diabetes awareness

Spreading the word about diabetes

Neville Pillay is one of Durban’s favourite DJs and comedians… Who just happens to be a Type 2 diabetic. We speak to him about keeping up with the Morning Rush on Lotus FM, with diabetes.

How long have you been diabetic?

I was diagnosed well over 12 years ago, when I was 28 years old. But I remember my doctor telling me at 24 that I was at higher risk for diabetes because of my family history, and that I should change my diet… If only I had listened then!

Was your diagnosis a surprise?

To be perfectly honest, I knew all the symptoms – frequent urination, constant thirst, itchy skin, the sweats – but I chose to ignore them. By the time I was diagnosed I wasn’t surprised at all.

Are any of your family members diabetic?

My dad was and my mom is – she’s a Type 1 diabetic. You would think that would have made me more aware of diabetes, but the way we were brought up, we were ignorant about it – it was just something that my mom had. Type 2, or adult-onset diabetes, is also a very different condition to Type 1.

Do you ever talk about diabetes on air?

Absolutely: every chance I get to relate my story, I do. Many of my listeners on Lotus FM are affected by diabetes in one way or another, so it helps to be able to share our stories.

Do you ever tell jokes about diabetes in your comedy shows?

Oh yes, for sure. My comedy is based on my life, so of course I do! For example, I’ve got a lot of friends whose dads have passed away and left them things: cars and houses, even a Jaguar – all kinds of things. What did my dad leave me? Diabetes. I also like pointing out the irony of the fact that Indians came to South Africa as indentured labourers to cut sugar cane… And what disease do we all get? The sugars! Diabetes.

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

It’s so difficult to do, so difficult. I’m not a pro at it and yes, I lapse every now and then. But for the most part I’m on point with eating well, staying away from sugary drinks and sweets and taking my medication. I’ve been a DJ since 1997 and I love it, but if you want any kind of stability or comfort zone, radio isn’t it. Every day is different and the landscape is constantly changing. So that’s an added challenge.

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

To constantly monitor your blood sugar and make the right choices. The difficulty is in making those daily healthy choices, even when you’re around other people who can eat anything they like. That said, I know that there are terrible side effects, so it’s well worth making the effort. I was diabetic for a long time before I was diagnosed, and I know there have been some debilitating effects on my body, so I’m very careful to take good care now.

What advice would you offer to diabetics who are struggling?

Make one small change at a time and eventually you will have changed your lifestyle to effectively manage your condition.

What makes your life sweet

My girls, Jordan and Skylar, and my job. I love to entertain and it drives me daily.

Get in touch with Neville: @topdan on Twitter or Neville Pillay on Facebook.

Keeping diabetics inspired

We chatted to community inspiration Veronica Vember about how she changes lives, one step at a time.

What got you interested in diabetes at first?

It all started whilst working in the vascular unit at Kingsbury Hospital. I realised that most people are not informed about managing diabetes after being diagnosed. So I became passionate in the control of potential complications, and Kingsbury management identified my passion and allowed me to do the vascular course in London as it’s not offered here. On my return, I did two presentations at the doctors academic meetings. At the time my husband had a myocardial infarction and had been diagnosed with hypertension and diabetes. The entire experience stimulated me to get involved with my community. Now my husband is one of the volunteers. I then started doing motivational talks at schools, groups, on radio and at our nursing college.

How did you start your community group?

I joined the Strandfontein Health Forum and offered to do the diabetes awareness events as there was no project as such. With the awareness held at the Strandfontein Clinic I handed out questionnaires and a suggestion box. The community asked for a diabetic support group: that’s what started it.

What keeps you inspired?

The positive attitude and enthusiasm of the volunteers, and noticing the excitement of the attendees. When we take a break, people want to know when we’ll be starting again. The continuous support of ‘diabetes life’ (a diabetic clinic at Kingsbury hospital) under the management of endocrinologist Dr May, Dr Tracy van Rensburg and nurse educator Sr. Dee Ferguson (my mentor). Positive feedback from the doctors at the day hospitals where the clients attend also keeps me going.

You were voted one of the Western Cape’s Lead SA heroes – how did this make you feel?

Surprised, shocked, emotional, confused and thankful towards the responsible person for the recognition. I’m very proud of the team of dedicated volunteer attendees as I can’t do this alone. It’s a team effort – unity is strength.

What advice do you offer your support group members when they are struggling?

To persevere, not to give up, not to give in, to be compliant, to attend the support group regularly. We do individual counselling and have a communication box available for constructive comments and replies.

How do you make diabetes inspiring?

We create a harmonious atmosphere: a safe environment with easy accessibility, clean, functional equipment and competent staff. We vary programs, presentations, literature, topics and menus (soup in winter and tea and a snack in summer). We also combine our decision making with the volunteers.

What makes your life sweet?

Carrying out our mission, vision and outcome.

S – be sensitive towards all

W – warn people about the consequences of not being compliant

E – educate people regarding a healthy lifestyle and change of mindset

E – be empathetic and empower people with knowledge

T – to be trained, to train others

Outcome:

To ensure that all community members are well informed, and reach and maintain normal glucose levels.

Get in touch with Veronica: Strandfontein Diabetic Support Group on Facebook

5 minutes with Bongi Ngema-Zuma

We chat to Bongi Ngema-Zuma, First Lady and founder of the Bongi Ngema-Zuma Foundation.

  1. Why did you start the Bongi Ngema-Zuma Foundation?

    It has always been my ambition to do something like that – I never came across anybody who told me about diabetes as a child, even when I was at school. But when you speak about it you find that each and every family is affected by diabetes in some way.

  2. How did your mother find out she was diabetic?

    My mother was not an educated woman, she was a housewife and only went to school up to Std 4. First she was told she had hypertension and received treatment for that. And then they investigated further and found out she had diabetes. Many people have had this happen – the underlying factor is diabetes. That’s why I encourage people to actively check their blood sugar. Whenever you go to the clinic you should get tested. What I learned from my mother is that changing her lifestyle made her live healthier and longer. She took every little lesson she could from the clinic – you eat like this, you don’t eat like that, you take your tablets, you eat so many times a day. What made it easier for her is that she made the whole family eat like that.

  3. What makes your life sweet?

    What makes me happy is chatting to people. I like getting people’s opinions on things, I like listening to people’s stories and visiting new places where I can learn new things.

Find out more about the Bongi Ngema-Zuma Foundation here.

 

All about insulin

There are no two ways about it: insulin is a miracle drug. It was discovered in 1921 and has saved millions of lives in the last 95 years. Andrea Kirk explores the topic.

“In people with Type 1 diabetes, insulin is essential for maintaining good health, and many people died from Type 1 diabetes before insulin,” says endocrinologist Dr Joel Dave. “Insulin therapy is started as soon as the diagnosis is made, and although being diagnosed with Type 1 diabetes can be a traumatic experience, with the use of insulin, you can maintain good health and achieve anything in life that those without diabetes can.”

For people with Type 2 diabetes, however, there is often a reluctance to start taking insulin. Some people manage to control their blood sugar without it, by making changes to their diet, getting more exercise and going on oral medication. But for others, insulin is a necessity.

“There’s a huge stigma about this,” says Mark Smith, who was diagnosed with Type 2 diabetes a year ago. “I feel like starting insulin would mean that I’ve failed at controlling my blood sugar with lifestyle changes.”

Diabetes educator, Jeanne Berg, sees things differently. “Diabetes is a progressive condition and insulin therapy is inevitable. Some people take longer to get to the point of starting insulin than others, but every patient with diabetes gets there eventually. There shouldn’t be any shame or sense of failure in this.”

Jeanne says that in the past, doctors would try to intimidate people with Type 2 diabetes into changing their lifestyle. “They’d say: if you don’t change your diet and get more exercise, you’ll end up blind, or have your legs amputated, and eventually you’ll die.” This blame-filled approach may be part of the reason there is still such a stigma associated with Type 2 diabetes. “People would think ‘this is all my fault, I did this to myself’, but that is not the whole truth,” says Jeanne. “Diabetes has a genetic inheritance factor to it as well.”

Doctors and diabetes educators today steer away from using scare tactics and encourage people to accept insulin as a means of coping and having a more flexible life with diabetes.

Are there any benefits to starting insulin sooner?

 

“In people with Type 2 diabetes, there is a theory that glucose can cause damage to the beta-cells of the pancreas, which are the cells that make insulin,” says Dr Dave. “The longer the glucose remains high, the more damage occurs. Since insulin is the best way to lower blood glucose, some suggest that insulin should be taken sooner rather than later in order to preserve beta-cell function for longer.”

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.

Diabetes in the community

We ask Dr. Tracey Naledi, the Chief Director of Health Programmes for the Western Cape Department of Health, to share her personal health tips and what the Department of Health has to offer diabetics who want to live a healthy, happy life with diabetes.

What does the Department of Health offer those with diabetes?

We focus a lot on prevention: diabetes prevention is so important. People need to be aware of the risk factors that lead to diabetes before we even start talking about the condition, so we highlight the dangers of a poor diet and being overweight, lack of physical activity, drinking too much and smoking. But this isn’t only the role of the Department of Health – it’s also important for individuals to understand what the risk factors are and to prevent them from happening in the first place.

We also screen people so that we can pick up those with early signs of diabetes, and provide proper diagnosis and treatment. If a doctor suspects you might be diabetic, it kicks in a whole process within our health facilities. But we also proactively do campaigns in community-based settings like malls, where we go out and invite people to test for hypertension, diabetes, cholesterol and HIV, and give them information on these conditions.

Do you believe community is important when living with a chronic condition?

Absolutely – I think community is important when you’re dealing with anything that government does. Government is something that works for the people: it is put there by the people to do things on behalf of the people, but at all times we need to be consulting with the people to be sure the things we’re coming up with are what they want. We have to make sure the way we’re doing things is what the community needs. That’s why we have processes to consult with community members, health facility boards and health committees, so that any problems can be discussed. Being close to the community is very important to us.

Why is diabetes a priority in South Africa?

Chronic diseases in general are a priority, because they affect so many people and are such a huge burden of disease. You also can’t just pop a pill for a chronic condition to go away: you need to treat it for the rest of your life. We have to make sure we have the capacity to deal with all these chronic diseases for a very long time. It’s a long term, lifelong thing. And the consequences of uncontrolled diabetes are actually quite serious.

What makes your life sweet?

God and my family. At the end of the day, when all is said and done, the most important thing to me is my family. My work one day will end, all the money in the world will disappear, all the material things will be gone, but there’s nothing I love more than coming home.

Natural supplements for diabetics

We all know that a healthy diet is key to managing your diabetes. But should you also be taking a diabetic supplement? Andrea Kirk asks the experts.

Living with diabetes can be challenging, so when you hear about a natural supplement that works wonders, it’s easy to get excited. “A number of supplements have been said to play a role in improving insulin sensitivity, blood sugar control, and helping to prevent complications of diabetes,” says endocrinologist Dr Joel Dave. “Although there is some observational evidence to suggest that some of these may be beneficial, unfortunately there are no large, long-term, placebo-controlled studies that prove any supplement is effective when it comes to diabetes.”

Dietician Cheryl Meyer agrees: “In some cases benefits have been shown, but at this stage there is just not enough scientific evidence.” Both experts believe that a well balanced diet should provide all the essential minerals and vitamins you need.

“I don’t recommend routine supplementation,” says Dr Dave, “but if someone is deficient in a specific vitamin or mineral, then I would recommend they take a supplement of that particular vitamin or mineral.”

When a supplement may be necessary

If you are experiencing specific symptoms and suspect you are deficient in a vitamin or mineral, speak to your doctor about having a blood test. Your doctor will make a recommendation based on the test results and may prescribe a supplement. Keep in mind that the type and dosage your doctor prescribes may be different from what is found on the shelf. Stick to your prescription rather than self-medicating.

Be careful of drug interactions

Dietary supplements can have adverse interactions with prescription drugs, other herbal products or over-the-counter medications, warns Meyer. The effects range from mild to potentially life-threatening, so it is important to disclose everything you are taking to your doctor.

Never replace your conventional prescription

“Don’t replace a proven conventional medical treatment for diabetes with an unproven health product or practice. The consequences can be very serious,” says Meyer.

“I generally advise my patients to steer clear of supplements unless we know for sure that it’s necessary,” says Dr Dave. “Rather focus on sticking to a healthy diet and lifestyle, monitoring your blood glucose and taking the medication your doctor has prescribed.”

 

Supplements and their claimed benefits

 

Alpha-lipoic acid
Alpha-lipoic acid (ALA) is an antioxidant made by the body. It is found in every cell, where it helps turn glucose into energy. Several studies suggest ALA helps lower blood sugar levels. Its ability to kill free radicals may also help people with nerve damage, which is a common diabetes complication. For years, ALA has been used to treat diabetes-related nerve damange in Germany. However, most of the studies that found it helps were based on using intravenous ALA. It is not clear whether taking it orally will have the same effect.
Source: University of Maryland Medical Centre

Chromium
Chromium is an essential mineral that plays a role in how insulin helps the body regulate blood sugar levels. For many years, researchers have studied the effects of chromium supplements on those with Type 2 diabetes. While some clinical studies found no benefit, others reported that chromium supplements may reduce blood sugar levels, as well as the amount of insulin people with diabetes need. Good food sources of chromium include whole grain breads and cereals, lean meats, cheese, some spices (like black pepper and thyme), and brewer’s yeast.
Source: University of Maryland Medical Centre

Fenugreek
Fenugreek seeds may be helpful to people with diabetes because they contain fibre and other chemicals that are thought to slow digestion and the body’s absorption of carbohydrates and sugar. The seeds may also improve the way the body uses sugar and increase the amount of insulin released. An Iranian study found that a daily dose of fenugreek seeds soaked in hot water may be helpful in controlling Type 2 diabetes. Another study from the US suggests that eating baked goods, such as bread, made with fenugreek flour may help to reduce insulin resistance in people with Type 2 diabetes.
Source: Healthline

American ginseng
Several studies have shown that American ginseng lowered blood sugar levels in people with Type 2 diabetes. The effect was seen both on fasting blood sugar and on glucose levels after eating. One study found that people with Type 2 diabetes who took American ginseng before or together with a high sugar drink experienced less of an increase in blood glucose levels.
Source: Penn State Milton S. Hershey Medical Center

Magnesium
Magnesium deficiency has been associated with increased risk of Type 2 diabetes. Some studies suggest that supplementing may be beneficial, but other studies have shown no benefit. A healthy diet should provide all the magnesium you need, so have your doctor check for deficiency before you consider supplementing. Good food sources of magnesium include legumes, whole grains, broccoli, green leafy vegetables, dairy products, seeds and nuts.
Source: Oregan State University and WebMD

The challenge of brittle diabetes

Do you know what brittle diabetes is? We asked one of our readers, Rencia, to share her story of living with brittle diabetes with us.

I was diagnosed as a juvenile diabetic at the tender age of 5 and a half. This was in 1987, when medicine was not as advanced as it is today.

Upon diagnosis, my parents were told that I would have to take insulin twice a day for the rest of my life and refrain from eating sweets, cakes and all the good things. At that point in my life I couldn’t grasp the enormity of being diabetic. I adhered to the diets and adapted quickly to the injections and glucose testing methods. I would often hear my parents discussing how doctors had advised them that I needed to be told that due to my diabetes I would never conceive children.

The strict control became non-existent when my parents got divorced. I guess as a teenager I didn’t understand the repercussions my teenage years would have on my life.

At the age of 19, I began to notice that my vision was being halved. I went to an ophthalmologist who had me undergo all kinds of tests to determine what the problem was. I was suffering from diabetes retinopathy: when the retina detaches from the back of the eye. If not treated as soon as possible, this leads to permanent blindness.  I underwent my first eye operation to reattach the retina in my right eye and had to wait four months with sight only in my left eye. During the 4 months, I lost the vision in my left eye too and for the remainder of those months I had no proper vision, just distorted images in my right eye.

After the operation to my left eye, I became critically ill with hyperglycaemia  (high blood glucose levels). I was in a coma for a few days. At this point I was being treated by my current specialist. He changed my insulin and put me on four insulin injections a day, as well as four blood tests a day. I had a new lease on life it seemed and I would take hold of it with both hands. I began to keep away from all forbidden items and all seemed well.

In mid 2007, I began having frequent lows and highs. Maintaining my blood sugar levels became more and more difficult, and it was worrying as I started losing chunks of my memory when I had a hypoglycaemic episode. I saw my specialist who diagnosed my diabetes as brittle diabetes. He explained that brittle diabetes is when you have hyperglycaemia and hypoglycaemia without much warning. There is no treatment for this, except frequent blood sugar checks.

I am often ill with mostly low sugar levels, ranging from 1.6 to 2.2. I’m seldom able to determine when these episodes occur which leads me into very dangerous ground. Brittle diabetes is a sub-type of Type 1 diabetes, a term used to describe particularly hard to control Type 1 diabetes. Those people who have brittle diabetes will experience frequent, extreme swings in blood glucose levels, causing hyperglycaemia or hypoglycaemia.

At the end of 2007, I was experiencing severe tenderness in my left eye and I visited my ophthalmologist who suggested I have my left eye removed as it was shrinking and becoming noticeable that there was no vision in the eye. I had the eye removed and 6 weeks later was fitted with a prosthetic eye.

Against all odds, I conceived my first child in 2010. It was a petrifying experience for me because I was so afraid of something going wrong. On the 4th of October 2010, I gave birth via C-section to my son Tyler. It was a very trying time keeping my levels down. I have successfully had two children – my second pregnancy was easier, though I was hospitalized three times in my first trimester. Once that was over, I maintained constant contact with my specialist and tried my utmost to keep my levels between 4 and 8mmol/l, so that I didn’t have to deal with the effects of my brittle diabetes.

Living with Type 1 diabetes is not as easy as most people thank. It’s a constant challenge and mine is slightly more difficult. However, I do try to rise to each of the challenges to the best of my ability. It’s my great desire to one day receive sponsorship in order to obtain a DAD (diabetic alert dog) – a dog trained to pick up if your blood sugar is high or low by the scent your body omits. Having one of these dogs as a brittle diabetic would be such a great help. It could be a lifesaver.

I urge parents, teenagers and even older individuals to take extra care of their diabetes from day one of diagnosis in order to prevent the challenges I face daily. See your doctors regularly and you could lead a fairly normal life. Diabetes is a life-altering illness, but with the correct care from day one you can lead a fairly normal life.

– Rencia Gabriel-Phillip

Would you like to share your story of living with diabetes with the Sweet Life community? Email us – we’d love to hear from you.

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.

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

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

 

New IDF Diabetes Atlas

Every two years, the International Diabetes Federation (IDF) publishes a Diabetes Atlas, with estimates of diabetes facts and figures from around the world. The 8th Diabetes Atlas is now live – take a look! Here’s more information about it.

To mark World Diabetes Day, the International Diabetes Federation (IDF) released new estimates on the prevalence of diabetes around the world, indicating that 1 in 11 adults are currently living with diabetes, 10 million more than in 2015.

Data published in the 8th edition of the IDF Diabetes Atlas confirms that diabetes is one of the largest global health emergencies. More action is required at the national level to reduce the economic and social burden that it causes.

Type 2 diabetes
Diabetes, which is associated with a number of debilitating complications affecting the eyes, heart, kidneys, nerves and feet, is set to affect almost 700 million people by 2045. Over 350 million adults are currently at high risk of developing type 2 diabetes, the most prevalent form of the disease. One in two adults with diabetes remain undiagnosed, emphasizing the importance of screening and early diagnosis.  Two-thirds of adults with diabetes are of working age and 8 million more adults living with diabetes are over 65 years old.

“Diabetes causes devastating personal suffering and drives families into poverty,” said Dr. Nam Cho, IDF President-Elect and Chair of the IDF Diabetes Atlas committee. “There is urgency for more collective, multi-sectoral action to improve diabetes outcomes and reduce the global burden of diabetes. If we do not act in time to prevent type 2 diabetes and improve management of all types of diabetes, we place the livelihood of future generations at risk.”

Diabetes and women
Diabetes has a disproportionate impact on women, the focus of IDF and its affiliated members in over 160 countries this World Diabetes Day.  Over 200 million women are currently living with diabetes and many face multiple barriers in accessing cost-effective diabetes prevention, early detection, diagnosis, treatment and care, particularly in developing countries. Women with diabetes are more likely to be poor and have less resources, face discrimination and have to survive in hostile social environments. Diabetes is also a serious and neglected threat to the health of mother and child, affecting one in six births and linked to complications during and after delivery.

“Women and girls are key agents in the adoption of healthy lifestyles to prevent the further rise of diabetes and so it is important that they are given affordable and equitable access to the medicines, technologies, education and information they require to achieve optimal diabetes outcomes and strengthen their capacity to promote healthy behaviours,” said Dr. Shaukat Sadikot, IDF President.

Urgent action needed
IDF welcomes all the international commitments on diabetes that have been made over the last few years and acknowledges that some advances have taken place. However, it is clear that urgent action is still required to achieve the targets agreed by UN member states in 2013 and 2015. These include a 0% increase in diabetes and obesity prevalence; 80% access to essential medicines and devices by 2025; and a 30% reduction in premature mortality from NCDs by 2030. To this end, IDF has launched a call to action for the 2018 High Level Meeting on NCDs, calling on governments to renew their commitments and increase their efforts towards achieving the agreed targets.

“IDF is calling for all nations affected by the diabetes pandemic to work towards the full implementation of the commitments that have been made. We have both the knowledge and the expertise to create a brighter future for generations to come,” said Dr Sadikot.

A happy life with diabetes

If you met Shiara Pillay, a happy, healthy and confident 21-year-old who loves Art and is studying International Relations and Diplomacy, you wouldn’t guess that she had a chronic condition. But Shiara is a Type 1 diabetic. She just doesn’t let it get her down.

When did you find out you were diabetic?

When I was in Grade 4 and just about to turn 10. It wasn’t too horrible a diagnosis in comparison to some – my parents noticed that I was losing an extreme amount of weight, I was very dehydrated and waking up in the night to pee – all the classic symptoms.

Then one morning I threw up and they took me to the doctor. I was in hospital for a week and since then I’ve figured out how to live as normal a life as possible with diabetes. The hardest thing to get used to was not being able to eat sweets!

How has diabetes changed your daily life?

I think I’m obviously way more healthy than I would have been because I have to watch what I eat. I have a great diabetes team, and they’ve helped me to adjust my medication and my meals whenever I need to. I like the idea of being able to eat everything in moderation.

How does it help to have a community of fellow diabetics?

It helps to know that there are others in the same situation, it reminds you that you’re not alone. Youth With Diabetes really helped me to meet other people who have to think about the same things every day. I also think diabetes education is so important – new diabetics especially need to know what helps and what doesn’t, what you can eat, how you should exercise, how you feel when you’re low or high. It’s nice for me to share my experiences too. I do have bad days, it’s annoying to have to inject every day, but it’s just something you have to make the best of.

What advice would you offer to other diabetics?

Just do it – you can’t get out of it. If you look after yourself, it’ll be better for you in the long run, it’s for your benefit. And it makes you healthier too!

What makes your life sweet?

Just being happy – when things are going well and the sun is shining!

Get in touch with Shiara: shiaraismyname@gmail.com or join the YWD Facebook page: www.facebook.com/YouthWithDiabetes

 

All about LifeinaBox

Have you heard about LifeinaBox?
I’ve been hearing a lot about it lately – it’s a “device that will revolutionize the transport of medication worldwide.”

Here’s what they say about it…

LifeinaBox is the world’s smallest fridge, and the culmination of many years of research to produce a universal solution that will allow users to travel any place, any time, knowing that their medication is kept at exactly the right temperature. Suitable for any heat-sensitive medication such as insulin, growth hormones, arthritis or multiple sclerosis medications, it allows users the freedom to travel anywhere, anytime, knowing that their medication is kept at exactly the right temperature.

This state-of-the-art device uses a combination of thermoelectric energy and batteries that will allow the user to be mobile with his medications under any conditions for up to 24 hours without the need to recharge his device. Operating on 110V or 220V or with a car cigarette lighter, LifeinaBox is totally environmentally friendly and contains no hazardous gases, tubes, coils or compressors.

The greatest inventions are often born out of simple necessity. Who would have an idea as absurd as making a fridge just to carry medication? We asked Uwe Diegel, co-founder of LifeinaBox, to tell us a little more about his idea…

How did you come up with the idea for LifeinaBox?

My brother, Dr Olaf Diegel, visited me in France in the infamous heatwave of summer 2003. Olaf is a well-versed traveler and is used to travelling with his insulin and keeping it cool using iceboxes and cooler bags (insulin, like many other medications, is sensitive to heat and should be stored at a temperature between 2 and 8°C).

Olaf booked himself into a small hotel near Auxerres in France. When he arrived at the hotel, he noticed that there was no fridge in his hotel room (even though he had particularly insisted on this when making his booking). He needed a fridge to store his insulin. So he arranged with the clerk at the entrance desk to keep his insulin in the fridge in the kitchen.

Olaf does not speak French, coming from New Zealand. A few hours later, Olaf needed his insulin and went down to reception to ask for it, only to discover that it was placed in the freezer by accident by someone in the kitchen. He is thus obliged to have the night pharmacy opened just to get some fresh insulin.

We decided to design the idea of a portable fridge and our prototype actually worked quite well, so we sent it to an industrial design contest run by NASA in the USA. The product became a winner at the contest, received unexpected publicity and became the subject of an international story on the CNBC TV network.

When and where will Lifeinabox be available to South Africans?

We just launched LifeinaBox on the 12th of September on the Indiegogo crowdfunding platform. Crowdfunding platforms are places where people can pay for a product in advance at a preferential rate, paying in advance, so that their money can be used to accelerate production. We are already on our 9th generation of working samples and are nearly ready to go into mass production at the beginning of 2018. So the physical delivery of LifeinaBox should be by the April/May 2018. LifeinaBox is by definition a product that is born global and that will be launched in all countries at the same time. But the quickest way for people to get their hands on a LifeinaBox is to order on the crowdfunding campaign, as the first waves of production will be dedicated to people who have already placed an order.


How much will it cost?

LifeinaBox is quite an expensive device to produce, because we need it to basically last forever. The expected price in South Africa would be somewhere between R2800 and R3000. Next year we will launch LifeinaTube, which is a much cheaper device because it will only hold a single insulin pen.

Where can it be used – must it be plugged in? Can it be taken on planes?

It can be plugged in just about anywhere, from 110 to 240V, in a car’s cigarette lighter, or with a battery pack. We are still developing the battery packs and will be able to have 3, 6, 12 or maybe even 24 hours of battery life. We are really working quite hard on the batteries to give it more mobility. Right now I am already at 12 hours, but I am sure that by launch time I will already have a 24 hour battery. It is for people to take to work (so they don’t need to put their medication in the work fridge), in the car for long car trips, at home (so that the children don’t have access to medication in the kitchen fridge) and it can also be used on a plane.

What’s your LifeinaBox elevator pitch?

Nearly 4% of the worldwide population is prisoners of its medication that has to stay in the fridge at all times. LifeinaBox is the world’s smallest fridge for the safe transport and storage of fragile medication. LifeinaBox gives millions of people worldwide the freedom to travel anywhere, any time, knowing that their medication is at exactly the right temperature.


What makes your life sweet?

I still, 30 years later, wake up in the morning and can’t wait to get to work. My work is wonderful, because I always strive for perfection. I never think of my products as medical devices, but more as tools for the heart. And if you can touch the hearts of people the possibilities are infinite.
My first career was as a concert pianist, so I still spend a lot of time behind the piano, especially with my children who are also musicians and artists.