease. I felt like a disease for too long and the silent rebellion that came from that feeling is not something I am proud of.
No matter how hard I tried, I always failed
I started smoking at a very young age, not for the same reason many other teenagers do. Someone once told me that it suppressed your appetite. I’ve always had an appetite like a bear, I’m always hungry. In later years I found out that I have a very fast metabolism and that’s the reason I have an unending hunger, but my 15-year-old self knew nothing about metabolisms and believed that if I could eat less my blood sugar would surely be more controllable. It worked, for about 3 months until I was addicted and it was too late to just stop.
When I realised I could get away with occasionally having sugar, the rebel dial went in the complete opposite direction, and I remember sneaking off to the shop to buy handfuls of sweets and sitting in the large tree in our front yard gorging on chocolates and ice-cream.
I felt isolated and scared a lot of time, terrified of disappointing my mother, terrified of dying or losing a leg. My mother, unknowingly, had threatened me many times with those outcomes. “If your blood sugar is high you will lose a leg.”
Mostly I felt like a failure. I couldn’t live up to the standards that were expected of me and no matter how hard I tried, I always failed. Inadvertently that feeling affected my whole life and I spent years not believing in myself: if I couldn’t do something as easy as control my diabetes, how could I succeed at anything else?
We are all different
It took me years, stubbornness and a lot of growing up to realise that, actually, I can do anything and controlling diabetes is not an easy task with set rules. We are all different, our bodies weren’t created out of a mould and we can’t treat any condition with a mentality like that.
I learnt to understand my mother’s way of showing her love and concern, and that her words were harsh out of love. I mourn the fact that we never built a relationship that so many other mothers and daughters share, we never built trust or a way to communicate that showed that we were interested in each other’s lives.
I hope that other parents with diabetic children will read this article and not make the same mistakes we made. Your child might be diabetic, but that should never overshadow the fact that they are human, with human feelings and experiences, dreams to become more and be their best.
Encourage and praise them for their efforts and never distance yourself from their lives.
Have you heard about the Cape Town Diabetes SA Children’s Camp? Don’t delay, register today! Here’s all the info you need, from Shelly Schutte, one of the organisers. She posted this on the Diabetic South Africans Facebook page:
The Cape Town Diabetes SA Children’s Camp is now just a few weeks away and we are getting all the preparations in place! It will be held from the 31st of August to the 2nd of September. We have a mix of new and more experienced leaders for the upcoming camp and had a fun training morning on Saturday the 4th of August. All leaders were guided through the programme and given advice and training on how to care for children on camp responsibly while also making sure everyone has fun! Please note we will have a doctor and dietitian at the campsite throughout the weekend.
Diabetes Camp is such a special opportunity for children, teenagers and adults to meet others who just ‘get’ what makes Diabetes both a challenge and a gift. It is also a chance to have lots of fun while learning more about how to manage Diabetes.
If you haven’t got your camp form in yet, please email Margot as soon as possible.
The cutoff for camp forms is the 15th of August. The camp is open for 9-14 year olds and costs just R200. If you are older than 14, you are absolutely welcome to come along but may be asked to assist the leaders in some way.
See you at camp!
Living with diabetes: Understanding diabetes nutrition
Did you know that the dietary guidelines recommended for people with diabetes are the same as those recommended for general health? That means you don’t need to prepare separate meals for yourself at home – your family can simply adopt your healthy habits!
10 helpful tips for a healthy diabetes diet
Follow these 10 tips each day to promote a balanced and healthy meal plan to help manage your blood glucose levels:
- Eat at least three balanced, regular meals each day, incorporating a variety of different foods.
- While your healthy meal plan does allow for a small amount of sugar found naturally in many foods, avoid excess sugar and refined carbohydrates, as these promote poor blood glucose control.
- Include small servings of high-fibre carbohydrate foods, such as oats, bran cereals, brown rice, sweet potato, baby potatoes, wholewheat pasta, seed loaf, beans and lentils.
- Aim to eat at least three servings of vegetables and two to three servings of fruit every day.
- Include a portion of lean protein into each of your meals to help improve blood glucose control.
- Lose weight, if necessary. A weight loss of as little as 5 to 10% of your body weight can dramatically improve your blood glucose control.
- Cut back on saturated fats, such as butter, chicken skin, high-fat dairy products, fat on meat
and processed meats, like sausage and boerewors.
- Use healthier monounsaturated fats such as olive oil, canola oil, avocado, nuts and peanut butter.
- Eat fish, especially oily fish like sardines, pilchards, mackerel and salmon, at least twice a week.
- Use salt sparingly, as excessive salt intake can lead to high blood pressure and heart disease.
Not sure what meal plan to follow? You can consult with a registered dietitian to compile an individualised meal plan specific to your needs, taking into account your food preferences, level of physical activity and lifestyle.
Eating for diabetes
Here’s a helpful guideline to illustrate what a balanced meal should look like, and how to divide up your plate. Aim for 1/4 plate high-fibre carbohydrates, 1/4 plate good quality proteins and 1/2 plate vegetables. Eat fruit in moderation, small amounts of healthy fats and some dairy.
Looking for delicious diabetes-friendly recipe ideas? Check out our free Sweet Life Pick n Pay Diabetes Cookbook!
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 email@example.com or toll free on 0800 11 22 88
For more fantastic information on diabetes and nutrition, visit Pick n Pay’s Health Corner.
Are you a sportsperson with diabetes? Do you have any advice to share with Mike about energy drinks?
I am a Type 2 diabetic who enjoys cycling. I’m looking for advice on energy drinks or sports drinks etc that are diabetic-friendly.
Just drinking water doesn’t help when the energy dips…
Our regular contributor Jane Sandwood tackles the topic of how to quit smoking if you have diabetes. Have you managed to quit smoking? Do you have any advice to share? Tell us your experiences, here or on Facebook, and it might help the rest of the South African diabetes community.
The health risks of smoking with diabetes
The health risks of smoking with diabetes are well documented; however, curbing nicotine addiction while managing your diabetes adds another layer of complexity to a notoriously difficult task. In South Africa, the prevalence of diabetes is increasingly rapidly, which in turn raises the stakes for smokers with diabetes to quit while controlling glucose levels. Because standard nicotine replacement options such as patches and e-cigarettes aren’t safe for diabetics, either, many are left with the daunting prospect of going cold turkey without a tangible removal plan. Fortunately, a range of treatment options exists for diabetics looking to quit smoking while managing their disease.
Early stages and treatment plans
Before quitting, smokers should consult their doctors to determine the best course of action. Because smoking suppresses appetite, some research suggests that diabetics who quit smoking struggle to control their blood sugar levels. As a result, individual diets may need adjustment to prepare for withdrawal from nicotine. Doctors can work with patients to devise a schedule or pattern that best suits their needs.
Most smokers will attempt to quit dozens of times before they are successful. While some attempt to gradually wean themselves off cigarettes, others go “cold turkey” and quit all at once. Although individual results vary, some research suggests that smokers who quit “cold turkey” were more successful than those who quit gradually. At any rate, it’s important to remember that quitting smoking is a continual process, and not something that happens ‘all at once’–even if you can pinpoint your last cigarette to a specific day. It’s normal to have setbacks, and plenty of ex-smokers can attest to the efficacy of quitting cigarettes, even it takes more than one attempt.
Moving forward with quitting smoking
Normally, diabetics will be able to quickly observe improvements and results in their own health within weeks of quitting smoking, which can encourage efforts to absolve from nicotine. It is also a good idea to consult medically supported research on the trajectory of nicotine withdrawal to give you a broader sense of what’s happening to your body as you continue the process of nicotine withdrawal. It may also be a good plan to keep a journal logging changes in mood, diet, blood sugar level, and other related factors to track individual growth throughout the process.
Quitting smoking is a frightening prospect for anyone addicted to nicotine, least of all diabetics. However, many viable treatment plans exist to help curb nicotine in a manner that is effective and safe. It won’t take much time to benefit from the wide range of advantages to quitting smoking as you continue the ongoing process of diabetic care.
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.
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.
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.
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 firstname.lastname@example.org or toll free on 0800 11 22 88
For more fantastic information on diabetes and nutrition, visit Pick n Pay’s Health Corner.
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.
Within 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.
Jane Sandwood, one of our regular contributors, tackles the issue of diabetes diagnosis 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.
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.
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.
Diabetes changes oral microbiome that promotes 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?
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.
Joburg diabetes specialists:
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.
4) Lancet Laboratory
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.
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
Dr Andre Pieterse, Linksfield
Centurion diabetes specialists:
Dr Wynand Jacobs near Unitas Centurion – he is the best!
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
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!
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 Soobramoney – very 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!
Kate Bristow is an excellent diabetes educator
Hilton diabetes specialist:
Dr Claudine Lee in Hilton
Welkom diabetes specialist:
Dr. Colyn: Internist at MediClinic Welkom
Port Elizabeth diabetes specialist:
East London diabetes specialist:
Unathi Daweti: diabetes nurse educator
She is the best…
Cape Town diabetes specialists:
Dr Hennie Nortje – N1 City Medical Chambers – 021 595 0922/3
Prof Francois Bonnici, UCT Hospital
It is a referral hospital but has an amazing team in Endocrinology. Prof Zollner is amazing!
Red Cross War Memorial Children’s Hospital
Also popular with those of us with no medical aid!
Tracy Ugarchund, dietician with a special interest in diabetes: Constantiaberg Mediclinic
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.
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!
Are you a runner? Do you have Type 1 diabetes? Share your advice, tips and lessons learned below…
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?
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.