diabetes and exercise

Living well with Type 1 diabetes, coeliac disease and ADD

Meet Shane Casserley: a Type 1 diabetic who is also juggling coeliac disease and ADD… while living his best life.

When were you diagnosed with Type 1 diabetes?
When I was 8 years old years. I am now 22.

Was your diagnosis a shock?
A huge shock. I was completely freaked out. I was hospitalised straight away and had to stay in hospital to learn to give my own injections and I was visited by a dietician to adjust my diet. After the initial shock wore off I went into depression.

When were you diagnosed with coeliac disease and ADD?
In 2011, when I was 16 years old.

How do they affect your diabetes?
They don’t affect my diabetes in any way but it was another huge diet adjustment because when you have coeliac disease you are not allowed to eat anything containing wheat or gluten. The ADD also does not affect the diabetes directly but indirectly it is a lot more difficult to remember to check your sugar regularly and give insulin when you eat.

How did you become interested in fitness?
When I was going through a rough time, a friend offered to take me with him to gym. It made me feel so good that I have been hooked ever since.

Why do you want to be a personal trainer?
Going to gym and changing my diet greatly improved my health and self image, and gave me the confidence that I lacked. I would like to do the same for other people, especially for diabetics who are battling.

How do you think regular exercise helps people with diabetes?
It has a big impact on stabilising sugar and thereby lessening the risk of future complications. At the same time, it increases your endorphins, which makes a person feel good psychologically and decreases depression.

What advice do you have for other diabetics who are struggling?
The most important thing is to accept that you have it and you can’t change it and rather learn to adapt to it. Once you have accepted it and you start eating right, exercising regularly and keeping a good check on your sugar readings, then you can lead a normal life. It is always good to get support from other diabetics.

Exercise classes for diabetics

Are you looking for a fun way to get fit? Here are a few exercise classes specifically for people with diabetes – we’ll add to this list as we find more! Please email us with details of other fun fitness classes for diabetics.


Latha Singh: Chatsworth, Durban

I’ve been an exercise instructor for the past 28 years. I teach exercise classes for women and senior citizen groups in and around Chatsworth.

I would love to spread my knowledge and literally hold exercise classes at hospitals (like Chatsmed Garden Life Hospital) and other venues to make people aware of the importance of exercise, especially people with diabetes.

My classes are currently at:

  • Malvern Library (Queensburgh): Monday and Wednesday from 8am to 9am
  • Shallcross Heidi School Hall: Tuesday and Thursday mornings from 8am to 9am
  • Woodhurst Library, Chatsworth: Tuesday and Thursday from 6pm to 7pm
  • Mobeni Heights Temple Hall: Wednesdays from 10am to 11am
  • Woodhurst Library: Thursdays from 11am to 11.30am

Email Latha to find out more.

 

Kayla Murphy: Randburg, Johannesburg

We are a private biokinetics practice in Randburg, Johannesburg. We specialise in youth and adult diabetic exercise classes: Fit for Diabetes (see below PDF for more info).

We are happy to do any free classes or participate in educational talks to get more involved and contribute to the diabetic community of South Africa.

Email Kayla to find out more.

Download (PDF, 1.05MB)

10 Fast facts about diabetes as you get older

Keeping your diabetes in check as you get older is not only possible, but important. Here’s what you need to remember.

  1. Diet is vital: be sure to eat as balanced a diet as possible. Not eating the right kind of food or often enough can result in low blood sugar. Drinking plenty of water is also important.
  2. The average HbA1c in the elderly population in SA is within national guidelines at around 7.3. What’s yours?
  3. Be prepared and always have at least 3 days of supplies on hand for testing and treating your diabetes.
  4. Hypos (low blood sugar) are a risk, especially in Type 2 diabetics who are on SUs (sulphonylureas). Severe hypos can result in comas, so it’s important to know how to treat them.
  5. Always keep a glucagon pen on hand for hypo emergencies (and make sure you’ve told someone close to you how to use it).
  6. Controlling Type 2 diabetes with Glucophage or Galvus can have a life-changing effect.
  7. It’s important to have regular blood pressure and cholesterol tests, and annual kidney, eye, teeth and feet check-ups.
  8. It’s a good idea for any diabetics over 65 years old to have a pneumonia vaccine shot. An annual flu shot is also beneficial.
  9. Keep active as it helps with mobility, balance, strength, mental wellbeing and insulin sensitivity.
  10. Studies show that older diabetics are more compliant than teenagers, the newly diagnosed, and even pregnant diabetics.

Yoga may help reduce heart disease risk

The millenary practice of yoga is fast gaining ground on a worldwide scale; known as an efficient stress buster that brings practitioners greater vitality and a better mood, it also helps prevent heart disease, which is good news for people with diabetes.

Heart disease a risk for people with diabetes

Adults with diabetes have a higher likelihood of heart disease for various reasons. Those with Type 2 diabetes, in particular, may have conditions that can increase this risk, including high blood pressure, high cholesterol and triglyceride levels, and obesity. Leading a sedentary lifestyle is another modifiable major risk factor for both cardiovascular disease and insulin resistance, so one way to reduce the risk for heart attack or stroke is to keep physically active through aerobic activity and, new studies indicate, yoga.

Yoga as a means to reduce cardiovascular disease risk

In a review of 37 randomized controlled trials, researchers from the Netherlands and the USA found that yoga can provide the same benefits in risk factor reduction as commonly recommended activities such as cycling or fast walking. These two forms of exercise could have comparable working mechanisms; that is, yoga could have more physiological benefits, and exercise more relaxing effects than was originally thought.

As a deeply spiritual practice affecting physical and mental health positively, yoga is being embraced in a plethora of mental health settings, including rehabilitation centres for substance abuse. Science is more accepting than in the past of so-called ‘alternative therapies’ like yoga since numerous studies have shown that spirituality is linked to greater happiness and reduced anxiety and depression – key factors in managing diabetes from an integrated perspective.

In the studies, yoga practice was associated with significant improvement in Body Mass Index (BMI), blood pressure, and lipid levels, particularly when patients also took medication.

Yoga and aerobic activity a winning combination

Another, more recent study, presented at the American College of Cardiology in 2017, found that those who already have heart disease but practiced yoga in addition to aerobics, saw twice the reduction in BMI, blood pressure, and cholesterol levels, as those who practiced either of these activities exclusively. Combining these activities could also increase exercise capacity and improve heart function.

Of course, even if you only have time for yoga, you will still be doing yourself plenty of good, since heart rate variability (an indicator of optimal heart health) is higher in yoga practitioners. Yet another study showed that yoga can reduce atrial fibrillation (‘heart quivering’) while improving heart rate, blood pressure, and general quality of life.

If you have diabetes, it is important to lower your likelihood of heart disease by staying active, keeping to a healthy weight, and tapping into the potential of combining yoga and aerobic activities, making time for each throughout the week. By boosting physiological changes and lower stress levels, you can kill two birds with one stone, finding greater enjoyment and vitality as an added bonus.

Your insulin pump questions, answered

If there’s one question we get all the time, it’s about the insulin pump: what is it, how it works and how to get it covered by medical aid. So we’ve gathered together all your Frequently Asked Questions, and found the answers.

Meet the expert

Name: Imke Kruger
How long have you been diabetic? 25 years
How long have you been on the pump? 5 years

What made you decide to get an insulin pump?
I battled to get my blood glucose under control on multiple daily injections, especially when doing sports. It was before my first 94.7 cycle challenge that my doctor suggested insulin pump therapy. It has changed my life! I can’t imagine life without my Accu-Chek Combo pump.

What do you love about the pump?
Everything! It helps me to live life the way I want to. I love the discreetness of it – I can give a bolus in a meeting or when going out with my friends, without anyone noticing.

What are some of the challenges?
The first two months were difficult to get used to sleeping with the pump, but now I don’t even realize that I’m wearing it. The challenge is more with diabetes – not the pump. It’s important to realise that insulin pump therapy is not taking the condition away. There are so many variables in diabetes, and that will always be a challenge.

When should someone consider getting an insulin pump?

  • If they are experiencing severe hypoglycaemic (low blood sugar) episodes despite careful management.
  • If they are on multiple daily injections, following a meal plan, testing their blood glucose levels 4 times a day, and still not getting target HbA1c results.
  • If they have irregular eating, working and resting times.

Insulin pump therapy won’t work for those who aren’t committed to it, and there isn’t enough evidence to recommend it for Type 2 diabetics.

A more comprehensive description of the Indications and Contra-Indications to Pump therapy can be found in the SA Guidelines for Insulin Pump Therapy. A Amod, M Carrihill, JA Dave, LA Distiller, W May, I Paruk, FJ Pirie, D Segal, Association of Clinical Endocrinologists of South Africa (ACE-SA) JEMDSA 2013;18(1):15-19.

 

FAQ about the insulin pump from our community:

 

  1. What is an insulin pump?

  • Insulin pumps are portable devices attached to the body that deliver constant amounts of rapid or short acting insulin via an infusion set.
  • The pump tries to mimic the release of insulin from a normal pancreas, but you have to tell it how much insulin to inject.
  • It delivers insulin in two ways: a basal rate which is a continuous, small trickle of insulin that keeps blood glucose stable between meals and overnight; and a bolus rate, which is a much higher rate of insulin taken before eating to “cover” the food you plan to eat or to correct a high blood glucose level.
  • Because the insulin pump stays connected to the body, it allows the wearer to change the amount of insulin they take with the press of a few buttons at any time of day. You can also program in a higher or lower rate of insulin delivery at a chosen time – when sleeping or doing sports, for instance.
  1. Where do you buy an insulin pump and how much does it cost?

You need to be a patient at one of the accredited pump centres in South Africa. Your doctor will decide if you are a pump candidate according to the Association of Clinical Endocrinologists of South Africa (ACE-SA) guidelines. If you are, you will need a script to claim the pump through your medical aid, or buy it cash from one of the supplying pharmacies.

  1. What are the advantages and disadvantages of using an insulin pump?

Insulin pump therapy improves metabolic control while giving you greater freedom and a better quality of life.

  • Your metabolism stays more stable, with better HbA1c values and fewer low blood sugar episodes.
  • You can be more flexible in your eating, if you understand the concept of carbohydrate counting.
  • You can participate in sports whenever you feel like it — without having to plan in advance

Disadvantages are that you have too much freedom in making food choices, and that there is a risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems.

Remember: Deciding on insulin pump therapy is not a simple decision and should be carefully discussed with your healthcare team.

  1. Will my blood sugar control be better if I use an insulin pump?

It all depends on you. You can wear a pump and it can have no impact on your blood sugar. Or you can use a pump, and with the right settings, motivation and help from your healthcare team, you can have better blood sugar control.

  1. Will I still have to test my blood sugar as much?

A pump patient needs to be a motivated patient who tests regularly, around 4 times a day.

  1. Are there insulin pumps that have a Continuous Glucose Meter attached?

Yes there are – it’s a good idea to discuss with your healthcare team which pump would best suit your needs

  1. How would the insulin pump be used for sports? Are there special casings made or will I have to play without it?

You can engage in any kind of physical activity while wearing an insulin pump. But for sports with intensive body contact and water sports we recommend temporarily disconnecting the insulin pump (not for longer than 1 hour). Special cases and pouches can protect the pump, but it’s always a good idea to insure it as well.

  1. At what age can you put a child on the insulin pump and how easy is it for them to adapt?

I would say at any age, but it’s best to get advice from your pediatric endocrinologist. Children often adapt the easiest of all age groups to insulin pump therapy.

  1. What is the risk of infection?

If you follow the right hygiene steps, the risks are low. You should always disinfect the pump site before inserting the infusion set. It is also critical to replace the infusion set every three days.

  1. How much is an insulin pump with and without medical aid?

That depends on the type of medical aid plan and whether the medical aid covers the costs fully or partly. It would be best to discuss this with your healthcare team or your medical aid. If your doctor agrees that pump therapy is the best option for you, they will send an application to the medical aid.

Ask the expert: Dr Claudine Lee, GP

“Pump therapy is a beautiful and practical way of delivering insulin that tries to fit in with you, the patient, in terms of meals, exercise and illness, as well as just living a normal life.”

 

Ice skating with diabetes

Of all the sports a diabetic could choose, ice skating – with its precision, edge of danger and need to be feeling 100% every time you take to the ice – isn’t the most obvious. But that didn’t stop KZN champ Rachel Lombard from competing.

Who did you skate for?

I was part of the Toti Seals Synchro Team, and we represented KwaZulu/Natal twice a year in the inter-provincial competitions, as well as the KZN championships.

How long have you been diabetic?

I was diagnosed about 10 years ago, when I was 7 years old. It was pretty traumatic, I was scared that I was dying because I was misdiagnosed – they thought it was cancer. It was a huge shock for my mom, but I just remember feeling relieved it was only diabetes and it wasn’t anything worse.

Is it difficult to compete when you have to worry about blood sugar levels on top of everything else?

I have an insulin pump, so that helps, but I still have to be very careful. I make sure my blood sugar is fine an hour or two before we’re due to go on the ice, because my pump is under my tights and my costume and it’s difficult to get to if I need to adjust my levels. I also test just before I go on the ice, because the adrenalin can do funny things to my blood sugar. And I make sure I always have fast-acting sugar on hand in case I go low.

What do you love about ice skating?

I love it mainly because it’s different, and because there’s a real community – especially with my team and the coach. I skate four times a week, so it’s also really good exercise.

What do you think the biggest challenge of living with diabetes is?

The testing – having to test all the time. And how you can never predict what your blood sugar is going to do: you’ll eat something and know how much insulin to take, and it works… And then the next time you eat exactly the same thing and take the same amount of insulin and it doesn’t work, for some reason.

What advice would you offer to diabetics who are struggling?

Get support: that’s the one thing you need, you can’t do it alone. Also be aware that parents go through the highs and lows of diabetes just as much – my mom does so much for me, I don’t know what I’d do without her.

What makes your life sweet?

Just my friends and family around me, helping me through any situation and offering support if I need it. That’s what makes my life sweet.

Get in touch with Rachel: ray.durban@gmail.com  

10 Fast facts about planning financially with diabetes

Newly diagnosed with diabetes? We get to grips with what your medical scheme can do for you, and what you might have to budget for yourself.

  1. Join a medical scheme
    Diabetes is a chronic condition that’s on the Medical Scheme Act’s Prescribed Minimum Benefits (PMB) List. All registered medical schemes in SA have to provide basic funding for your diagnosis, treatment and care.
  2. Register your condition
    Make sure your condition is registered with your scheme, and be sure to do this again each time you switch. Find out how the registration process works: you’re likely to have to complete a form with the help of your doctor.
  3. Stay on a scheme
    If you leave your current scheme, or join a scheme for the first time, the new scheme may impose a waiting period of 3 to 12 months. During this time, your costs may not be fully covered. Do your research before you join a new scheme and avoid breaks where you don’t belong to a medical scheme at all.
  4. Use a healthcare broker
    Understanding what’s covered by all the schemes out there can be complicated. Do your research with the help of a healthcare broker. Their services are free of charge.
  5. Reassess your plan
    Once a year, you can shift from a basic to a more comprehensive plan, and vice versa. Ask your scheme for your medical records and check what you’ve had to pay out of your own pocket during the year. Do the math to see if it makes sense to upgrade or downgrade your plan.
  6. Check which meds are covered
    Even the most basic plans cover diabetes medication, as long as you choose from the formulary (the list of approved medication). Ask for this list before you choose a plan. Your prescribed medicine might not be available on the scheme’s most basic plan, but it could be on another, more comprehensive plan, or on another scheme’s formulary list.
  7. Stick to Designated Service Providers (DSPs)
    These healthcare providers (doctors, pharmacists and hospitals) have an agreement with your scheme, which means their rates are usually fully covered. Get hold of your scheme’s DSP list and use them. Expect a co-payment if you use a doctor outside of this network.
  8. Go for your consultations
    This will depend on your plan, but some of your doctor’s visits will be covered up to an agreed rate. Some schemes, for example, cover annual visits to the GP, dietician, podiatrist, ophthalmologist and other specialists in full.
  9. Check up on tests and equipment
    Diagnostic tests are usually covered in full, as well as annual HBA1c, creatinine microalbumin and lipid tests. Insulin pumps and other specialised equipment might only be covered by top-tier plans, or not at all.
  10. Use those additional benefits
    Many of SA’s schemes offer free coaching, education and reward programmes. Make use of these benefits – they’ll help you to manage your condition better, saving you money in the long run.

Using laughter as medicine

You would never guess that Trevor Davids, a business consultant, film and TV producer and biker filled with the joys of life, has Type 2 diabetes. That’s because he’s managed to take diabetes in his stride.

When did you find out you were diabetic?

Six years ago, in November 2010. I had all the usual symptoms – constantly thirsty, needing to urinate a lot – and I looked them up on the internet. Up came: diabetes. I read up on the condition before going to the doctor, and then announced, “I have diabetes.” We took the necessary tests and my blood sugar was really high (18mmol/l), so I was put onto insulin tablets immediately. Diabetes doesn’t run in my family, I’m not overweight and I do a lot of exercise, so I’m not a typical Type 2 case. I do have high blood pressure that runs in the family. When I was diagnosed with diabetes I had already given up alcohol ten years before, but I was smoking 40 cigarettes a day, so I had to give that up too. After 31 years of smoking, I quit on the first try. Once I make up my mind about something, there’s not much that can move me.

How has diabetes changed your daily life?

I’m a lot more conscious of my eating patterns now. I never used to eat breakfast – I’d grab something on the run, snack in the afternoon, and then eat a big plate of food in the evening. I had to learn to be less flexible about food. Eat a regimented breakfast, lunch and dinner, look at my intakes and learn about low GI. I couldn’t have done it without my family – my wife Norma and son Danté have been the most amazing support.

How do you manage to focus on the lighter side of living with a chronic condition?

I never focussed on the darker side of diabetes! I’m a very positive person, I like being focussed on doing something well. In challenging times, I just take it in my stride and deal with life’s knocks as they come.

Is there anything diabetes has stopped you from doing?

No. Only smoking! I’ve actually been able to take on more daily life challenges since being diagnosed, because I restructured and reorganised my life, so I now have more time.

What advice would you offer to other diabetics?

If you’ve just been diagnosed, don’t worry – it’s not as daunting as you think. It can become a lifestyle condition, you just need to adapt your lifestyle. Diabetes is part of who you are now, and denying it doesn’t make it go away.

What makes your life sweet?

Life itself! And my family, of course. And laughter: the ability to laugh and create a laugh. I believe that people can live a long time if they can learn to laugh in the face of adversity. I like to use laughter as part of my medication.

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.

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!

The stigma of diabetes

Children with diabetes often experience stigma. Carine Visagie explains how to make life easier for your child.

When Njabulo Dlamini was diagnosed with diabetes at the age of 16, he didn’t reveal his diagnosis to his friends. Fear of being called a drug addict, and standing out from the crowd, made him keep it a secret until the age of 19.

After he met Jenny Russell from Diabetes South Africa’s Durban branch, this young man (also an Idols star) started using his experience to break down some of the myths about the condition. But many other children with diabetes still have to deal with rejection and ridicule – so much so that their mental and physical health suffers.

Is there something that can be done to eliminate this social side effect of diabetes? We asked the experts.

Don’t make a fuss

When parents, teachers and other role models make a diabetes diagnosis and the day-to-day management a simple part of life, other children are more likely to accept this model as the norm. “Children don’t usually have preconceived prejudices, and they tend to follow models of behaviour set out for them,” says paediatric endocrinologist Dr Michelle Carrihill. “There’s no reason for children with diabetes to feel stigmatised if everyone is shown the right way to behave.”

Parents have a special role to play in this process, which starts with giving school staff and classmates the correct info. The more informed others are, the less likely it is that they’ll treat the child with diabetes differently.

Not sure where to start? Here are some guidelines*.

How you can help:

  1. Learn as much as possible about your child’s condition and do a simple presentation to teachers and classmates explaining what diabetes is, and what blood glucose testing and insulin injections involve. This moves the kids’ response away from fear and suspicion towards acceptance.
  2. Provide teachers with written information about your child’s needs. Include:
  • A care plan for your child’s routine school day.
  • A plan for days when the routine isn’t followed (for example, during outings).
  • Signs and symptoms that could indicate a problem.
  • What to do in an emergency, including all necessary contact information.

Make these plans with the teachers’ input, so that their roles are clear and accepted. A diabetes educator, dietician or diabetes specialist nurse can assist.

  1. Explain to teachers that blood glucose testing, additional trips to the bathroom and eating extra carbohydrates may sometimes be necessary. No big deal should be made of this.
  2. Explain that your child can exercise and also take part in outings, just like the other kids: there’s no need to treat them differently.
  3. Some kids are okay to inject in front of friends, while others are not. Ask the school to provide an area where your child will feel comfortable to test and inject. This could be the corner of a classroom or the nurse’s office, as long as the space is clean and quiet. They shouldn’t have to resort to the school bathroom.
  4. Ask teachers to provide positive support and encouragement, especially if your child seems anxious. Also ensure that a staff member is always available to them, so that they know who to ask for help.

* From Dr Carrihill, Jenny Russell and diabetes educator Kate Bristow.

Remember:
Your child should always have their medical info and emergency contact details on hand: an ICE band or MedicAlert bracelet will do the trick. Find out more at www.medicalert.co.za

Backpack checklist:
Make sure your child’s backpack always has:
– Testing equipment (a glucose monitor, lancets and strips).
– Insulin in a small cooler bag.
– A quick-acting sugary food or drink (like Super Cs).
– A glucagon emergency kit for severely low blood sugar emergencies: be sure to show teachers and older friends how to use it!

Join the community: Does your child have diabetes? Come and talk to us about it at www.facebook.com/DiabeticSouthAfricans

 

Extreme sport and diabetes

Richard English has Type 1 diabetes – but that hasn’t stopped him from embarking on all kinds of adventures, including a seven day, 1000km cycle across England and Scotland. We ask him for his secrets to a healthy life with diabetes.

When did you find out you were diabetic?

Eight years ago, when I was 25. I had been feeling incredibly under the weather and stressed, but I blamed work and too much partying – I just thought I was run down. Then I started getting all the symptoms: extreme thirst, dramatic weight loss, drinking 2 litres of water a night and needing to pee every hour.

How has diabetes changed your daily life?

Obviously I have to inject insulin before I eat anything, and I test my blood sugar more or less before every meal. Exercise is also more of a need than a want – I always used to exercise, but now I can see the effect on my blood sugar results, immediately. That’s very motivating.

I went cold turkey on a lot of things when I was diagnosed, and I haven’t kept any bad habits. I’m 20kg lighter than I used to be, and I don’t over-indulge any more. I suppose, in my case, diabetes could be seen as a positive thing. I wasn’t living a healthy life before I was diagnosed, and I have a better quality of life now.

I don’t think I could have adapted so well to life with diabetes if it weren’t for my wife, Casey. She never left my side, and all the dietary changes I adopted she did too. She also helped a lot in the early stages, when there was just too much information for me to absorb. She got behind the science of it and now knows more about low GI and its effect on blood sugar than I do!

Have you always been a cyclist?

I got my first bike when I was 5 years old, and I’ve almost always had a bike. Cycling is a big part of my life, and I really love it. I stopped exercising for about 6 months after my diagnosis, because I was uncertain about what it would do to my blood sugar, and every so often I have to cut a ride short because I’m going low. But most of the time diabetes doesn’t get in the way of my cycling at all.

Can you tell us about the Ubunye Challenge?

The Ubunye Challenge is a triathlon event organised by an old Rhodes friend of mine, Cameron Bellamy in 2012. He decided to raise funds for the Angus Gillis Foundation by doing an extreme cycle, swim and rowing challenge. I joined him for the cycle – I rode for seven consecutive days and covered 1000km through howling gales, rain, sleet and snow. It was in April, which was supposed to be spring, but it was shockingly cold. By the third day, we outran the weather and I saw my shadow for the first time. That was a good moment! 1000km seems like an unbelievable distance, but if you do it in 120km chunks it’s not that bad.

What advice would you offer to other diabetics?

To me, the most important thing is that you have to stay positive and optimistic, because diabetes is not going to go away. As soon as you can smile at it and look it in the eye, you’re on your way to living a happy life with diabetes. The sooner you can get positive about it, the better.

What makes your life sweet?

My wife Casey, my wonderful son Robbie, weekends with friends, good food, my bike, and exploring my new home city of London.

Get in touch with Richard: molorich@gmail.com

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.

Exercise meets meditation

Looking for a sport that’s relaxing and good for you? Yoga is not only a fantastic form of strengthening exercise, it’s also great for calming the mind – something most diabetics need! Here are some simple poses to try at home.

As a diabetic, the one thing you’re told over and over is that exercise is good for you. And it is! But sometimes exercise feels a bit too much like hard work. Now that the weather is colder it’s hard to get out for a walk or a run, and gym is not for everyone. That doesn’t mean you can sit back and wait for the weather to warm up, though! Yoga has just the right mix of strengthening, balancing and heart-racing poses, and you should take a few quiet minutes to lie down at the end of each class. Yes, that’s right! Exercise that makes you lie down!

There are specific reasons why yoga is good for people with diabetes, too. Yoga teacher Tasha Saha explains: “As well as better fitness and cardiovascular (heart and vein) health, yoga massages and increases the function of the internal organs, balances the endocrine system and has great effects on the release of stress hormones,” she says. “All of these are factors that affect blood sugar, so it’s no surprise that a number of big studies have shown that regular yoga can reduce blood sugar levels.” Another part of yoga that sets it apart from other exercise is that it increases body awareness – understanding how your body feels – which makes it easier to stay at a healthy weight and to make better food choices.

But which yoga to choose? In general, hot yoga (Bikram) and flow yoga (Ashtanga) are more difficult, so it’s better to begin with a slower practice like Hatha or Iyengar. Some poses (especially those that are active in the belly and lower back) are particularly good for diabetics because they target the pancreas, which can help to lower blood sugar levels. “But a balanced yoga session will work on every system in the body,” says Tasha, “as well as the mind and emotions too – lowering stress levels and helping you towards balance.” As every diabetic knows, balance is the magic word!

Here are a few yoga poses to try at home – these are very good for lowering blood sugar. If you can’t get to the full pose, go as far as you can. As you become more flexible, you will be able to stretch more. If something is sore, stop! Yoga should never be painful.

Seated twisting poses and forward bends

These stimulate the digestive organs and help the insulin work better in the system.

Seated forward bend

First: Sit on the floor with your legs out in front of you. Flex your feet and press down through your heels. Place your hands on the floor next to your hips and sit up straight, opening your chest.

Then: Take a deep breath in, and without curving your back, lean forward from the hips, not the waist. Either hold on to your feet or use a strap around the soles of your feet. Make sure your elbows are straight, not bent. Be careful not to pull yourself down – you want to lengthen the spine, not force it. Keep your head raised and aim to get your belly touching your thighs, and then your ribs. This might take a few months!

Finally: When you’re ready to come up, lift the body away from the thighs, take a deep breath in and slowly straighten up. Stay in this pose for: 1 to 3 minutes.

Half Lord of the fishes

First: Sit on the floor with your knees bent and your feet on the floor. Slide your left foot under your right leg to the outside of your right hip, with your left leg on the floor. Step your right foot over your left leg and place it on the floor outside your left hip. The right knee will point up to the ceiling.

Then: Exhale and twist your body towards the inside of your right thigh. Press your right hand against the floor behind you, and your left upper arm on the outside of your right thigh near the knee. Stay in this position, breathing deeply, then exhale and release.

Finally: Return to the position you started with, and repeat on the other side for the same length of time.

Stay in this pose for: 30 seconds to 1 minute. 

Standing poses and flow poses

Any pose where you have to stand or flow from one pose to another is excellent for the blood and heart systems.

Warrior

First: Stand up straight, with your feet together and your hands at your side. Breathe out, and step your feet apart, as wide as you can while still feeling balanced. Turn your left foot in 45 degrees, and your right foot out 90 degrees. Make sure the right heel and the left heel are in line with each other.

Then: Breathe out, and rotate your body till you are facing over the front foot. Raise your arms over your head, and reach towards the ceiling. Drop your shoulders and arch your upper back a little. With your back heel firmly pressing into the floor, breathe out and bend your front knee over your front ankle.

Finally: Reach through your arms and, if possible, bring the palms together. Keep your head looking forward or looking up at your thumbs.

Stay in this pose for: 30 seconds to 1 minute.

Poses which ground the body

These help to refresh the pancreas, liver and other abdominal organs.

Locust

First: Lie on your belly with your arms on either side, palms facing up, and your forehead resting on the floor. Turn your big toes towards each other and clench your butt.

Then: Exhale and lift your head, upper body, arms, and legs off the floor (this may take some practice!) Firm your butt and strengthen your legs. Raise your arms and stretch back through your fingers. Look ahead, but be careful not to stick your chin out. Keep the back of your neck long.

Finally: Breathe out and release. Take a few breaths and repeat (if you want to!)

Stay in this pose for: 30 seconds to 1 minute. 

Poses where the feet are higher than the head.

These direct the flow of blood towards the pancreas and relieve pressure in the feet.

Legs-up-the-wall

First: Lie with your back on the floor, in as straight a line as possible, with your legs up against the wall in a 90 degree angle (your body should form half of a square). Rest your shoulders on the floor and allow a small gap between your hips and the wall.

Then: Rest in this pose.

Finally: When you’re ready to come out of it, turn to the side for a few breaths and then come up into a sitting position.

Stay in this pose for: 5 to 15 minutes.

Want to give it a try? Many yoga studios offer free classes to beginners. Most gyms also offer yoga classes at a fraction of the price of private classes.

“Remember that everyone is different, so the range you will be able to work into will be different in each pose. It’s a good idea to start with a one-on-one yoga session so that you learn how your joints and muscles work within a safe range of motion. That way, you’ll be in control of the intensity and can adjust it for your fitness levels.”

– Sarah Hall, Biokineticist