Inspiring Stories

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.

Finding flavour in diabetes-friendly food

We chat to Ishay Govender, acclaimed foodie writer, about her love of cooking and how to make Indian food just as tasty – but a little healthier.

You have a family history of diabetes – have you been tested yourself?

I get my blood sugar and cholesterol tested once a year – every year. Because I’m aware that Type 2 diabetes is often a hereditary condition, I’m very conscious of my health and how food contributes to my wellbeing. In traditional homes there’s an emphasis on food and family as a way of expressing love, and I know I’ve inherited that from my mother and grandmother – sharing food with people is my way of expressing that love.

Have you made any changes to your diet because you know Type 2 diabetes runs in the family?

I’ve learnt to alter things slightly so that they’re healthier but still have lots of flavour. When we first found out that my mom was diabetic I did a lot of research, and made sure she went to a dietician and found out specifics of how to change her cooking style. That said, we grew up in a very healthy household so the changes weren’t too difficult.

What advice would you offer to people who are struggling to eat a healthy diet?

I think the most important thing is to accept and make peace with the fact that you have diabetes – it doesn’t make sense to fight it. Also, food should never be about restriction, it’s about enjoyment. Change the spotlight from focusing on what you can’t have to what you can enjoy. It’s a great time to explore flavours, textures and a sense of fun in the kitchen.

Have you learnt any ‘tricks’ to make traditional Indian food a little healthier?

A few! Here are the main ones:

  • Cook with less oil – it is possible, especially if you use olive oil cooking spray.
  • Don’t eat double starch (i.e. rice and potato curry, or curry and roti)
  • Cook vegetables for a shorter period of time so that they keep some of their goodness – things like okra and butternut don’t have to be cooked to mush.
  • Rethink vegetables – they don’t only have to be pickled or curried, they can be fresh with interesting dressings. I try to include half a salad in a meal, with a yoghurt dressing (plain low fat yoghurt with toasted cumin seeds, mint and lemon zest – delicious!)
  • I only use baby potatoes with their skins on – they’re low GI and the skin has fibre.
  • Brown rice is so much healthier than white rice – it’s full of fibre and has a lovely nutty flavour. You also need less rice because it fills you up more.
  • Spices and herbs are a diabetic’s best friends! They add such flavour and zest, and you can experiment with different combinations to make a dish more interesting.

What makes your life sweet?
The pleasure of enjoying food and food travel with my husband. Cotton pyjamas and fresh linen. The knowledge that even someone with a ‘soft’ voice like mine, can make a difference using it.

Get in touch with Ishay: @IshayGovender on Twitter / Instagram / Vin

Agents for Change

We chat to Buyelwa Majikela-Dlangamandla, a diabetes educator who trains local healthcare workers in a programme called Agents for Change, about diabetes in the workplace.

Can you tell us about Agents for Change?

Agents for Change is a diabetes training outreach programme, supported by the World Diabetes Foundation, that aims to improve diabetes care in rural and semi-urban areas of South Africa. The goal is to empower healthcare providers and people living with diabetes to manage their diabetes to prevent diabetes-related complications.

The first part is two days of intensive and interactive training that provides participants with a sound knowledge of diabetes. Practical skills in preventing and managing lifestyle conditions are demonstrated, like how to prepare affordable healthy food. Participants set their own goals of what they wish to change in their lifestyle habits and workplace.

Six months later, the same participants come back for the second phase where they share their experiences, successes and challenges in carrying out their planned changes. We focus on behaviour counselling and the stages of change. People with diabetes are invited and they volunteer to share their real life experiences to be discussed as case studies for learning. Agents for Change has trained more than 1,500 healthcare workers and reached thousands of South Africans since 2008.

How are you involved?

I run the workshops with Noy Pullen, the project manager.

How did you become interested in diabetes?

My father had diabetes and so did all of his siblings, so there’s a family connection. I have also been working as a diabetes educator since 1995 at Groote Schuur Hospital and am currently working as a clinical educator at the University of Cape Town.

What is the most important message you share in your training?

Three things:

  1. Choosing a healthy lifestyle can prevent and/or delay the onset of diabetes.
  2. People living with diabetes can enjoy a healthy, normal life.
  3. A positive attitude leads to a meaningful life.

What is the most surprising lesson for the participants?

That the effect of physical activity on blood sugar levels is similar to that of blood glucose lowering medicines and insulin.

Once they have finished their training, what happens?

They are encouraged to start support groups and vegetable gardens. Those groups are called “Khula Groups”. They get continued support from the project – reading material and gifts – and they are always linked to the project manager on SMS or email.

How many people has Agents for Change helped?

Agents for Change has trained more than 1,500 healthcare workers and through them reached thousands of South Africans since 2008.

What advice would you offer to people living with diabetes who are struggling?

I can never fully understand how diabetes affects people who live with it, so it wouldn’t be right for me to offer advice. Because diabetes affects people differently, the approach should be personalised. However, I do notice that those who have accepted diabetes as part of their lives and taken charge of their own health find it easier.

What makes your life sweet?

Living in the moment, love and smiles from people around me.

Get in touch with Buyelwa: buyelwa.majikela-dlangamandla@uct.ac.za or find out more about Agents for Change at www.worlddiabetesfoundation.org: Projects.

Howza’s life with diabetes

Musician, actor and Type 1 diabetic – we find out how Howza fits it all in.

How long have you been diabetic?

Since 2003: I was 21 at the time. I was actually introduced to diabetes from a very young age because my father had Type 2 diabetes, but I was very ignorant – I didn’t know what it was until I got it. But I think the younger you are, the easier it is to adapt your life.

What was your diagnosis like?

You know, all the symptoms kicked in – loss of weight in a very short space of time, dehydration, constantly going to the toilet. I didn’t understand what was going on. When you lose weight like that you instantly associate it with HIV/AIDS, because there’s so much awareness of that. So obviously I panicked… But I did the responsible thing and went to the doctor – that’s when I found out I was diabetic. I wasn’t exactly relieved, the doctors put the fear of God in me by telling me all the things that could happen to me. It was hard to come to terms with…. But I was scared, and I was willing to turn my life around for the sake of living longer.

What’s the biggest challenge of living with diabetes?

Obviously diet and exercising. I was saying to my wife the other day, as much as I enjoy going to gym, it’s never easy. You need to find a way to motivate yourself to go to gym 3 or 4 times a week – self-motivation is important to live a healthy life. Nobody likes gym, in all honesty! But at the end of the day, when you put your mind to it, you’ll end up enjoying it.

I used to live a very unhealthy lifestyle – eating fast food and drinking every day. That had to change. I’m not saying be a health nut, but you need to find a way to do things moderately. If you’re going to drink, you need to drink responsibly and be aware of your sugar levels. I decided, instead, to stop drinking. But it was difficult for my friends to understand – you’re not drinking, so all of a sudden you’ve become a priest! It wasn’t easy, trust me, that was the most difficult part, especially as a youth. But at the end of the day I became selfish and told myself, “It’s not about them, it’s about me.” If I don’t take care of myself, they’ll still be cool – I won’t.

What advice would you offer to other diabetics?

I always say to people – look, I’m living with it, it’s not the end of the world. As cliché as that might sound, that’s the actual truth. I’m living a healthy, normal life with diabetes. Like I said, I don’t want to put myself on a pedestal and act like I’m perfect. I have my challenges. So when I speak to the youth I try to be as open and truthful as I can, so that they can relate. At the end of the day, the bottom line is that you have to be responsible for your own life.

What makes your life sweet?

My daughter, Tumelo.

Get in touch with Howza: @Howza_SA on Twitter