diabetes in South Africa
Fun and informative posts about diabetes in South Africa.
From Facebook (Diabetic South Africans):
Belinda wants to know if there are any parents of Type 1 diabetic kids out there… Want to share advice?
Some advice: the treatment of diabetes is not a perfect science. What works for one person may not work for the next. You need to make notes of what works for your child. This will take much of the guess work out of controlling your child’s blood sugar.
Allow your kids to have a say and let them see the effects. Never wrap them in cottonwool! Let them live, learn and experiment!
Hi. I’m also new to this. My little girl was diagnosed in May. She’s 2 and a half. Very scary and completely heart breaking often.
Hi Belinda – join Kids Powered by Insulin if you haven’t yet. You’ll get good advice and support there. My son is 15 – diagnosed when he was 13. A good endo and educator, healthy diet and an understanding of how much insulin is needed and how each insulin works has helped us a lot so far. Take care x
Hi there my daughter is 3 years old and Type 1 diabetic, she was diagnosed last year two weeks before her 2nd birthday.
Belinda there are LOTS of us – join the Facebook group Kids Powered by Insulin.
Never tell them they can’t do something because of diabetes. As a child, I was told that I can’t do many things because of my diabetes – I missed out on a lot.
My daughter is 9 years old now and was diagnosed when she was 4. I would love to help anyone who has had to endure diagnosis – it was 3 months of pure hell and would have loved a shoulder to cry on or some tips to help.
Thank you everybody for the reply. I am feeling much better that there are so many parents that are prepared to give me advice!
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.
If there’s one question we get all the time, it’s about the insulin pump: what is it, how it works and how to get it covered by medical aid. So we’ve gathered together all your Frequently Asked Questions, and found the answers.
Meet the expert
Name: Imke Kruger
How long have you been diabetic? 25 years
How long have you been on the pump? 5 years
What made you decide to get an insulin pump?
I battled to get my blood glucose under control on multiple daily injections, especially when doing sports. It was before my first 94.7 cycle challenge that my doctor suggested insulin pump therapy. It has changed my life! I can’t imagine life without my Accu-Chek Combo pump.
What do you love about the pump?
Everything! It helps me to live life the way I want to. I love the discreetness of it – I can give a bolus in a meeting or when going out with my friends, without anyone noticing.
What are some of the challenges?
The first two months were difficult to get used to sleeping with the pump, but now I don’t even realize that I’m wearing it. The challenge is more with diabetes – not the pump. It’s important to realise that insulin pump therapy is not taking the condition away. There are so many variables in diabetes, and that will always be a challenge.
When should someone consider getting an insulin pump?
- If they are experiencing severe hypoglycaemic (low blood sugar) episodes despite careful management.
- If they are on multiple daily injections, following a meal plan, testing their blood glucose levels 4 times a day, and still not getting target HbA1c results.
- If they have irregular eating, working and resting times.
Insulin pump therapy won’t work for those who aren’t committed to it, and there isn’t enough evidence to recommend it for Type 2 diabetics.
A more comprehensive description of the Indications and Contra-Indications to Pump therapy can be found in the SA Guidelines for Insulin Pump Therapy. A Amod, M Carrihill, JA Dave, LA Distiller, W May, I Paruk, FJ Pirie, D Segal, Association of Clinical Endocrinologists of South Africa (ACE-SA) JEMDSA 2013;18(1):15-19.
FAQ about the insulin pump from our community:
What is an insulin pump?
- Insulin pumps are portable devices attached to the body that deliver constant amounts of rapid or short acting insulin via an infusion set.
- The pump tries to mimic the release of insulin from a normal pancreas, but you have to tell it how much insulin to inject.
- It delivers insulin in two ways: a basal rate which is a continuous, small trickle of insulin that keeps blood glucose stable between meals and overnight; and a bolus rate, which is a much higher rate of insulin taken before eating to “cover” the food you plan to eat or to correct a high blood glucose level.
- Because the insulin pump stays connected to the body, it allows the wearer to change the amount of insulin they take with the press of a few buttons at any time of day. You can also program in a higher or lower rate of insulin delivery at a chosen time – when sleeping or doing sports, for instance.
Where do you buy an insulin pump and how much does it cost?
You need to be a patient at one of the accredited pump centres in South Africa. Your doctor will decide if you are a pump candidate according to the Association of Clinical Endocrinologists of South Africa (ACE-SA) guidelines. If you are, you will need a script to claim the pump through your medical aid, or buy it cash from one of the supplying pharmacies.
What are the advantages and disadvantages of using an insulin pump?
Insulin pump therapy improves metabolic control while giving you greater freedom and a better quality of life.
- Your metabolism stays more stable, with better HbA1c values and fewer low blood sugar episodes.
- You can be more flexible in your eating, if you understand the concept of carbohydrate counting.
- You can participate in sports whenever you feel like it — without having to plan in advance
Disadvantages are that you have too much freedom in making food choices, and that there is a risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems.
Remember: Deciding on insulin pump therapy is not a simple decision and should be carefully discussed with your healthcare team.
Will my blood sugar control be better if I use an insulin pump?
It all depends on you. You can wear a pump and it can have no impact on your blood sugar. Or you can use a pump, and with the right settings, motivation and help from your healthcare team, you can have better blood sugar control.
Will I still have to test my blood sugar as much?
A pump patient needs to be a motivated patient who tests regularly, around 4 times a day.
Are there insulin pumps that have a Continuous Glucose Meter attached?
Yes there are – it’s a good idea to discuss with your healthcare team which pump would best suit your needs
How would the insulin pump be used for sports? Are there special casings made or will I have to play without it?
You can engage in any kind of physical activity while wearing an insulin pump. But for sports with intensive body contact and water sports we recommend temporarily disconnecting the insulin pump (not for longer than 1 hour). Special cases and pouches can protect the pump, but it’s always a good idea to insure it as well.
At what age can you put a child on the insulin pump and how easy is it for them to adapt?
I would say at any age, but it’s best to get advice from your pediatric endocrinologist. Children often adapt the easiest of all age groups to insulin pump therapy.
What is the risk of infection?
If you follow the right hygiene steps, the risks are low. You should always disinfect the pump site before inserting the infusion set. It is also critical to replace the infusion set every three days.
How much is an insulin pump with and without medical aid?
That depends on the type of medical aid plan and whether the medical aid covers the costs fully or partly. It would be best to discuss this with your healthcare team or your medical aid. If your doctor agrees that pump therapy is the best option for you, they will send an application to the medical aid.
Ask the expert: Dr Claudine Lee, GP
“Pump therapy is a beautiful and practical way of delivering insulin that tries to fit in with you, the patient, in terms of meals, exercise and illness, as well as just living a normal life.”
One of the most common complications of uncontrolled diabetes is diabetic neuropathy – but do you know what it is? Here are the basics of what it is, how to avoid it, and how to treat it if necessary.
- Diabetic neuropathy is the most common complication of diabetes.
- Neuropathy is short for “peripheral neuropathy” which means nerve damage in the peripheral nervous system.
- The peripheral nervous system includes all the nerves outside the brain and spinal cord, and connects the central nervous system to the hands, legs and organs.
- Diabetic neuropathy is caused from damage to the small blood vessels that supply the nerves.
- Blood vessels are damaged by high blood glucose levels, having diabetes for many years and abnormal blood fat levels.
- Smoking and excessive alcohol use can also cause diabetic neuropathy, as can mechanical injury to the nerves (like carpal tunnel syndrome).
- Symptoms can include numbness and tingling in the hands and feet, erectile dysfunction, dizziness, muscle weakness and changes in vision.
- Some common signs of peripheral neuropathy are sharp, jabbing pain that may get worse at night, and pain when walking.
- Diabetic neuropathy can’t be cured, but there are treatments to help the symptoms.
- The best treatment for neuropathy is good blood sugar control, which will prevent the condition from getting any worse.
From Facebook (Diabetic South Africans):
What advice would you give a newly diagnosed diabetic?
Get as much info as you can. Prepare to make lifestyle change. Respect the illness and it won’t control you
Don’t think you are any different from any other human. Carry on and enjoy yourself: everything in moderation. Exercise a lot and eat well – no problem!
Vat een dag op ‘n slag. eet gesond en doen oefeninge. en als wat ‘n nie-diabeet doen kan diabete ook doen!
Cut out anything white (sugar, flour, bread, chips, etc) and start an exercise program.
Don’t dwell on it too much. My Type 1 diabetic son of 8 understands his illness yet just gets on with life. He is a happy child and a true inspiration to the people around him.
Relax – it’s not the end of the world. It can be so overwhelming at first, but remember you have a manageable condition (note, not disease) God bless you!
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
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
We all know that more and more people are now living with Type 2 diabetes. It used to be seen as a condition for the wealthy, but today it’s increasingly common in every community – rich and poor. Nicole McCreedy takes a look.
Diabetes in South Africa is often associated with the Indian community among whom – compared with other cultures – it is more widespread. According to a study by the Human Sciences Research Council and Medical Research Council, 61% of South African Indians over the age of 45 have pre-diabetes, and are more likely, with age, to develop Type 2 diabetes.
But the Indian community is no longer the only group facing the diabetes challenge. It is now being reported as one of the leading causes of death in areas where diabetes was once unheard of.
The rapid rise in diabetes
There are a number of factors that put a person at risk for developing Type 2 diabetes. A family history of the condition, your lifestyle – what you eat, whether you smoke and how often you exercise – as well as your environment all play a role.
In the past, the Indian and white population in South Africa were more likely to be urbanised and wealthier, while Africans lived in the rural areas. Living in an urban environment often means longer hours at work, commuting and easy access to cheap fast foods. This type of lifestyle is linked to higher levels of overweight and obesity, and in turn diabetes. A study from 2005 found South African Indians ticked all the boxes: a diet low in fibre and high in unhealthy fats, physical inactivity, and insulin resistance.
However, in recent decades, South Africa has undergone both political and economic change. As a result, many people living in rural areas, especially Africans, have moved to cities for work and better opportunities. Being less physically active and eating a more Western diet (high in carbs and fats) is contributing to the growing diabetes burden in the African and coloured communities.
South Africans are fat
The relationship between overweight/obesity and Type 2 diabetes is critical. An unhealthy diet and not enough exercise can lead to being overweight or obese. Carrying extra weight, especially belly fat, is bad for your health, specifically leading to insulin resistance, high cholesterol and high blood pressure. All of which are damaging to long-term health.
What’s scary is that in South Africa, 7 out of 10 women and 4 out of 10 men have significantly more body fat than is healthy. The issue of overweight and obesity is emerging as a particular health concern among black women living in urban areas where there is a high rate of HIV. Weight gain, especially among black women, has always been seen as a sign of wealth, health and success in traditional African society, while being thin is associated with being HIV-infected. But overweight and obesity is also linked to diabetes. In a study on body perception among urban-dwelling black women, as many as 90% were overweight and obese, while almost three-quarters had diabetes.
The next generation
Your lifestyle not only affects your own health; it can also impact the health of your children. High blood sugar levels in pregnancy impact the unborn baby’s genes, making them more vulnerable to Type 2 diabetes later in life. Babies exposed to high blood sugar in the womb may have a higher birth weight and this can continue into adulthood with serious effects on their long-term health. Among South African Indians, where high blood sugar has been a problem for much longer, diabetes is now showing up at a much younger age than ten years ago – as early as between 25 to 45 years old.
Ignoring the problem
For many individuals, diabetes is a problem they don’t want to acknowledge. “A big concern is that people with diabetes are not taking their condition seriously enough,” says Jenny Russell from Diabetes South Africa’s Durban branch. “They want to swallow their tablets and carry on their unhealthy lifestyles.” According to Jenny, “in the Indian community, it is almost accepted as ‘normal’ that if you have diabetes, you will have diabetes-related complications: limb amputation, blindness or needing kidney dialysis.”
Others struggle with feelings of guilt. But whatever your culture, as Jeannie Berg, a pharmacist and diabetes educator in Mpumalanga, says:
“Diabetes is the same for everyone. Don’t let it define your life: it is not who you are, it is a part of your life you need to manage.”
Ask the dietician: Cheryl Meyer
From our community: “Can anyone tell me about madumbis for diabetics – good or bad for us, and how much can we eat?” Lynette Hitchcock.
Madumbis, amadumbe, African potato or taro – call them what you will, they are delicious! They have a rich, nutty, earthy flavour and a stickier texture than potatoes. Like potatoes, they fall into the carbohydrate group of foods and can be roasted, mashed or boiled.
The key to eating proudly South African carbohydrates like madumbis, roti, pap or samp in a healthy diabetic diet is portion control! Counting the carbs in your meals and being aware of the carbs you eat can help you match your medication or activity to the food you eat. This can lead to better blood sugar control.
Remember: Everyone needs a different amount of carbohydrate at each meal and/or snack – the amount that is best for you depends on your:
- physical activity
- current blood sugar
- blood sugar targets
Not sure how many carbs you should be eating? Ask your doctor or dietician for help.
|A general guide:|
|Carb limits for women||Carb limits for men|
|Meal||30 – 60g||45 – 75g|
|Snack||15 – 30g||15 – 30g|
What does this mean? A food that has 15g carbohydrate is called “one carb serving”. One slice of bread or a small piece of fruit each have around 15g carbohydrate, so they are equal to one carb serving.
One carb portions of Proudly South African foods:
|1 carb serving||50g madumbi|
|1 small roti (35g)|
|⅓ cup pap (60g)|
|⅓ cup samp (75g)|
|½ cup sweet potato (100g)|
|1 medium mielie (140g )|
|½ cup rice (50g)|
|1 x 15cm tortilla or wrap (35g)|
|½ cup pasta (100g)|
|1 slice bread (30g)|
|1 small apple (115g)|
As much as possible, try to stick to this portion size, with a serving of protein (meat, fish, chicken, eggs, beans) and half a plate of vegetables or salad.
How to cook amadumbe: Scrub them clean and steam or boil until soft. Drain and cool slightly before removing the skins. Serve dusted with black pepper, a dash of salt and a drizzle of olive oil. Yum!
Amadumbe in numbers:
100g portion boiled amadumbe has: *
- 600 kJ
- 5g plant protein
- 1g fat
- 5g of carbohydrate
- 1g fibre
* According to The SA Food Tables
All diabetics know that foot care is really important, but do you know why? Preventing foot ulcers is an essential part of keeping your feet healthy. Here are some great tips.
- Foot ulcers are skin ulcers where the skin has broken down under the foot and you can see the tissue underneath it.
- Diabetics are at greater risk of foot ulcers because high blood sugar for a long period of time can damage the nerves in the feet, which means you won’t be able to feel pain and might not notice a foot injury.
- A diabetic foot ulcer can develop after even the smallest injury, like stepping on a little stone with bare feet. Ulcers are easily infected and can take weeks or even months to heal.
- 15% of people with diabetes may develop a foot ulcer.
- More than half of all diabetic foot ulcers become infected.
- Foot ulcers are the most common reason for diabetics needing to go to hospital.
- Luckily, they are also easily prevented: by carefully controlling blood sugar levels to prevent nerve damage.
- It is very important to check the feet, including the areas between the toes, for cuts and sores – every day.
- Keeping the feet clean and dry is essential – but do not soak them.
- Be sure to have your feet checked once a year by a doctor or podiatrist.
We chat to Bongi Ngema-Zuma, First Lady and founder of the Bongi Ngema-Zuma Foundation.
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.
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.
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.
Of all the sports a diabetic could choose, ice skating – with its precision, edge of danger and need to be feeling 100% every time you take to the ice – isn’t the most obvious. But that didn’t stop KZN champ Rachel Lombard from competing.
Who did you skate for?
I was part of the Toti Seals Synchro Team, and we represented KwaZulu/Natal twice a year in the inter-provincial competitions, as well as the KZN championships.
How long have you been diabetic?
I was diagnosed about 10 years ago, when I was 7 years old. It was pretty traumatic, I was scared that I was dying because I was misdiagnosed – they thought it was cancer. It was a huge shock for my mom, but I just remember feeling relieved it was only diabetes and it wasn’t anything worse.
Is it difficult to compete when you have to worry about blood sugar levels on top of everything else?
I have an insulin pump, so that helps, but I still have to be very careful. I make sure my blood sugar is fine an hour or two before we’re due to go on the ice, because my pump is under my tights and my costume and it’s difficult to get to if I need to adjust my levels. I also test just before I go on the ice, because the adrenalin can do funny things to my blood sugar. And I make sure I always have fast-acting sugar on hand in case I go low.
What do you love about ice skating?
I love it mainly because it’s different, and because there’s a real community – especially with my team and the coach. I skate four times a week, so it’s also really good exercise.
What do you think the biggest challenge of living with diabetes is?
The testing – having to test all the time. And how you can never predict what your blood sugar is going to do: you’ll eat something and know how much insulin to take, and it works… And then the next time you eat exactly the same thing and take the same amount of insulin and it doesn’t work, for some reason.
What advice would you offer to diabetics who are struggling?
Get support: that’s the one thing you need, you can’t do it alone. Also be aware that parents go through the highs and lows of diabetes just as much – my mom does so much for me, I don’t know what I’d do without her.
What makes your life sweet?
Just my friends and family around me, helping me through any situation and offering support if I need it. That’s what makes my life sweet.
Get in touch with Rachel: email@example.com
Ask the dietician: Genevieve Jardine
From our community: “My favourite food isn’t very good for me… I love braais and chips, hamburgers and hot dogs. Is there any way to make these delicious foods better for me? Help!” Thabo Duma.
All of us like a bit of pleasure in life, and nothing beats a treat now and again. The attraction of junk food lies in its “quick fix” ability to satisfy food cravings. Unfortunately, what makes junk food so delicious is also what makes it unhealthy. Junk food tends to be high in kilojoules, bad fats and refined carbohydrates. Because it tastes so good, it’s also hard to stop eating. You may get away with one biscuit, but 4 or 5 will cause a significant increase in blood sugar.
When relaxing with family and friends, you want to be able to enjoy holiday food: take-outs, braais and easy meals. There are definitely ways to enjoy these times without feeling left out – and without packing on the extra kilograms!
For take-out options, choose grilled chicken breast or beef hamburgers with salad (no chips!) Or try grilled chicken breast, spicy rice, coleslaw and green salad. Choose water or a diet fizzy drink to go with your meal, and obviously skip the dessert. Try to avoid food that’s high in fat and refined starch and sugar – pizza, deep fried chips and sugary drinks are all a bad idea.
Who said a braai couldn’t be healthy? Bring chicken or beef kebabs and braaied corn on the cob, with carrot salad and green salad on the side. These are a much better choice, and much lower in fat and carbs than boerewors and chops, garlic bread, pap and gravy or white bread rolls. And they’re delicious!
If you’re looking for delicious snacks, here are some yummy diabetic-friendly options:
|Snack||Portion||Energy||Carbohydrate (including sugar)||Fat|
|Popcorn (lite)||2 cups popped||636kj||15g*||7g|
|Dried fruit||2-4 pieces||381kj||21g||0g|
|Low GI biscuit||1 biscuit (30g)||440kj||15.3g||5.8g|
|Lean biltong||Handful (30g)||346kj||1g||2g|
* Remember that one carbohydrate portion = 15g.
Compare those to regular snacks and you’ll see the difference:
|Snack||Portion||Energy||Carbohydrate (including sugar)||Fat|
|Chocolate||1 bar (50g)||1120kj||30g||15g|
|Energy bar||1 bar (40g)||739kj||22g||7g|
|Biscuits (with icing)||2 biscuits (33g)||676kj||30g||7g|
|Sweets (boiled)||125g packet||316kj||18g||0g|
|Potato crisps||1 packet (30g)||766kj||24g||12g|
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
The day that you are diagnosed with diabetes is a day that is hard to describe. The world stops but at the same time a neverending rollercoaster ride starts: one you never asked to get on in the first place.
I remember sitting in the doctor’s office and a funny thing happened: he said the test results came back and you’re a Type 1 diabetic. After that I was in shock. The funny thing is I knew that he was talking because his lips were moving, but honestly I have no idea what he said. It was all a blur to me. All I remember thinking is: how can this happen? I never ate much sugar and now I’m going to die. But at least I have an answer to why I’ve been feeling so sick the last few months.
After the shock set in, I remember going to the book shop to basically buy any book that had been printed that mentioned the word diabetes, and then reading them all and being more confused than ever as they all contradicted each other. After the initial diagnosis, the doctor suggested that I go and see an endocrinologist.
Well, I saw a few of them and what they were all good at was sitting me down and telling me the negative side of the disease. How you can lose your eyesight and your feet and how if you get wounds there is a good chance they won’t heal well. Then in the next breath, they explain that now you will need to go on a strict diet and inject for everything you eat ever. They seem to wonder why you look so depressed and have an attitude of, what’s the point to life any more?
At some point during the initial diagnosis, it seems we all go on a sort of autopilot. We inject when needed and ask every question we can think of, and blindly trust what our doctors say, because they’re the professionals and know what they’re talking about, right?
What we don’t realise then is that diabetes is a common condition but it’s also very individually based. What makes my levels go up can have no effect on a friend’s levels. The other thing we learn on our journey is that at some point all diabetics and carers become doctors, dietitians and endocrinologists. The only difference between us and the real doctors is that they have diplomas and we don’t, but we have the life experience and they don’t.
What I have learned the most in my love-hate relationship with diabetes is that while I hate the constant management and daily injections, being diabetic has made me a stronger person and taught me to stand up for myself. In a weird way, it has given my life a kind of warped purpose. So I guess I will always love to hate being diabetic. You know what? That’s actually okay and totally healthy.
From our community blog:
I wonder if anyone can advise me. I’m 27 (soon to be 28) and was diagnosed as a Type 2 diabetic in 2010. When I lived in South Africa, my average blood glucose would read between 5-7 and I would have occasional episodes of hypoglycemia.
Since I moved to South Korea, I have had the opposite problem. My reading first thing in the morning before breakfast is 10-14! I eat special K cereal with skimmed milk diluted with water for breakfast, a garden salad with no dressing for lunch and an average meal for dinner. I take Metformin 500 twice a day (I’ve been on that dose since I was diagnosed) and exercise regularly but I can’t seem to drop my blood glucose to within healthy levels.
I can’t really seek medical help because with my job, I can be deported if they find out I’m diabetic.
How can I get my blood sugar down?
Hi Kerissa, Just wondering if you eat snacks in between your meals as well? My dietician has me eat 7 times a day. Here are my thoughts:
- Find a doctor that specialises in diabetes, you might need your medication changed. I was been diagnosed in August 2012 with diabetes, my medicine has changed since and now I’m on both metformin and insulin.
- As far as I know, special K is a no-no for cereal. Rather eat oats with an apple.
Make a change in your breakfast and see if that helps. Then test 7 times through the day for 2 days and take that to your doctor’s appointment.
Hope you can get it under control. I battle sometimes too, you are not alone!
I’ve been a Type 1 diabetic for 11 years now, so I can give you some input. Good carbs as far as I know (low GI) are: oats not Oats So Easy, brown rice, sweet potato, rye bread, brown rice cakes. Healthy fats are good for your joints and lowering the GI of a meal or snack (fish oil/omega 3 oil, 30g of almonds, quarter avocado). Good proteins are handy for maintaining muscles. Don’t forget to drink sufficient amounts of water daily to stay hydrated.