Sweet Life diabetes community blog.
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.
Podiatrist – Rae Bernstein
Diabetic Nurse Educator – Vanessa Brown
Ophthalmologist – Dr Peter Van Lingen/Dr A Taylor Donald
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
Dr Jhetam: ophthalmologist at Milpark Hospital and private clinic in Lenasia
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!
Dr Kathy Bridgens: opthamologist
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.
It’s one of the questions we get asked at Sweet Life all the time. Do I have to change my lifestyle – and my diet – to manage Type 2 diabetes?
Well, that depends. Most of the time, Type 2 diabetes is caused directly or indirectly by issues of diet and lifestyle – it’s sometimes called a ‘lifestyle disease’. That said, there is a strong genetic component, so it’s not helpful to think that you ‘gave yourself diabetes’. That kind of attitude isn’t going to help you live a healthy, happy life with diabetes.
Take a close look at your lifestyle. Do you think it’s one of the reasons you were diagnosed with Type 2 diabetes? Do you eat a lot of fried, fatty food? Is there enough fresh fruit and vegetables in your diet? Do you eat a lot of processed food or refined carbohydrates? Do you eat large portions, even if you’re no longer hungry? If so, it might be time for a lifestyle revamp. Take a look at Sweet Life’s Ask the Dietician articles for advice on a healthy diabetes diet.
Family with diabetes
One of the hardest things for newly diagnosed diabetics is making the changes necessary for their health, while still being part of the family. For many people, family meals are an important part of the day, and having to either eat a different variety of a meal or eat at different times or in a different way (a plate of food instead of sharing from communal plates, for example) is a difficult adjustment. Some families are fantastic at supporting the newly diagnosed, others find it too much of a challenge. Sweet Life has written about the challenges of family life with diabetes in our Partner’s Corner articles – you can find out more about families with diabetes here.
Remember that it’s important to sit down and explain to your family why you need to make certain changes, and how they can benefit from them too. Those who have adopted a healthier lifestyle – one that’s rich in fresh food and regular exercise – not only see the effects in their blood sugar results, but in their overall wellbeing.
Have you had to change your lifestyle because of diabetes?
Not sure what to make for dinner? Let us help! Check out our delicious free diabetes-friendly recipes to get ideas for dinner that are tasty, healthy and good for people with diabetes (and all those without diabetes!)
You’ll find recipes for:
- Spinach and Leek Pie
- Grilled Boerie, Cauli Mash and Relish
- Korean Beef Lettuce Wraps
- Baba Ganoush with Tortilla Crisps
- Guilt-free Baked Chicken
- Hearty Beef and Bean Soup
- Delicious Chicken Barley Salad
All with nutritional information to ensure you know the carbohydrate count, protein and fibre in each dish.
Looking for a specific diabetes recipe? Let us know!
And don’t forget to check out our free diabetes cookbook, which you can read online or download and print out.
Here’s to healthy, delicious, diabetes-friendly meals!
I’d like to introduce a new contributor to Sweet Life: one of my favourite Instagram feeds, Tracy Sanders. Also known as @type1tracy. Tracy has Type 1 diabetes, but that doesn’t stop her from doing anything in life… Check out what she has to say, below, on a solo trip to Italy.
H O N E S T Y 💭H O U R: Firstly, I just want to say whatever you want to do, whatever you dream of, or whatever adventure you seek. You can do it. With diabetes. Without diabetes.
Secondly, this isn’t an inspirational “Diabetes can’t stop you from living your dreams” message, let’s be potently honest, it sure as hell can. If you choose to passively sweep through this life ignoring diabetes, your body, it’s messages, type one will create walls and obstacles.
You have to be practical💪. You have to take charge💥. You have to apply yourself and take responsibility. Take on responsibility WITHOUT resentment. 🙏Without wishing otherwise, “I wish I didn’t have diabetes, I wish I could be lucky like my friends who don’t have to inject”. It is important to acknowledge these thoughts💭, be intensely curious about them and their origins, and let them go.
Taking responsibility does not mean aiming for perfection (it does not exist). It’s about refusing to let numbers define you🚫, putting effort 💪🏼into working FOR your numbers and looking after your mental health too: patience, self-love and kindness, forgiveness, gratitude.
Being alone in Italy, it dawned on me the kind of responsibility that I was carrying with me.🙈 If I had a low, the only person I could rely on was myself.
The thoughts of mid-sleep hypoglycemia developing into seizures did creep into my mind. 🤔I have never had such before, but this does not mean it’s not possible. It just means I better make 100% sure it doesn’t happen as there will be no one to run into my room to help me. Careful bolusing, dinner well before I sleep, glucose sweets🍬 always on hand & at my bedside. Small practicalities that make all the difference. But I had gelato🍦, I had pasta🍝, I skipped dinner, and ate until my tummy was bursting😂 I had some nasty BGs and a lot of good ones
Yes you can be free, you can explore, you can run that event, you can lower your HBA1C, you can have a beautiful healthy pregnancy. But you first need to have a RAW and HONEST conversation with yourself. How can you make a change, take charge and free yourself of any little bits of a victim mentality that can lurk in the setting of chronic disease?
There are some questions that only diabetics know how to ask – and answer… This is your space to ask any diabetes questions you like – and give answers to the rest of the community. After all, we’re all in this diabetes journey together!
Share your experience, your tips and advice, and your challenges with diabetes on this page.
Please bear in mind that any information shared here is from the diabetic community, and has not been supplied by a medical doctor. Don’t make any changes to your medication without first consulting a medical professional. That said, diabetes is a social condition, and we can all learn from each other as we strive towards better control.
Have a question?
Write an email, attach a photo (if you want to) and we’ll publish it here! Give as much information as you can about the issue and we’ll work through it together!
Diabetes question (an example!)
Subject: Eating curry sends my blood sugar up
Email: Every time I eat curry my blood sugar goes through the roof… Has anyone else experienced this? I’m eating chicken curry with naan and taking what I think is the right amount of insulin. By Joe Blog (www.yourwebsite.com)
Pics: If you want to add photos to your post, simply add them as an attachment in the email and we’ll put them up as part of your blog post.
Once your blog post is live, we’ll invite the rest of the community (particularly from Facebook) to join us in sharing advice.
Have a diabetes question? Let’s answer it!
Ask the dietician: Genevieve Jardine
From the community: “I don’t understand the whole ‘low carbs high fat or high protein’ idea – how do carbs, fat and protein work together? Is there a happy middle ground, or does it need to be all or nothing?” Wessel Jones
To understand what all the fuss is about, we need to look at the history of diabetes treatment. Treating diabetes (both Type 1 and Type 2) by lowering carbohydrates (carbs) has come and gone out of fashion over the last century. This debate is not a new one and it is probably not going to go away.
Before the invention of insulin, the only way for a diabetic to survive was to cut out the foods (carbs) affecting blood glucose. With the advent of insulin, the focus switched from lowering carbs to lowering fat to help reduce heart disease. Fast forward a couple of decades and we can see that we have failed in reducing obesity, diabetes or heart disease. It’s not as simple as just diet: it’s about physical activity, stress, diet and environment.
How do carbs work in the body?
What is quite simple is that carbs cause blood sugar to rise and the more carbs you eat, the higher the blood sugar goes. If a person wants to control their blood sugar, it’s a very good idea to reduce carbs. The big question is: how low do you go? A “low carbohydrate diet” can have anything from 20g to 130g of carbohydrate per day.
Remember: One portion of carb (a medium apple, a slice of bread) = 15g carb
The amount of carbs depends on the individual, their control, their medication and their weight. There is a growing amount of scientific evidence that low carb diets improve glucose control and help with weight loss.
Where do fat and protein fit in?
When carbs are cut, the amount of protein or fat (or both) go up. And this is where the debate heats up. The concern is not the low carb, but the increase in saturated fat or fat in general. Remember that not all fat is the enemy and there are good fats that play a very important role in the body.
A benefit of protein and fat is that in the immediate, they do not cause the same spikes in blood sugar. When you lower carb intake you have an immediate blood sugar lowering effect. When this happens, and you have fewer spikes and dips in blood sugar, your appetite is better controlled. The fuller you feel, the less likely you are to snack and the fewer kilojoules you consume. The fewer kilojoules you consume, the more likely you are to lose weight.
The problem with the low carb approach is that, like everything else, it needs to be a lifestyle. When you add carbs back into your diet you will put on weight, especially if you have increased your fat and/or protein. You can’t have it all: full fat products and also carbs. The most important goal is to increase your vegetable intake and try to eat as close to nature as possible. Eat foods in their most original form.
When it comes to deciding on the right ratio of carbs : fat : protein, work with a dietician. It may take time to find your correct balance and you need to be monitored properly with blood tests and possible medication adjustments.
I got this amazing email from one of our community members last week and had to share it. Would you like to share your story with the Sweet Life community? Email me – we’d love to hear it.
What an absolute treat to read your magazine and continually refer to it.
I have been Type 1 diabetic for 14 years. As much of a roller coaster ride as it has been, I would not swop being diabetic for anything in the world.
The people you meet along this journey, the knowledge you gain about how your body functions and responds, the prior knowledge you get from high glucose readings before you get ill and a complete understanding of the people I meet who possibly battle with elevated glucose levels or hypoglycemia.
Being Type 1 diabetic makes you aware on every level – spirit, body, mind, soul, feelings, thoughts, allows for wise choices (although if not wise then the consequences that accompany these – you have actually just got to smile, knowing that this is within your control), tolerant and respectful of others.
It is without a doubt, a gift.
The International Diabetes Federation reports an average of three and a half million people in South Africa are living with diabetes. Three and a half million of us struggling with the insufficient production of insulin by our bodies – and many more undiagnosed. There is no question that diabetes is one of the most common healthcare concerns of South Africa and its citizens. So what diabetes treatment updates are there?
Well, there are reasons to hope and possibly celebrate. Recent years have seen great advancements in the diagnosis and treatment of diabetes globally. Scientists and medical professionals alike continue to work tirelessly in pursuit of a clinically tested and dependable way to improve the lives of those living with diabetes and possibly prevent the diagnosis of further cases. That work is beginning to show with some great breakthroughs in the treatment of diabetes. Here are some treatment advancements coming to the forefront and what it may mean for diabetes patients across South Africa.
Diabetes treatment options are changing
In 2016, the world received word of the first artificial pancreas being brought to the market for the first time. Although distribution and availability of the system remain fully explored, it is certainly garnering attention for its ability to help patients living with Type 1 diabetes by reducing the chances of hypoglycemia. The development has been cited by many studies as having the ability to transform diabetes by offering improved glycemic control. It responds to either low or high glucose levels and automatically adjusts the insulin levels accordingly.
With overwhelming success rates, South Africans saw the first version launch in 2009 along with Europe before later being expanded upon and eventually approved by the FDA in the United States of America. New drugs such as empagliflozin have also shown a great deal of promise in reducing cardiovascular risk. South Africa’s senior population has one of the highest cardiovascular risks in the world and this is directly linked to diabetes. The most common causes of death in diabetic patients have been shown to be either stroke or heart disease.
New development in insulin treatment for diabetes
For those living with diabetes, insulin is a key part of their daily lives. Diabetes means the body is unable to process glucose which in turn affects blood sugar. This is caused by the body either producing too little insulin or the insulin produced not working properly. Another exciting development in recent years is the development of longer lasting and more efficient medication for those having to do regular injections of insulin. Technological inventions such as the insulin pen by Timesulin are especially aimed at the senior population. The pen tells you when you last took an insulin dose. The device is now widely available from distributors in South Africa and has been largely welcomed.
Diabetes awareness is shifting
Public awareness around South Africa and amongst South Africans about diabetes is changing. Organisations such as SEMDSA (the Society for Endocrinology, Metabolism and Diabetes of South Africa) have released updated guidelines alluding to dietary guidelines for those with diabetes. The government is playing its part as well with an announced sugar tax taking effect in April 2018.
The Sugar Beverage Levy dictates that for beverages with sugar content exceeding 4g per 100ml is taxed at 2.1 cents per gram of sugar content. The tax is apart of the Healthy Living initiative being pursued by the government and saw information roadshows being held across South Africa to educate the public about the tax. Introduction of a sugar tax is hoped to deter the consumption of sugary beverages, a large trigger for patients and also a contributing factor for being diagnosed with diabetes in the first place.
Diabetes awareness in the workplace
Corporate wellness programs are now being offered by employers and more food establishments and canteens across South Africa are offering healthier options. More and more online resources and publications are promoting the need and tips for healthy eating on a budget. With over 37 percent of the population not being able to afford an adequate healthy diet thanks to food prices, the timing of these promotions is perfect.
Although these steps are certainly in the right direction, there remains a long way to go in fighting the spread of diabetes in South Africa. Better education along with an increased priority on healthcare lists are among some of the pressing options. By preventing and treating diabetes early, it is not only the country’s population that stands to benefit greatly, but also its economic standing.
Tired of the same old exercise routine? If the thought of putting on your running shoes makes you want to curl up on the couch, it’s time to find something new. Here’s what Nicole McCreedy suggests.
Dance is a great form of exercise, but most importantly it’s fun. So if motivation is an issue for you, then it may be time to try a dance class.
Dancing is a workout for the whole body. A half hour of vigorous dancing burns as many calories as jogging! But not only is it good for the heart, it’s also a weight-bearing activity. This makes for strong bones that, in turn, may reduce the risk of falling and osteoporosis. Depending on the dance form, it can also help to strengthen muscles in the stomach and thighs, and improve balance, posture, and coordination. Plus, the mental work to remember dance steps and sequences actually boosts brainpower and develops memory. For those with diabetes, dancing – like other forms of physical activity – promotes weight loss and lowers blood sugar.
And there are so many options to choose from! Whether your style is stomping your feet in gumboots or to ‘sokkie’ on the dance floor with your partner, you can still enjoy the health benefits.
Gumboot dancing has its roots in South Africa among black mine workers, but is now world-famous. Rhythmic body movements using all parts of the body accompanied by a forward bending motion are characteristic of African dance, and dance steps are performed with the feet and knees facing forward. Percussion often dominates the music – some dance studios hire drummers to accompany classes and rehearsals.
You don’t need to be a great dancer, or be born with rhythm, to have a good time in Zumba classes. The upbeat Latin American rhythms of salsa, flamenco, and merengue music make Zumba classes feel more like a dance party than a workout. But Zumba classes are more than just a good time. Regular weekly attendance at Zumba improves health and fitness levels, and can lead to weight loss.
Indian classical dance
The origin of Indian classical dance stems from sacred Hindu musical theatre styles. The umbrella term, Indian classical dance, includes seven major styles: Kathak, Bharatnatyam, Manipuri, Kathakali, Odissi, Kuchipudi and Mohiniyattam. Indian classical music is played with the dance, and percussion forms part of this musical backdrop. It is common for dancers to wear bells around their ankles to complement the percussion. This form of dance is known to improve physical fitness, tone the body and increase stamina. The concentration required strengthens mental abilities, self-esteem and helps the body-mind relationship.
Styles of ballroom dance include waltz, foxtrot, tango, cha-cha, swing, and others. With very few exceptions, all of these are danced with a partner. People with diabetes attending ballroom or Latin American dance classes are also more likely to keep participating in the activity over time, compared with an exercise programme at home or at the gym. “Studies have also found that compared with traditional cardiac workouts, people with heart conditions who danced for just 20 minutes 3 times a week saw significant improvements in their heart health,” explains Kate Bristow, a Diabetes Specialist Nurse in Pietermaritzburg and the Midlands.
Did you know?
According to a study in “The Arts in Psychotherapy”, the activity of dance releases mood-improving chemicals into our bodies that literally help alleviate depression. Social bonds are also increased in group dance sessions and this helps reduce stress in the long-term.
Ask the expert: Ilona Padayachee, Biokineticist
Tips to stay motivated
Staying motivated isn’t hard if you stay flexible and have fun. Eventually, you’ll realize that you’re actually enjoying the workout – and before you know it, you’ll be looking forward to exercising.
- Participate in group exercises
Having a friend that holds you accountable is a way of keeping motivated to exercise. Group exercise classes are usually fun, especially if it’s with a group of friends.
- Play music
When you feel discouraged or experience a slump in motivation, put on some fun tunes and your mood will soon change.
- Don’t make exercise seem like hard work
When you start treating exercise like hard work, that’s exactly what it will become. Your exercise routine should be light, fun and exciting rather than something you have to do. Don’t let yourself get a bad attitude towards exercise: if this happens you’ll be more likely to give up than press on to reach your exercise goals.
- Keep an exercise log
Having a visual reminder of the days you work out will keep you motivated to keep going. Also make a note any time you reach your exercise goals: if your clothing fits you better, if you’re feeling and looking healthier, or if your blood sugar levels have stabilised.
- Hire a personal trainer
When you start paying for services, you’re more likely to stick to the exercise programme. Most personal trainers will charge you the full rate if you cancel at the last minute, so you’re less likely to do that!
- Keep positive
Always try to have a positive attitude towards exercise. A positive mind can help you to achieve all of your exercise goals and remain focused and motivated.
What’s the one piece of advice all diabetics should listen to?
We asked our Panel of Experts… Here’s what they had to say:
“Focus on the good-for-you foods you want to include in your diet, rather than the things you want to limit.”
Cheryl Meyer, Dietician.
“Make small changes to your diet that could bring about a bigger change in your health. Swap white bread for low GI bread, for example, and leave off the butter.”
Faaiza Paruk, Dietician.
“Exercising, keeping to the right BMI and eating a good diabetic diet are all essential because these factors determine the amount of medication you need. It’s also important not to smoke, to take your medication properly and to visit your doctor regularly.”
Dr. Joel Dave, Endocrinologist.
“Ask yourself: ‘Have I got diabetic retinopathy: Yes or No?’ The only way you can know that answer is if someone competent and trained has looked at your retina and given you the answer. So visit an ophthalmologist every year!”
Dr. Dale Harrison, Ophthalmologist.
“Always use a good diabetic foot cream. Examine your feet every day, especially if you have neuropathy. Check your shoes with your hands before you put them on to be sure there isn’t anything in them. Ensure your shoes fit properly and have enough space so that there are no pressure areas that could cause blisters or wounds.”
Andy Blecher, Podiatrist.
“Go to a qualified podiatrist for a thorough Diabetic Foot Assessment at least once a year. Ask questions and be informed.”
Anette Thompson, Podiatrist.
Any advice to add?
For radio presenter and TV actor Kini Shandu, Type 2 diabetes gave him new meaning. Here’s what he has to say about his condition.
Kini Shandu is a radio presenter on one of KZN’s biggest radio stations, Gagasi FM, a TV personality on SABC’s biggest telenovela, uZalo, and the founder of Inqaba Media. He’s also a father of two and a Type 2 diabetic.
When were you diagnosed?
I was diagnosed with Type 2 diabetes in 2010 – six years ago now.
How did you cope with the diagnosis?
It wasn’t easy coming to terms with the new lifestyle, especially because I felt I was too young to be diabetic.
Has it become any easier with time?
Yeah, it has. It became easier once I came to accept that it was my new reality. Having family and friends who support me all the way makes a great difference.
What’s the hardest part about being diabetic for you?
The pressure of making sure I don’t default on my medication: having to keep my medication kit with me, even when I’m travelling. We are all human and we can forget, but this is a challenge I just have to face. Reminders on my cellphone help me a lot!
How do you balance a busy life with eating right and exercise?
I jog every morning and I try by all means to eat as clean as I can. There are times when I miss junk food, but knowing the damage it could do is enough to switch my brain straight to its senses.
You’re a radio presenter on Gagasi FM, do you talk about diabetes at all?
Yes, I do talk about it a lot. I’m fortunate to have Gagasi FM listeners who follow me closely: they know I’m diabetic and are very supportive. I also make sure I spread the word on every platform I get.
Could you tell us about your TV acting?
I play the character of Shaun, a lawyer, on the SABC1 telenovela, Uzalo, weekdays at 8:30pm. The character is the complete opposite of me, but I’m loving it and I’d like to do more TV gigs in the near future.
What advice would you offer to diabetics who are struggling?
Accept the situation and take it one step at a time. Diabetes is a silent killer, so take a stand and fight it. Surround yourself with people who love and support you.
What makes your life sweet?
The fact that I’m diabetic! Joking. I love my life, I live an awesome life, I live with no regret. I thank God for each and every day in my life: diabetes gave me a new meaning to life.
Ask the dietician: Cheryl Meyer
From our community: “I get invited to lots of business meetings and workshops that are catered… Needless to say, none of the catering is healthy! What do I choose or how do I deal with this situation?” Rene Prinsloo.
Many of us consume at least half of our meals and snacks during work hours, which makes our food choices in catered meetings and workshops very important. Here are three steps to consider:
Step 1: Build your plate
- Aim to fill half your plate with vegetables or salad. Look out for vegetable skewers, veggie sides, crudités (chopped raw veg), soup or salads.
- Next, add a healthy carbohydrate: either a wholegrain/high fibre starch or a piece of fruit.
Look out for:
- Wholewheat bread
- A seeded roll
- Wholewheat pita
- Wholewheat pasta/noodles
- Wholewheat wrap
- Brown or basmati rice
- Fresh fruit
- For long-lasting brain and body power, add a source of protein.
Some good protein choices:
- Lean cold meats
- Grilled chicken
- Mini meatballs
- Legumes like beans or lentils
- Fish like tuna, sardines or pilchards
- Cottage cheese
- Boiled eggs
Sauces like low-fat mayonnaise, sweet chilli sauce, hummus or guacamole are optional but not essential.
- Deep-fried foods (like samoosas, spring rolls or vetkoek)
- Sausage rolls and pies
- Croissants, muffins or other pastries
Step 2: Choose portions with caution
- Be sure to start the day with a balanced breakfast and keep healthy snacks or a packed lunch on hand to avoid arriving at a meeting hungry.
- Use smaller plates and serving utensils to help manage how much you dish up.
- Sit far away from the food to avoid “picking”.
- Use the size of your hand to determine sensible and healthy portion sizes and curb overeating:
- A fistful is equal to one cup and can be used to estimate the portion size for carbohydrates (starches and fruits).
- The size of the palm of your hand can be used to estimate the portion size for protein. For a stew, curry or casserole this would be about half a cup.
- The tip of the thumb is equivalent to one teaspoon and can be used to estimate the portion size for all oils, butter or mayonnaise.
- The thumb can also be used to estimate the portion size for peanut butter or hard cheese.
Step 3: Carefully consider your choice of drink:
Some good choices are:
- Still or sparkling water
- Tea or coffee
- Vegetable juice
- Low-fat milk
- Sugar-free fizzy drinks
Ketones and ketoacidosis are often mentioned in relation to diabetes, but what are they exactly?
- Ketones result when your body burns fat for energy.
- They are formed when the body doesn’t have enough insulin to use glucose for fuel.
- A urine test is traditionally used to test for ketones: some blood glucose meters can also test for ketones.
- Ketones make the blood more acidic.
- Ketones in the urine combined with high blood sugar are a warning sign that your diabetes isn’t under control.
- Diabetic ketoacidosis (DKA) is caused by a combination of high blood sugar that causes a rise in ketones. The ketones are an indication of how acidotic the patient is, and the acidosis can be fatal.
- DKA is serious and can lead to diabetic coma.
- DKA is rare in Type 2 diabetics and more common in Type 1 diabetics with uncontrolled blood sugar.
- Symptoms of DKA are thirst, frequent urination, high blood glucose, constant tiredness, nausea, vomiting, abdominal pain, dry/flushed skin, breathing difficulty and confusion.
- If these symptoms ring a bell, see a doctor as soon as possible to get your blood sugar under control.
We’ve got a dose of winter workout motivation that will ensure the only layers you’ll be adding this chilly season are layers of clothing! Lee-Anne Spurdens gives us the ideas.
While it’s tempting to stay under a blanket all winter long, hibernating isn’t good for your body or mind. Exercise is essential to manage your diabetes well, keep away the winter blues and build a healthy body – which also means you’ll be able to battle the winter germs better. Need some ideas to get you started? Here are seven of our favourites.
- Skipping Mobile, inexpensive and effective, this might be the most winter-friendly workout around. If it’s too cold or wet to skip outdoors, any indoor non-slippery surface will do (even in front of the TV). Skipping ups the heart rate, burns calories and strengthens muscles and bones. Start with five to 10 minutes a day.
- Boot camp If a little authority is what you need to get moving, you could be a winter warrior in the making! Boot Camp Academy SA (bcasa.co.za) offers “military” style boot camp classes across the country for all fitness levels.
- Exercise videos If you prefer to be drilled from the comfort (and warmth) of your living room, an exercise DVD is a good option. And who better to whip you into shape than martial arts guru, Billy Blanks? His legendary Tae Bo workouts are a mix of taekwondo and boxing, and available from takealot.com.
- Fit radio Sometimes all you need to get you moving is the right music. The Fit Radio app delivers a fresh new workout soundtrack whenever you need it and is guaranteed to get you off the couch, even if all you do is dance around your living room. Which brings us to…
- Dancing A tonic for body and soul, the ultimate stress buster and a fun way to warm up a cold body! From ballet and ballroom to hip hop and salsa, there are adult classes available for just about every type of dance. Check out dancedirectory.co.za to find a class in your area – soon you’ll be walking taller, sitting straighter and bending down more easily.
- Walking A brisk, daily 30-minute walk can help maintain a healthy weight, strengthen bones and muscles, manage high blood pressure and heart disease, improve balance and lift your spirits.
- Running If you’re ready (and willing) to take your walking up a notch, why not try a local park run? These free, timed 5km runs take place every week all over the world, are open to all levels and are a great way to get the whole family moving and make new workout buddies. Visit parkrun.com to find a run near you.
Morning movers and shakers
Generate some heat on chilly winter mornings with this 3-minute blood-pumping routine:
- Jumping Jacks: Jump your feet out and sweep your arms up over your head, then jump feet together and bring arms to your side. Repeat for 60 seconds.
- Side squats: Squat as low as you can, stand up and take a step to the side. Squat down again. Repeat on the other side. Keep going for 60 seconds.
- Plank: Get into a push-up position. Bend your arms to the floor, and rest your body weight on your forearms. Your elbows should be directly beneath your shoulders, your body in a straight line from head to feet. Hold for 60 seconds.
How to motivate yourself to get off the couch
Ask the expert: Ilona Padayachee, Biokineticist
Enjoyment: This is the key to staying motivated, so make sure you enjoy whatever exercise you choose.
Goal setting: This reaffirms a sense of mission, purpose and direction. Set goals during winter to keep you motivated, and reward yourself for sticking to your exercise routine.
Variety: Change up your workout routine to prevent it from becoming boring – try different activities, train outdoors as well as in, and work out with a partner to keep things interesting.
Your toes might be in hiding over winter, but that doesn’t mean you should neglect them. Podiatrist Anette Thompson has this advice for healthy winter feet:
- Treat dry, flaky skin with an exfoliating foot scrub and a good foot and heel balm.
- Warm feet up by soaking them in warm (not hot) water for five to 10 minutes. Follow with foot balm and thick socks for extra snugness.
- Shoes with inflexible soles prevent natural bending at the ball of the foot, which can cause circulation problems. Tight shoes and a toe shape that does not match your foot shape can also limit circulation. Wear low-heeled shoes with flexible soles that don’t squeeze the front of your foot (this can cause inflammation of the big toes or ingrown toenails). Buy a larger size if you wear thick socks, and choose shoes with built-in cushioning – this promotes circulation under the ball of the foot.
From our community blog:
I am new to this site.
Last night I was at the casualty section of Wilgeheuwel Hospital in Joburg because my 2 year-8-month year old son has been very listless and vomited and I thought he probably had gastro. He was diagnosed about 2 hours ago with Type 1 diabetes and was taken straight to ICU to be stabilised and to have tests done.
This was an overwhelming, terrifying moment for me — I know very little about Type 1 Diabetes and my OCD thinking went into a tailspin about “what if he is in a situation one day where there is no insulin available and and and…”
Forgive me for sounding so panicked, but I am utterly at sea and trying to come to grips with the news. I am writing in the hope that someone can tell me everything’s going to be okay – that the ‘episodes’ or emergency situations will be able to be handled with confidence and success, and that (bar all the huge adaptations we’ll make to our lives), he will be okay.
I’d really appreciate any comfort anyone can give to this totally inexperienced, upset mom.
My son is also a diabetic. He was diagnosed at age 12, nearly 6 years ago. I just wanted to say: hang in there. Your child will be okay. He will one day be able to cope with this all. Just remember that this is not your fault. Nothing could have prevented this. Do join our group on Facebook: Kids powered by insulin. This group has helped me through some tough times.
Remember there is light at the end of the tunnel. Keep the faith. It will get better, that I promise.
All will be okay as long as you take care of it and treat it accordingly.
Keep monitoring your son’s diabetes and it will be fine!
Oh my, I know the feeling of absolute devastation! I was diagnosed with Type 2 diabetes three years ago at an oldish age, and I live alone, and thought the world had come to an end. Obviously for such a little one it is very difficult… I’m very aware of what I eat. Living with diabetes is difficult, but doable.