diabetes

10 Fast facts about travelling with diabetes

All you need to know about going on holiday with diabetes – Type 1 or Type 2.

  1. Make sure you have enough medication to last your whole holiday – including insulin injections or tablets, testing strips, needles and lancets. Take a little extra if you can, and don’t forget things like batteries for your glucometer.
  2. If you are on insulin, take a copy of your prescription and a letter from your doctor that says you need to carry your injections with you at all times. Some security checkpoints will ask for this, so it’s best to be prepared.
  3. Insulin needs to be kept at a constant, cool temperature – never above 30°C and never below freezing. Be sure to take a cooler bag to keep it at the right temperature wherever you travel.
  4. Never leave your medicine in direct sunlight! Check that if you’re on a long bus trip, it’s kept close to you and out of the sun.
  5. Always carry some sugary snacks with you in case of hypoglycemia. A roll of Super Cs or some sugar packets will do the trick.
  6. Be aware of the effects of exercise on your blood sugar. If you’re exploring a new city, you may be walking more than usual so your blood sugar could go lower than it normally does.
  7. If you’re going overseas, sign up for medical insurance or ask your South African medical aid what their overseas policy is. You want to know exactly what to do in case of emergency.
  8. If you’re travelling across time zones, adjust the time you take your long-acting insulin slowly (over a few days) so your body has time to adjust to the new time zone.
  9. Try to stick to somewhat-recognisable food so that you can accurately guess the carb content and know what it will do to your blood sugar.
  10. Have fun! Don’t let diabetes stand in the way of you experiencing everything you can while you’re on holiday.

Teenagers and diabetes

“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.

Dear Jesca,

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

 

 

 

Tackling the Challenges of Diabetes and Obesity in Africa

I was lucky enough to be invited to the most fascinating diabetes conference in Cape Town recently: Tackling the Challenges of Diabetes and Obesity in Africa.

The line-up was truly impressive (more on that below) but what really struck me was how engaged and passionate all the attendees were about the issues of diabetes and obesity, and what we – as individuals, researchers and caregivers – can do about it.

But first! The amazing speakers and their topics.

The first day was chaired by Professor Naomi Levitt, the Head of Diabetic Medicine and Endocrinology at the University of Cape Town. Prof Levitt gave an overview of the issues of diabetes and obesity in Africa, and led the discussions after each talk. Her passion for diabetes research in South Africa is palpable.

Professor Justine Davies is a Professor of Global Health from Kings College London and started us off with a talk on Health systems challenges of deadling with diabetes in sub-Saharan Africa. She’s the previous editor of The Lancet journal and gave insights from The Lancet Diabetes and Endocrinology Commission. A fascinating look at just how severe the problem is in sub-Saharan Africa.

Then it was Dr Ankia Coetzee‘s turn. She’s a Clinical Endocrinologist at Stellenbosch University, with a special interest in gestational diabetes. Her talk – Gestational Diabetes Mellitus: The Alchemy of Diabetes Prevention? – suggested that treating those with gestational diabetes holistically can be a key to unlock future Type 2 diabetes.

After a short tea break to let the information digest, Salaamah Solomon, a Dietician from Tygerberg Hospital, spoke about Challenges in Nutrition Education – specifically, how essential it is to make nutritional information as simple as possible so that it can be easily adopted.

Then Professor Julia Goedecke, a Researcher at the South African Medical Research Council, spoke about her research into Mechanisms underlying insulin resistance in black South African women, which sparked a whole debate around exercise and diet as two critical components in Type 2 diabetes management (along with medication, of course).

After a fascinating lunch spent absorbing more diabetes information, Professor Tandi Matsha, the Head of the Department of Biomedical Sciences at Cape Peninsula University of Technology spoke about Epigenetics and Type 2 Diabetes. I didn’t know much (if anything) about epigenetics, so this was a real eye-opener for me.

And then Dr Sundeep Ruder, an Endocrinology Consultant and Lecturer at the University of the Witwatersrand, took things in an entirely new direction with his presentation about Philosophy in Diabetes – how it is our goal as humans to be peaceful, blissful and happy, and too often we use food as a cheap trick to get us there. (Among many other fascinating points!)

I had to get home to my young children, so sadly I missed Professor Carel Le Roux‘s talk: Can we approach obesity as a subcortical brain disease to address prediabetes and diabetes? I also missed Professor Andre Kengne‘s talk on Diabetes and BMI trends in Africa – both of which were discussed a lot the next day.

The next day was World Diabetes Day, and Dr Rufaro Chatora from the World Health Organisation gave some opening remarks about World Diabetes Day.

Then it was time for the keynote presentation, by Professor Jean Claude Mbanya, Honorary President of the International Diabetes Federation (Africa Region and Global), and Professor of Medicine and Endocrinology at the University of Yaounde, Cameroon. He gave a fascinating presentation on Global and Africa’s Burden of Diabetes, releasing the latest research from the 8th IDF Diabetes Atlas.

Then it was Dr Eva Njenga‘s turn to tell us about diabetes in Kenya. She’s the Chair of the NCD Kenya Alliance and the Director of the Kenya Diabetes Management and Information Centre, which she co-founded. They get funding from the WDF and partner with the Minister of Health to make a tangible difference to people with diabetes in Kenya. She spoke about Changing lifestyles to combat Diabetes, Obesity and other NCDs.

It was really the most extraordinary two days of diabetes discussions, talks, information sharing and inspiration. I left feeling so motivated to make a difference to people with diabetes in South Africa, and so inspired by all the doctors, researchers and healthcare workers who are so involved in diabetes in our country.

I can’t wait for the next one!

Making diabetes delicious

It might seem as though being a restaurant chef would be too tempting a job for a Type 1 diabetic, but 30-year-old Vanessa Marx has made an art out of making healthy food delicious – and accessible.

When did you find out you were diabetic?

I was about sixteen and in high school – seriously bad timing! I had all the usual symptoms. I was drinking about four litres of water a day and falling asleep during class because I was so exhausted. My mom eventually suspected diabetes and I had to be hospitalised. It was a traumatic experience. I’ve always loved food, and I remember lying in my hospital bed naming all the foods I could never eat again… It was a long list!

How has diabetes changed your daily life?

That’s a hard question, because it’s so much a part of my daily life. It can be difficult, sometimes, explaining to people who don’t have diabetes how you’re feeling. If I wake up with low blood sugar, for example, I’m exhausted before the day begins. People understand a throat infection, but they often don’t understand what waking up low feels like. As a head chef, I need to be alert every day, taking charge of the kitchen. There’s no room in a busy kitchen for feeling tired or unwell because of high blood sugar or needing time out to have something sweet because of low blood sugar.

Isn’t it difficult to be around food all day? How do you resist sweet treats?

It is quite tricky! Often just the act of making sweet treats for someone else satisfies the urge for me but other times I’m pretty tempted: what puts me off is that I know how I’ll feel later. I do believe in “everything in moderation”, so I allow myself a treat now and then. As long as it’s a once-off, and I’m not doing it every five minutes!

What advice would you offer to other diabetics?

Be disciplined! Pay attention to your diet: what you eat plays a huge role in how you feel. Also don’t feel like you’re on your own, don’t be afraid to ask for help – talk about your diabetes, and explain to those around you what it feels like. There’s still a stigma around diabetes, that it’s only people with weight problems who are diabetic. But the only way we’re going to change that is by talking about it.

What makes your life sweet?

My family and friends, and my work.

Get in touch with Vanessa: @vanessajaynem on Twitter and Instagram

10 Fast facts about high cholesterol

All you need to know about what cholesterol is – and how to deal with high cholesterol.

  1. Cholesterol is a fatty substance that is naturally present in your blood and cells.
  2. It is measured in four parts: total cholesterol; LDL (low-density lipoprotein) which is the “bad cholesterol”; HDL (high-density lipoprotein) which is the “good cholesterol”; and triglycerides (a form of fat that the body makes from food sources, such as sugar and alcohol).
  3. Your body needs some cholesterol for healthy functioning. But many people have too much of the “bad” type and too little of the “good” type.
  4. In some cases, high cholesterol is inherited, but more often it is the result of an unhealthy lifestyle and too much saturated fat in your diet.
  5. Having high cholesterol does not cause any physical symptoms that you would be aware of. That’s why it’s often called a silent killer.
  6. Doctors advise that you have your cholesterol tested at least once a year. If you have diabetes, you’re aiming for an LDL reading of less than 2.8mmol/l.
  7. People with Type 1 or Type 2 diabetes are at higher risk for cardiovascular diseases such as heart attack and stroke. This risk increases if your LDL cholesterol is high.
  8. Many of the things that help to control your diabetes will also help to lower your cholesterol. Four lifestyle changes that can make a huge difference: lose weight; exercise more; avoid saturated fat; quit smoking.
  9. “Good” HDL cholesterol helps your body get rid of the “bad” LDL cholesterol. Include more healthy monounsaturated fats in your diet to assist this process. These include avocado oil, olive oil, peanut oil, avocados and most kinds of nuts.
  10. Keep in mind that these lifestyle changes aren’t always enough. Some people may need cholesterol-lowering medication too.

Dance your way to better health

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.”

Candy Tsamandebele: living with Type 2 diabetes

Indigenous Afro-Soul artist Candy Tsamandebele talks to us about living with Type 2 diabetes.

When did you find out you had Type 2 diabetes?

After the death of my son through an accident. It was unexpected to say the least.

Was it a shock?

Yes it was.

How did you have to adapt your lifestyle?

I started with what I ate and drank. It was difficult at first, but with time I got used to it.  Secondly, my lifestyle all together.

How do you balance a busy lifestyle with eating well and exercise?

Sticking to a strict diet. Also understanding the consequences of ignoring that diet.

What advice would you offer to those living with diabetes?

Just take it one step at a time. Take your medications on time and eat healthy.

What makes your life sweet?

Music. It really does.

Some background on Candy and her outreach work:

August 2, 2011 was one of Candy Tsamandebele’s most trying times in her life when she lost her son in a car accident. Six months later she was diagnosed with Type 2 diabetes. Not one to be kept down, two years after the trauma, Candy garnered strength to launch CANDY TSAMANDEBELE FOUNDATION. She uses the foundation to teach young women and the youth in general about values and it is her vehicle to drive and leave behind a legacy as she continues to grow in the music industry.

The main aim of the Candy Tsamandebele Foundation was to teach kids about music, the importance of culture, significance of language, youth development, medical assistance, helping with school uniforms to needy, and several other initiatives that are close to her heart.

Every year Candy Tsamandebele dedicates her time to carry out community building initiatives such as visiting schools and donating school uniforms, as well as motivating the youth both in and out of school. She encourages young people to use their natural abilities and talents to make it through life. During her motivations, she always talks about the importance of getting tested for diabetes and other chronic conditions and adhering to taking treatment once diagnosed.

Since she was diagnosed with diabetes, Candy Tsamandebele has made it her mission to be a national diabetes warrior. She is a force to be reckoned with and she will stop at nothing for as long as she is needed to make a difference.

Find out more at www.candytsamandebelesa.com

Diabetic pregnancy and the pump?

From our community blog:

I am a Type 1 diabetic since 1991. I have had two children and desperately want a third, but cannot face another pregnancy like the second due to severe hypoglycaemia that kept occurring.

I want to get a pump – my doctor did initially suggest it and I have asked for a referral to a centre that deals with pumps. I also would like to know what the chance of getting a pump on medical aid is if it is recommended by a doctor and if the medical aid is paying for CDE at the moment?

I am trying to control my sugars now but even tracking them 6-8 times a day, taking multiple extra shots when needed and tracking my diet closely is not helping.

– Bronwyn

Comments:

Hi Bronwyn,

The CDE has 5 pump centers in Johannesburg. 011 7126000. They also have an amazing 5 day course called DINE. Speak to Michelle Daniels.
Kimberley

Hi Bronwyn,
I hope this may be of some help in resolving your control problems. I used a pump for 10 years and found it to be helpful particularly as you can control the long acting (basal) insulin for your individual requirements. You programme the pump to dispense whatever you need for each hour of the 24 hour day which will be exclusive to your needs.
A phone call to your medical aid should be able to tell you if they will support the purchase fully or partially. I stopped using mine because my levy on the consumables was increasing beyond reason.

It needs time and expertise to learn how to use the pump. I know we are all different but I believe that with the proper advise and treatment you should be able to get control before getting a pump. It will help your new doctor (it seems you need one) if you keep a record of insulin taken, food consumed, and exercise taken.

I’m a chairman of a support group, find one of these as they can also be very helpful.

Mervyn

The daily sweat

Getting active every day can feel like a bit too much to ask for… Which is why Cindy Tilney’s asked the experts to give us easy ways to keep fit – no matter how old you are!

We all know exercise is good for us, but exercising to the max – especially in later life – can be too much of a good thing. It’s essential not to stress the body by exercising too hard, says Professor Wayne Derman, the Director of the U-Turn Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of South Africa. “When planning an exercise routine, it’s important to consider any medical condition you might have, as well as any medication you’re taking and how it may affect you while exercising,” says Prof. Derman.

Older age also comes with a bigger chance of aches and pains because of problems like osteoarthritis and rheumatoid arthritis – if these names ring a bell, it’s a good idea to be more careful about the kind of exercise you choose, and to consult a medical professional (a biokineticist, physiotherapist or sports physician) when planning an exercise routine. Be sure to check if any medications you are on will interfere with this routine, reminds Prof. Derman.

Be informed

“It’s essential to go for a health check and orthopaedic assessment before starting any exercise programme,” says biokineticist, Sarah Hall.

Get checked for:

  • Cardiac weakness
  • Any existing injuries
  • High blood pressure
  • Ischaemia (restriction in blood supply)
  • Uncontrolled diabetes

Also be aware that falls are more likely if your balance isn’t what it used to be.

Warning signs:

The right kind of exercise has benefits for every chronic condition, says Prof. Derman.  But watch out for:

  • Feeling breathless to the point that you can’t talk when exercising
  • Any pain.

“The saying ‘no pain no gain’ is not true,” he says. “Your body should be in a state of relative comfort while exercising.”

So what should you do?

It’s important to include all of these steps in an optimal exercise programme, as they all have different functions, say Derman and Hall. These include:

  1. The warm up: This involves stretching and preparing your body for exercise.
  2. Flexibility training/stretching: This focuses on increasing the range of motion of the joints and stretching the body to release tension in the major muscle groups – calves, quads, glutes, hamstrings, back, chest and arms.
  3. The aerobic phase: Involves movement of the large muscle groups to increase the heart rate. It can be walking, jogging, cycling, aqua aerobics or rowing, for example.
  4. Muscle strength resistance training: Using elastic bands or circuit training to make muscles stronger. This is particularly important for people with diabetes, as it can help the muscles involved in the absorption of insulin to become more sensitive, which helps blood sugar control.
  5. Stability training: Exercises like plank position that help balance and core stability.
  6. The cool down: This involves stretching and relaxation to allow the heart rate to go back to normal and the body to return to a resting state.

Remember: The goal is to exercise 20 to 30 minutes on most days of the week.

3 Top tips for people with diabetes:

  1. Don’t begin exercising if your blood sugar is either too high or too low (over 16 or below 4.8).
  2. If you are using insulin, always take something sweet with you when you exercise, in case of hypoglycaemia (low blood sugar).
  3. Avoid injecting into large muscle groups just before exercising.

What kind of exercise is best for older people with diabetes?

We asked biokineticist Sarah Hall to give us a sample exercise routine. Here’s what she said:

Warm up: 5-10 minute brisk walk

Stretch: Standing calf and quad stretch, chest, shoulder and bicep stretch, lying down hamstring stretch and cat stretch for the back

Aerobic: Step for 2 minutes

Muscle strength: Like bicep curls, wall push-ups and abdominal crunches (sit-ups)

Aerobic: Walk or jog on the spot for 2 minutes

Stability: Plank position

Cool down: Repeat stretches

Puppies, baby goats, hedgehogs and pre-diabetes

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

Here’s the explanation:

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

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

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

So here are those videos… They are amazing.

Puppies:

Baby goats:

Hedgehogs:

10 Fast facts about foot care

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

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

How to deal with a diabetes diagnosis

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

Dear Razan,

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

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

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

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

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

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

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

Make it a good one.

– Jeannie Berg, Diabetes Educator

 

Exercise made easy

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

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

  1. Before (or after!) work

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

Ask the expert: Sarah Hall, Biokineticist

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

  1. On your way to work

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

Ask the expert: Sarah Hall, Biokineticist

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

  1. In the office

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

Ask the expert: Sarah Hall, Biokineticist

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

  1. At home

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

Ask the expert: Sarah Hall, Biokineticist

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

  1. On the weekend

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

Ask the expert: Sarah Hall, Biokineticist

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

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

–       Help your body to use insulin better.

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

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

–       Improve your blood sugar control.

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

Living well with diabetes

From Facebook (Diabetic South Africans):

What does living well with diabetes look like for you?


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

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

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

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

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

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

The challenge of gestational diabetes

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

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

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

How did you find out you had gestational diabetes?

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

What were your symptoms?

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

Does diabetes run in the family?

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

What did you do to manage your gestational diabetes?

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

What advice would you offer to women with gestational diabetes?

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

What makes your life sweet?

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