Ajita Ratanjee is a registered dietician on the Sweet Life Panel of Experts. She shares some of her diabetes dietary tips with us today.
Blood sugar control is of the utmost importance for a diabetic. To date, many diabetics have a challenge keeping their glucose levels controlled. A combination of the following 3 factors ensure good glucose control:
- Use of medication (oral meds or insulin injections)
Foods to avoid
Most diabetics I meet are familiar with the “AVOID” list of foods. These are the obvious sugars e.g. Sugar, sweets and chocolates, sugary cooldrinks, cakes, pastries, biscuits, ice-cream, puddings etc. If you’re a diabetic and continue consuming the above list, then you are literally accelerating the chances of complications of diabetes: nerve damage, blurred vision, kidney failure, sores on feet etc.
However there are many who are compliant with the “AVOID” list yet may still find that their blood sugar levels remain elevated. Many years of clinical experience working with diabetics has allowed me to create a shortlist of other foods that are most likely spiking your blood sugar and you’re not even aware they are the cause. They are “healthy” food choices; however they tend to spike blood sugar and are not the best choice for a diabetic.
Other foods that spike blood sugar
These foods should also be avoided:
- any 100% fruit juice,
- dried fruit,
- energy drinks,
- flavoured bottle water,
- energy bars,
- muesli (containing nuts and dried fruit),
- popcorn, and
100% Juices and dried fruits are a concentrated source of natural sugar resulting in blood sugar elevation. Most energy drinks are loaded with sugar and are not suitable for diabetics. Energy bars tend to be marketed as low-fat, however that is not the same as sugar free (at all!)
The important thing to remember is that a diabetic should be aware of all foods that elevate bloods sugar levels. Grains, fruit and vegetables are all healthy but they need to be eaten in the correct portions to keep sugar controlled. Protein helps to stabilize sugar and thus an extra serving of meat / fish / chicken / egg etc. will not elevate glucose as much as an additional slice of bread / rice / potato.
The magic diabetes diet lies in the correct proportion of carb to protein at meals and snacks, and the correct portions at every meal and snack.
Choosing the right food
Fatty fish are high in omega 3 – tuna, sardine, salmon and mackerel are high in essential fatty acid. These are protective towards cardiovascular health and have anti-inflammatory properties. Diabetics are at high risk of heart disease thus omega 3 supplements are highly recommended. Make sure that you use good quality omega 3 that is heavy metal free.
Alcohol is metabolized as a sugar so plan in your glass of wine (preferable red and dry) or whiskey.
My key message in a nutshell would be – it’s not just about “no sugar” but rather getting the carbohydrate and protein balance. Test your glucose regularly; at different times of the day. This enables you to monitor your control throughout the day. Test your sugar before a meal or 2 hours after a main meal. Keep a record of your blood sugar readings.
At Easy Health Wellness we assist our clients by teaching them how to exchange carbs and how to count carbs to ensure that they always are in balance at each meal and snack, and they can enjoy variety in their eating plans. We also stock a fabulous range of sugar-free products to support our diabetic’s client needs.
The diabetic way of eating is a very healthy way of eating. We can all do with avoiding the refined carbs and eating regularly.
Find out more at www.easyhealthwellness.com or call 012 997 2783.
Being a supportive partner can be both a gratifying and a challenging role – especially when living with a person with diabetes. Diabetes affects the whole family, not just the one taking medicine.
Want to know how you can help?
1. Try to keep food temptations away and have healthy options at home. Support the diabetic in your family by having everyone eat healthy. And don’t nag if they sometimes ‘cheat’ or stray from their eating plan.
2. Make time to do exercise together – lots of fun exercises can be done as a family. Make exercising regularly a habit for both of you.
3. Remind your partner to see their medical team on a regular basis. Help them set up a few questions to ask so they get as much as possible out of the visit.
4. Set a reminder to have their monthly medication fetched from the pharmacy in time. Encourage them to test their blood sugar often.
5. Educate yourself about diabetes. Learn as much as you can, from the right sources – Dr. Google is not always right!
6. Learn to know the signs of hypoglycemia (low blood sugar) and what to do about it. Know how to test your partner’s blood glucose if necessary, and how to inject glucagon in an emergency.
7. If sexual problems arise, talk about it. Counseling may help if one partner feels rejected, and there is medication for erectile dysfunction if it becomes a problem. Just ask!
8. Look out for any signs of depression, mental fatigue or diabetes burn-out. Take action on these signs, as depression is not something that will heal itself.
9. Respect your partner’s personal decisions. This is sometimes very difficult, but you need to show your faith in them – diabetes is, at the end of the day, their condition.
10. Help your partner maintain balance in their life. Offer them a shoulder to lean on and help them to find solutions to their problems – but don’t try to solve the problems for them.
– Jeannie Berg, Diabetes Educator
“This year I have a diabetic child in my class and I don’t really know what to do. I want to make him feel supported but I also don’t want to make a big fuss about the fact that he’s diabetic – he seems to be managing it very well… What do you suggest?” Linda Nkosi.
I think it’s great that you want to lend support to your learner who has diabetes. However, being in charge of children with diabetes can be a challenge unless you know about the condition – it’s a good start for you to get more information on diabetes.
Children with diabetes often feel isolated and alone. Having to test your blood sugar several times a day, keep tabs on what you eat, and give yourself insulin shots or other medicine is enough to make anyone feel self-conscious and different.
If he is willing to do an awareness project with you, it could be very helpful for the whole class. It’s very important to first talk this idea through with him and his parents, though – some people prefer to hide their diabetes and pretend that it doesn’t exist. If you tackle this project in an exciting way, the child will feel involved and the other children in his class will enjoy the topic and then, like children do, just move on to something else. Children are like that. They soon move on, but the message of hypos, testing and shots will be stored in their memory banks.
Remember that this child must always be treated like his classmates. Don’t make exceptions. Always remember, he is a child first. He has diabetes, but that doesn’t give him more or less rights than the child next to him.
Like everyone else, kids with diabetes get along better with a little help from their friends. What a lucky person he is to have a supportive teacher like you!
– Jeannie Berg, Diabetes Educator
“My teenage son doesn’t want to take his insulin. He rebels against it as if it’s something only I want him to do, not something he needs to do to keep him alive. What can I do?” Jesca Ncube.
Even the brightest, smartest and most driven of teens have a hard time dealing with the day-to-day demands of diabetes. Having diabetes is often the one thing that trips them up.
They feel that their freedom is compromised. They are stuck in a zone where they are constantly asked about their blood sugar and as a result some lie about testing and taking shots: they suddenly experience a sort of “freedom” by lying and getting away with it. A wake-up call is usually when they land up in hospital. Most diabetics are prepared to try and do something to prevent that from happening again.
Because we live in a fast moving world, today’s teens have little time for themselves. Many teens are stressed, tired, and often have difficulty keeping up with the things they want to do, never mind the things they don’t want to do. Teens are risk-takers and struggling for independence – within this struggle, taking care of their diabetes is definitely not a priority.
So to answer your question:
The most important thing is to stay involved.
- Try and coach your teen into some kind of “contract” between the two of you regarding his insulin. Encourage him and make him accountable. Ask him what is helpful for you to do and what is not. Listen carefully.
- Find a health-care provider he likes and let him be educated about diabetes and the optimal treatment. Get him to meet up with other teens who are also living with diabetes.
- If the shots are bothering him, find out why exactly and see if you can change things to make a difference.
- Find out if he could be a good candidate for an insulin pump. Teens love technology and they usually do very well with pumps because they are growing up in a world exploding with new technology.
- Never be afraid to seek counseling. A teen might refuse to look after himself because he is depressed.
- This is the difficult part: you as a parent know the importance of insulin in your teen’s life. Try to explain it to him and ask him to work with you. Baby steps.
The good news is that most teens who have periods of giving up on their diabetes care eventually mature and start to do better again. Be your teen’s best friend: best friends do not judge and always stand by you.
– Jeannie Berg, Diabetes Educator
Who said exercise had to be at the gym? Here are some fun ways to get active without even noticing it.
The joy of dancing is that it’s good exercise, but so much fun that you won’t even notice you’re getting fit… Much better than trying to jog around the block! Dancing is, at heart, both art and sport. If you’ve been tempted to pull some moves like you’ve seen on TV’s Strictly Come Dancing and So You Think You Can Dance, but haven’t managed to make the move from the couch to the dance floor, this is the year to do it!
Why dancing is good for you
What many people don’t realise is that dancing has a number of health benefits. Dance is a full mind and body workout that burns calories and lowers your heart rate, blood pressure and cholesterol. As with all kinds of exercise, dancing makes the body more sensitive to insulin, which means the insulin works better in your system. Because dancing is a weight-bearing activity, where the body works against gravity, it can also help strengthen bones, improve balance, posture and coordination. Dancing offers the opportunity to socialise and make friends, and moving your feet to a good tune can be a real pick-me-up. Apart from reducing stress, the biggest benefit of dancing is that it is fun (lots of fun!)
How to get involved
Whether you like to jive, tap, or tango, shake your belly or let yourself go to the beat, there’s a style of dancing that’s right for you. Different types of dance include ballroom, ballet, nia, afro-fusion, hip-hop and free dance, among others. The first step is to have a plan. Ask yourself what style of dance you think you might enjoy – do you like something more formal, or free? Then, consider how much time you can spare in your week, how fit you are and if you have any pre-existing injuries.
Once you know what you want, it’s time to find it! Check community noticeboards and local gyms to find out when and where classes or events are being held, and invite a friend to go with you if you feel too shy to go to the first class on your own. Convinced you have two left feet? Take lessons. Most dance studios hold beginners’ courses and welcome people with disabilities. Learning a new skill can be a real confidence booster and if you start now, you’ll definitely have new skills to show off at your end-of-year Christmas party!
What to wear
Wear comfortable clothing that gives you freedom of movement and shoes that fit the dance form. Some classes, like ballet, tap or jazz, might need special footwear depending on your level. Avoid wearing jewellery, as earrings, rings and necklaces can scratch you or get caught in clothing. Most importantly? Wear a smile.
How to warm up
Remember that because dancing isn’t the same movements that you do in daily life, you need to warm the body up and treat the dance hour like an exercise session, with a warm-up, movement preparation, dance, and cool down. Once you’ve done your warm-up and you understand the main demands of the type of dance you’re doing, you can let your body go and enjoy.
Ask the expert: Sarah Hall, Biokineticist
Here’s how to warm up for each of these dance styles:
Ballroom: A large focus of ballroom is technique and posture, so you need to ensure that in your warm-up you help lengthen your spine. The goal is to engage your neck, shoulder blades and core muscles, so that you reduce strain and tension from this form of dancing.
Nia: This dance is about moving with balance, without too much effort. It is a combination of yoga, modern dance, jazz and tai chi. A whole body warm-up with deep breathing would be best here.
Ballet: Although rhythmic and seemingly calm, ballet is one of the most demanding kinds of dance. Muscle endurance, power and strength, as well as flexibility of joints, are all required. Before starting ballet classes, it’s a good idea to try a few one-on-one classes or test out the poses so you know how far you can move.
Hip-Hop: This is an extremely physical but hugely enjoyable dance form. Hip-hop uses movements that require strength and balance to control your body weight. Body weight exercises that prepare the body for this challenge, like dips, push-ups, sit-ups, lunges and squats, would be great to include in your warm-up. It’s also a good idea to strengthen and protect the spine because it’s such a high impact form of dance.
Free dance: Spontaneous and with no choreography, free dance has no rules and boundaries. So it’s important to combine the tips of all the types of dance above and ensure that you follow the structure from the warm-up to the cool down.
Ask the expert: Fiona Prins, Diabetes Educator
“Being active helps control blood sugar levels, so when you have diabetes it’s really important to exercise. As a rule, aim for 30 minutes a day, five days a week. Regular physical activity will help keep your weight down, reduce blood pressure, raise good cholesterol (HDL) and lower bad cholesterol (LDL) in the bloodstream. Other benefits of exercise include being able to sleep better and better health in general.”
“My son was just diagnosed with Type 1 diabetes and I want to know what to do about children’s parties and play dates? I don’t want him to feel ‘different’ but I also want to make sure his blood sugar won’t get out of control.” Linda van der Merwe.
I’m not sure how old your son is, but diabetes at any age can be difficult. Rest assured, what seems overwhelming now will eventually become routine.
Diabetes affects a child’s emotions, and badly controlled blood sugar can make diabetics feel irritable. If your son forgets to take insulin for a piece of cake at a birthday party, for example, he could end up fighting with his friends. Talk to him about the kind of food that will be at the party and help him to make decisions about which foods to choose, and which to avoid. Make sure he has something sweet on him in case he goes low, and chat with him about what to do if he feels funny. Most importantly, let him know that you are only a phone call away.
Yes! The thought of your child going off to a party at someone else’s home may make you scared. Away from your control, over-excited by all the fun and surrounded by delicious high sugar and high carb treats. A parent’s worst diabetic nightmare. But just remember: a child with diabetes is still a child. And children LOVE birthday parties!
It’s a good idea to call the host parent and find out what sort of food and drinks are planned for the party. You can even offer to provide a platter of your child’s favourite (diabetic-friendly) snacks, so that he can share them with his friends. Let the host know that you will have your phone on you the whole time.
Lastly, try to relax. With careful planning, your son can safely enjoy birthday parties as part of his childhood.
– Jeannie Berg, Diabetes Educator
Making choices and decisions every day about life with diabetes can be tough… But luckily there are solutions to make it much easier. Nicole McCreedy has rounded up some favourite tools for you to choose from.
Each of us is different, so the methods and tools we choose to manage our diabetes need to be different too. The trick is to find solutions for self-management that work for you every day. Here are some ideas to get you started:
- Become an expert on diabetes
Gather as much information as you can on diabetes and how it affects your body. Make sure that your information is from a respected source, based on accurate scientific evidence. Ask your doctor to direct you to relevant books or websites. Understand the role that insulin plays in transporting glucose in the bloodstream to your muscles. This will help you to better know what impact foods such as carbohydrates or sugar will have on your blood glucose levels and how much insulin your body may need. With this knowledge, it does become easier to plan ahead and predict – to a degree – how your body will react.
- Learn to live with diabetes
It is common to feel overwhelmed, angry or sad when you’re living with diabetes. You may know the steps you need to take to stay healthy, but have trouble sticking with your plan over time. Try to make peace with your diagnosis and take control of your situation: eat well, exercise often and go for regular check-ups.
Ask the expert: Dr Joel Dave, endocrinologist
“Adapt your lifestyle and diabetes care to achieve good diabetes control and a good quality of life. This can definitely be done – try to include a multi-disciplinary team in your care to ensure balance in all areas.”
- Find ways to cope with stress and other factors
Heat, sickness, exercise, your menstrual cycle and stress are all factors that need to be considered when managing your treatment. Recognise and address these factors as they arise. Stress, for example, can raise your blood glucose levels, so in times of stress you may have to monitor your blood sugar more often.
- Be prepared and have a system
If you inject insulin, ensure that you have a supply readily available on hand for when you need to take it. Plan ahead by storing pens at work and at home, remembering to keep them cool. Create a system that works for you and helps you to remember when to inject yourself. A missed injection can cause knock-on unwellness when you try to make up for it later.
- Count your carbohydrates
Carbohydrate counting is helpful as it allows you to figure out more accurately how much insulin to give yourself before a meal to keep your blood sugar under control. Get into the habit of reading labels on the foods that you eat, as it will teach you to better estimate quantities, which can help you to be more accurate.
There are a number of mobile apps available for you to use on your phone:
- Glucose Buddy stores the data you need to manage diabetes without a lot of hassle. You can input your blood glucose numbers, insulin dosages and how many carbs you eat at each meal.
- Diabetes Buddy helps you manage your diabetes by tracking the factors that influence your blood sugar levels, monitoring the fluctuations, planning ahead and making it easy for you to share your data with your doctor.
- ACCU-CHEK® 360° diabetes management app provides easy tracking of your diabetes data. A choice of graphic reports helps you identify trends and patterns in your blood sugar levels to support better management of your diabetes.
What are your favourite diabetes apps? Let us know in the comments and we’ll include them!