diabetes awareness

‘Being diabetic is a gift’

I got this amazing email from one of our community members last week and had to share it. Would you like to share your story with the Sweet Life community? Email me – we’d love to hear it.

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What an absolute treat to read your magazine and continually refer to it.

I have been Type 1 diabetic for 14 years. As much of a roller coaster ride as it has been, I would not swop being diabetic for anything in the world.

The people you meet along this journey, the knowledge you gain about how your body functions and responds, the prior knowledge you get from high glucose readings before you get ill and a complete understanding of the people I meet who possibly battle with elevated glucose levels or hypoglycemia.

Being Type 1 diabetic makes you aware on every level – spirit, body, mind, soul, feelings, thoughts, allows for wise choices (although if not wise then the consequences that accompany these – you have actually just got to smile, knowing that this is within your control), tolerant and respectful of others.

It is without a doubt, a gift.

It is amazing how when you change your mindset and adopt an attitude of gratitude, how life truly shines in its full form.
Make no error, there are days when I sit on my kitchen floor and weep in frustration – as ‘for no reason’ my sugar levels are astronomically high (21.0) or scarily low (1.8) and then I do adopt the ‘oh woe is me’ and sob. Then when I’m done I get up and reconsider things with fresh eyes and chances are good I know what I have done wrong, or that my insulin pens are not working as they should or my change in hormones as I get older has added a new spin.
I have a diabetic friend who is wise, a mind blowingly phenomenal psychologist who practices the Demartini approach. At one of my ‘I can’t do this’ moments, she told me to get myself a journal and write down 200 reasons why I am grateful for the gift of having diabetes. Initially I balked at the mere thought – then when you get started you just keep going and smile as you write or nod like a lunatic. I am on 150 reasons and it’s been a couple of months – but I look back and reread these and then put one foot in front of the other again, with purpose.
– Lara

Diabetes on air

For radio presenter and TV actor Kini Shandu, Type 2 diabetes gave him new meaning. Here’s what he has to say about his condition.

Kini Shandu is a radio presenter on one of KZN’s biggest radio stations, Gagasi FM, a TV personality on SABC’s biggest telenovela, uZalo, and the founder of Inqaba Media. He’s also a father of two and a Type 2 diabetic.

When were you diagnosed?

I was diagnosed with Type 2 diabetes in 2010 – six years ago now.

How did you cope with the diagnosis?

It wasn’t easy coming to terms with the new lifestyle, especially because I felt I was too young to be diabetic.

Has it become any easier with time?

Yeah, it has. It became easier once I came to accept that it was my new reality. Having family and friends who support me all the way makes a great difference.

What’s the hardest part about being diabetic for you?

The pressure of making sure I don’t default on my medication: having to keep my medication kit with me, even when I’m travelling. We are all human and we can forget, but this is a challenge I just have to face. Reminders on my cellphone help me a lot!

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

I jog every morning and I try by all means to eat as clean as I can. There are times when I miss junk food, but knowing the damage it could do is enough to switch my brain straight to its senses.

You’re a radio presenter on Gagasi FM, do you talk about diabetes at all?

Yes, I do talk about it a lot. I’m fortunate to have Gagasi FM listeners who follow me closely: they know I’m diabetic and are very supportive. I also make sure I spread the word on every platform I get.

Could you tell us about your TV acting?

I play the character of Shaun, a lawyer, on the SABC1 telenovela, Uzalo, weekdays at 8:30pm. The character is the complete opposite of me, but I’m loving it and I’d like to do more TV gigs in the near future.

What advice would you offer to diabetics who are struggling?

Accept the situation and take it one step at a time. Diabetes is a silent killer, so take a stand and fight it. Surround yourself with people who love and support you.

What makes your life sweet?

The fact that I’m diabetic! Joking. I love my life, I live an awesome life, I live with no regret. I thank God for each and every day in my life: diabetes gave me a new meaning to life.

Get in touch with Kini: Kini Nqaba Shandu on Facebook, @kinishandu on Twitter or Instagram.

10 Fast facts about ketoacidosis

Ketones and ketoacidosis are often mentioned in relation to diabetes, but what are they exactly?

  1. Ketones result when your body burns fat for energy.
  2. They are formed when the body doesn’t have enough insulin to use glucose for fuel.
  3. A urine test is traditionally used to test for ketones: some blood glucose meters can also test for ketones.
  4. Ketones make the blood more acidic.
  5. Ketones in the urine combined with high blood sugar are a warning sign that your diabetes isn’t under control.
  6. Diabetic ketoacidosis (DKA) is caused by a combination of high blood sugar that causes a rise in ketones. The ketones are an indication of how acidotic the patient is, and the acidosis can be fatal.
  7. DKA is serious and can lead to diabetic coma.
  8. DKA is rare in Type 2 diabetics and more common in Type 1 diabetics with uncontrolled blood sugar.
  9. Symptoms of DKA are thirst, frequent urination, high blood glucose, constant tiredness, nausea, vomiting, abdominal pain, dry/flushed skin, breathing difficulty and confusion.
  10. If these symptoms ring a bell, see a doctor as soon as possible to get your blood sugar under control.

Finding the right food for diabetics

Sometimes the biggest challenge to eating a healthy diet is finding the right ingredients: here’s how Annora Mostert, the founder and group owner of Anja’s Pantry, and Alliyah Geldenhuys, who just opened Anja’s Pantry Plumstead, did just that.

Do you have a special interest in diabetes?

“It soon became clear that people with diabetes have the biggest need for healthy low carbohydrate and sugar-free food,” explains Annora. “So we involved trained nutritionists to guide us in what the right type of products should be for diabetics, and started to change the content of our pantry.” The result? All the products in Anja’s Pantry stores are now diabetic friendly. Some of the store owners also have close family members with diabetes, so as a team they work together to stock the right kind of products.

Do you think awareness is growing around healthy food alternatives?

“Absolutely! Social media is the biggest contributor creating awareness, but the awareness is now affecting policies. The research is so clear and the problem is so great that the South African government has followed the UK government in introducing a sugar tax next year on foods to try to curb the high sugar content in processed foods,” says Annora. As a result, all their stores offer a wide range of food products that are sugar-free and low carb so that those who want to avoid sugar can still have a variety of foods to choose from. “Our range of food products is now over 200 items with more being added all the time. This becomes a mini grocery store for the large percentage of the population that are either diabetic or pre-diabetic, those who have allergies or those who just want to lose weight while enjoying their food.”

How did you choose the location of Anja’s Pantry Plumstead?

Anja’s Pantry in Plumstead is right next door to a number of fast food restaurants. “We chose the location on purpose,” explains Alliyah, the owner of the store. “We want to provide healthier options to those in Plumstead and surrounds. It’s often difficult to prepare home cooked meals and so called ‘proper food’ with the fast paced lifestyles that many of us lead today. We end up simply settling for the quickest and easiest option available, but often these are unhealthy food choices. With our easy to prepare premixes and pre-prepared items such as pizza bases and meals, we are hoping to make it much easier for those wanting to enjoy a more nutritionally sound meal.”

Do you think there’s a particular need for healthy alternatives in the Muslim community?

“Yes! Traditional Muslim food is well known for being loaded with unhealthy fats, excessive carbohydrates and sugars. Diseases such as diabetes, high blood pressure and cholesterol are rife within the Muslim community and have sadly become a way of life for many within the community. I think it’s possible to ‘eat yourself healthy’, and that if we can share this vision and all that it stands for it will change the lives of many and allow Muslims to re-think their food choices.”

Do you have any advice for those who are struggling with their diabetes?

“Living a sugar-free and low carb life shouldn’t be that difficult,” says Annora. “We know that it is more expensive since real food items aren’t mass produced and made with lots of chemicals, but it saves so much on unnecessary medical bills.” Alliyah agrees. “An important part of managing your condition is to eat healthy meals and steer clear of certain items. Always read labels and check the ingredients of items that you purchase, as product packaging can often be misleading!”

What makes your life sweet?

For Annora, it’s feeling healthy and eating without feeling guilty. For Alliyah: “My amazing family, who made the opening of this shop a reality. It would never have happened without their help, guidance and support.”

Get in touch with Anja’s Pantry: Anja’s Pantry – the Food Farmacy on Facebook, @Anjas_Pantry on Twitter or www.anjaspantry.co.za

10 Fast facts about hypoglycemia (low blood sugar)

Hypoglycemic episodes (hypos) can be a scary experience for all involved: here’s what you need to know to deal with one.

  1. A hypo is a sudden low blood sugar episode.
  2. The optimal blood glucose range is 4 to 7mmol/l. With a hypo, blood glucose levels are usually lower than 3mmol/l.
  3. Initial symptoms are nervousness, sweating, intense hunger, trembling, weakness, palpitations, or trouble speaking (depending on the person).
  4. The best thing to treat a hypo is fast-acting carbohydrates: 15-20g of sugary carb (a few sweets, 2 tablespoons of raisins, a tablespoon of honey or half a cup of fruit juice).
  5. The key is to catch low blood sugar early – as soon as it starts dropping – and treat it with a small dose of something sweet.
  6. If blood glucose drops too low it can get to the stage where the brain is not getting enough glucose.
  7. Symptoms of this are confusion, drowsiness, changes in behaviour, seizure and eventually coma.
  8. In case of a severe hypo, a glucagon emergency kit may be necessary. This once-off injection instantly raises the blood sugar, and is particularly useful when the person with diabetes is unconscious or unable to swallow.
  9. Notify all those close to you what to do in an emergency and how to use a glucagon injection.
  10. Test often to keep your levels as well controlled as possible.

Living the low carb life

When Vickie de Beer’s son Lucca was diagnosed with Type 1 diabetes, she started a journey that ended with her publishing an award-winning cookbook and lifestyle guide: The Low Carb Solution for Diabetics.

Looking back, what do you wish you’d known when Lucca was first diagnosed with Type 1 diabetes?

That insulin takes much longer to reach the blood stream than we were told. I had a lot of anxiety about Lucca going into a hypo after eating, and it was completely unnecessary. I also wish I knew what a huge impact carbohydrates had on his blood sugar! We did carb count and test and inject diligently, but there were always unexplained highs and lows that frustrated me and made Lucca feel awful.

What inspired you to write The Low Carb Solution for Diabetics?

We have always, from the first day, taken Lucca’s diabetes seriously. We did everything the doctors and dietician told us. We adapted our diet to eating only low GI foods and tested Lucca’s blood sugars diligently. Every time we went to the doctor they congratulated us on his great HbA1c result and said that we were doing everything possible for Lucca’s health.

The doctor always said that the next step would be to control the extreme fluctuations between high spikes and lows in Lucca’s blood sugar. I could never get clear information on how we were supposed do that though, apart from doing what we were already doing. About a year ago I met Prof Tim Noakes at the book launch of Real Meal Revolution. We significantly reduced our carbohydrate intake, but did not remove carbohydrate completely from our diet.

I didn’t understand how we could remove all the carbohydrates from Lucca’s diet as suggested by the LCHF (Low Carb High Fat) movement. We were taught that children needed carbohydrates for energy, growth and brain function and I also knew that Lucca needed to get insulin. If we took away the carbohydrates how would he get the insulin he needed? I still gave the children small amounts of Low GI carbs like brown rice and brown pasta with their evening meals. Lucca’s blood sugar did not improve significantly – I would say that we were on a moderate carb diet.

A few months ago I made contact with a group in the USA that follow a low carb high protein (not high fat) diet with great success in managing steady blood glucose levels in Type I diabetic children. This way of managing diabetes is based on a book: Dr Bernstein’s Diabetic Solution. Dr Bernstein has been a Type 1 diabetic for 69 years. After reading his book and studying various other low carb websites and books, we decided to change the way we eat.

Do you have any tips for people who feel overwhelmed at the thought of changing their way of eating?

Do it gradually. We started with breakfast (because the boys love bacon!) and then did dinners – lunchboxes were the last!

What advice would you offer to people living with diabetes who are struggling?

Diabetes is in the details. The best tool is to test constantly and diligently. The bottom line is that cutting carbs makes diabetes easier to manage. All the hundreds of reasons I used to give to explain Lucca’s unstable sugar – the heat, stress, tiredness – it was always the carbs!

What makes your life sweet?

Hugs from my boys! Playing board games with them (and winning), swimming and braaing with them, reading with them… The fact that Lucca’s blood sugar is under control has changed our lives. We had a lot of anxiety in our life beforehand. Although we still test and inject diligently, the anxiety is gone. I think we have finally taken control of diabetes, and diabetes has lost its control over us.

Get in touch with Vickie: @Vickiefantastic on Twitter

Taking diabetes education to schools

When Roxanne and Derick de Villiers wanted to enroll their son Noah in pre-school, they didn’t think diabetes would be an issue. When it turned out it was, they turned the situation around.

Can you tell us about Noah’s diagnosis?

It was just before his 3rd birthday. When Noah got really sick and then diagnosed with Type 1 diabetes, we were really emotional. Here was our little boy who had this huge change in his young life: nurses and needles – that’s a picture we will never forget. But we can promise you this: in the midst of those overwhelming emotions, your parental instinct to protect your child immediately kicks in and your mind opens up so much to take in all that you need to. There is an urgency to get on top of the changes and adapt as quickly as possible.

Has it become any easier with time?

It has, it really has. You know that old saying that time is a healer? We believe time is a teacher. Diabetes is now second nature and so much a part of life. Having other family members also educated about Type 1 diabetes has made it easier as well because they can also test and inject when necessary.

When did Noah start pre-school?

Noah actually started pre-school the January before he was diagnosed with Type 1. When the pre-school was informed about him being diagnosed, the principal and his class teacher were at the hospital and were really supportive about this change in his life. What really impacted our lives positively was that they were prepared to learn and take part in this process too.

Could you tell us about the school application process?

At Noah’s first pre-school in 2012, he was already enrolled ahead of being diagnosed. We then made a home move and Noah needed to move pre-schools too. The school we enquired at for enrolment was amazing. Applying for Grade R was a little bit different and more involved. They had never had an application that included full disclosure of the child having Type 1 diabetes. We had a few meetings with the Executive Head and we pressed on for the understanding that we (the school and parents) could put a fair process in place that would protect both the child and the school without discarding school laws.

We needed to be a voice for Noah, for other diabetic children to follow and especially for the parents of diabetic children who go through this worry and want to enroll their precious children at the schools of their choice. The Executive Head and Regional Head of Noah’s grade school were true blessings because they agreed to put the suggested process in place and were on board to becoming the forward thinking, proactive and progressive school that they are. A beautiful school/parent relationship exists now.

What advice would you offer to other parents about diabetes education in schools?

The education is ongoing. It is never a once-off. Urge the school to have more teacher / parent sessions to talk openly about Type 1 diabetes. Whether your medical support is private or public, involve the nurse, the pediatrician, or the professor looking after your child. There is a big need, a big want and a big drive for education in this area. Minds need to be changed about diabetes and its management within the school system.

What makes your life sweet?

For Noah, having control of the DSTV remote and the Smart Tab and for us, his parents, seeing him so confident and secure even though he lives with diabetes.

Photos taken at Noah’s current school, Curro Century City.

Lessons learnt from a diabetic pregnancy

Sweet Life editor and Type 1 diabetic Bridget McNulty shares her pregnancy story – and what she wishes she’d known before she fell pregnant.

How long have you been diabetic?

I was diagnosed in October 2007… It was a very dramatic diagnosis: I was admitted to ICU for five days and was apparently only three days away from a diabetic coma because my blood sugar was so high.

Did you have to prepare to fall pregnant?

I told my endocrinologist ahead of time that my husband Mark and I were thinking of having a baby, and he gave me the go-ahead because my blood sugar was already well-controlled: my HbA1c results were 7.0 and below for the year before I fell pregnant. I also mentally prepared for the pregnancy, because I knew it would require a lot of discipline and that my diabetes would become even more of a full-time job than it already was!

How did having diabetes affect your pregnancy?

I had to be in extremely tight control throughout – HbA1c results of 6 and below (which I didn’t think was possible before I fell pregnant!) and blood glucose results of 7.8mmol/l or below an hour after eating… Where possible. I also had to test even more frequently than usual (up to 8 times a day). I had HbA1c tests every month and saw my endocrinologist every month, and I couldn’t indulge in pregnancy cravings like eating a whole tub of ice-cream! I had to be very strict with my diet. But it’s amazing how much easier it is to do when your motivation is the health of your baby.

How was the birth experience?

As smooth as I could have hoped for. I chose to have an elective C-section: it was either that or an induction, as all babies born to diabetic moms have to be born at 38 weeks. In the week before the birth my blood pressure started creeping up, and I was retaining a lot of water. Because diabetics are at greater risk of pre-eclampsia, my gynecologist decided to bring the birth forward two days, from the Monday to the Saturday. It was hugely exciting, and hugely nerve-wracking. Arthur, my baby boy, was born totally healthy and weighed in at a (very) healthy 4.5kg. We fell in love with him instantly.

What was it like having a young baby, with diabetes?

It was a real challenge in the early days. Breastfeeding plays havoc with blood sugar control, and causes really persistent lows. Sleep deprivation is tough to deal with, and it’s so overwhelming having a new baby and trying to learn how to be a parent that my diabetes kind of took a back seat for a while. I remembered to inject and test, but that was about it.

What do you think the biggest challenge of a diabetic pregnancy is?

Although 9 months doesn’t seem like that long at first, it feels like a really long time to be non-stop super-disciplined.

What advice would you offer to diabetics who are struggling?

You will feel so much better if you get your blood sugar under control. It is so worth it in terms of health and energy and general happiness to do what it takes to get good control. I know how hard it can be, but the reward is a healthy, happy life with diabetes – and that’s about as good as it gets.

What makes your life sweet?

My two sweet children, my wonderful husband, my awesome family and friends and the sweet life I’m living!

 

Get in touch with Bridget: @sweet_life_mag on Twitter or hello@sweetlifemag.co.za

Climbing Kilimanjaro – with diabetes

It’s the highest mountain in Africa, but that didn’t stop Neil Rae – a Type 1 diabetic for 50 years – from wanting to climb it. We chat to Neil, 63, about his preparation, the climb itself, and life with diabetes.

How long have you been diabetic?

I was diagnosed on the 13th December 1964: over 50 years. I’ve seen a lot of changes for diabetics in my time – there’s a lot more we can eat, the technology to monitor blood sugar levels is a lot more advanced and the insulin pen sets are much more convenient. We’ve come a long way since the gas cylinder with a tin cup that I used to sterilise my glass syringes when I was at university!

What made you decide to climb Kilimanjaro?

I grew up in Lesotho and I’ve always had a love for mountains. I don’t know how many decades ago, I said to myself I wanted to set a goal for my diabetes: to climb Kilimanjaro when I’d lived with it for 50 years. About 18 months ago I contacted Novo Nordisk, the people who manufacture my insulin, to ask if they’d like to partner with me. They were very excited to join the challenge. As you can see it’s been a long-term goal of mine…

What did you do to prepare?

I’ve always been a relatively fit person, and I do a lot of walking with my wife Shaye, in and around the streets of Johannesburg and in the Drakensberg. I was walking between 30 and 40km a week and over weekends doing long walks in Westcliff – they have a flight of 222 stairs built into the rock face, and with a heavy rucksack on your back it’s good training! I did the climb with my doctor, Dr Bruce Ilsely and David Broomfield from Novo Nordisk so as a team we were well prepared.

How did you know what to eat and drink while climbing, and how to balance your blood sugar?

Balancing blood sugar was obviously going to be a challenge – spending between 7 and 8 hours a day climbing up and up and up all the time. It was tricky to balance that amount of exercise with the food supplied by the people who organised the walk – we didn’t take any food with us. Normally my sugar is very well controlled, so the plan was to do very regular checks of my blood sugar levels, see what we were going to be given to eat and then decide how much insulin to take. It turned out that I didn’t eat very much – I became nauseous quite early on, once we were over 3500m.

What was the hardest part of the climb?

The hardest part for me were the ascents and descents because you had to climb up mountains and then down into valleys, and there was a lot of very rocky pathways – walking from rock to rock. Some days we went up and down two or three times in a day. We left Moshi on the Monday and we summited on the Thursday night/Friday morning. Unfortunately I wasn’t able to make the summit – I got up to about 5000m and my altitude sickness was so bad that Dr Bruce said to me, “If you carry on, you’re going to die”. Once I got back down to the base camp at 4600m, then I was fine: it wasn’t diabetes related at all.

What advice would you offer to diabetics who are struggling?

In my opinion, every diabetic who’s struggling has got to develop a lifestyle routine: get up in the morning, check your blood sugar, decide how much insulin you need and what you’re going to eat for the day. You have to have a definite lifestyle routine, and stick to it every day. Discipline is so important to a diabetic. If you don’t have the routine and don’t have the discipline, you’re not going to live with it for 50 years!

What makes your life sweet?

I’m very fortunate: I’m married to a lovely lady and I have two daughters and four grandchildren now. My family, my life and everything in it makes my life very sweet.

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.