diabetes in South Africa

Fun and informative posts about diabetes in South Africa.

Parenting a child with diabetes

There’s been a lot of talk on our Facebook page about how diabetes affects the whole family. Especially after this guest article about how Diabetes destroyed my relationship with my mother. Today, we have the other side of the story to tell – a mother’s story of parenting a child with diabetes.

type 1 diabetes

Before diabetes

 

The World Cup Soccer was upon us! The atmosphere was abuzz with all the excitement and schools were closing for holidays. My girls were gearing up for a slumber party to celebrate Kirsten’s 16th birthday, great excitement filled the house as friends arrived present laden and ready for a night of storytelling and fun after an evening at the fan walk.

I asked her not to sleep near two girls who had a cold as it was a long holiday and I didn’t want her to get sick. The party came and went and Kirsten got the dreaded cold. She left two days later to go and spend time in Elgin with a few close friends and when she arrived home with bronchitis was put on antibiotics. She was looking very pale and her loss of weight was almost shocking. The doctor seemed concerned at the time but said we could go away and to see him on our return.

Langebaan was like a breath of fresh air compared to the madness in Cape Town and we were looking forward to a couple of days rest with good friends. Kirsten crawled into bed and did not move. We spent days trying to get her to eat to no avail and then she started vomiting: something was wrong and we could all see it. The chemist said there was a bad virus going around and she stuck to fluids for a couple of days: Energade, Powerade and naartjies were her only input.

The scariest day of my life

 

I could see that there was something drastically wrong on the Sunday night – it was as if she was not registering my presence, her knees had swollen to the size of rugby balls, her movement was staggered and she looked like a skeleton with skin on. I could not sleep worrying about what was happening to my beautiful daughter, was it what I had feared the most?

The morning came and with it came the scariest day of my life. I went down to check on her and she was semi-comatose. We threw everything into the back of the car and got back to the doctor in Cape Town in record time with her passing in and out of consciousness. I ran into the doctor and I said what I had been dreading to say: “I think she has diabetes!” Tests were run and confirmation came through two hours later: Kirsten was a Type 1 diabetic, her HBA1C registered as her being one for at least 3 months prior to diagnosis and she was immediately started on insulin. A new chapter in our lives had begun.

Let me just add here that on my husband’s side of the family diabetes was prevalent and I had always had a fear that my children would one day be diagnosed. I had constantly had them checked throughout their childhood. I thought by now they were all safe from this terrible burden.

Days filled with diabetes

 

Our days were filled with diabetes: from doctors to specialists to diabetic educators and reps, it was like a neverending story and a huge overload of information. Could the doctors be wrong? What if it was the energy drinks and naartjies we had given her that had sent her sugars over the top? Could she wake up next week and be fine? “No” was the answer to all our questions and we had to resolve ourselves to the fact that all of our lives were forever going to revolve around diabetes.

Kirsten would have to inject herself three times a day at mealtimes and once before bedtime for the rest of her life. Our days of running into the shops turned into hours reading every label and checking the carb count. All temptations were banished from the house, no more fast foods, as we started our new journey.

Unfortunately for Kirsten, things just did not seem to want to come right. She had lost 11 kilograms and had no muscle on her at all, her BMI was only 16. She could only manage to grab a millimeter of skin to inject but her blood sugar levels were fantastic and her endocrinologist was very impressed with her management thereof. Despite her levels being fine, she kept getting recurring lameness in her legs (from walking the one moment to waking up lame the next), as well as severe neck pains and constant chest infections. We had to forbid anyone near her who was even remotely sick.

At the beginning of December we were thrown into shock as she woke up with a mass of glands on either side of her groin, she was scanned and the glands were in excess of 3cm each so it looked like a bunch of grapes. We anxiously waited as they ruled out lymphoma, but praise be to God, it was not so, and she was blasted with antibiotics to reduce the glands.

Complications of diabetes

 

Our annual holiday to Plett arrived and everyone was so eager and happy to get there, days filled with friends and relaxation and just time to forget about the negatives of the past six months. We enjoyed the first week without a hitch and then once again Kirsten fell ill: she could not eat anything which was most frustrating as diabetics have to eat, and we landed up in the hospital where they could not find anything wrong. Two days later she could not even drink without crying and when her breathing became difficult we once again packed up everything and raced back to the doctors who knew her history in Cape Town.

She can’t recall at all how she got back home, she had lost all the weight we had painfully tried to put onto her and she was admitted for an esophagogastroduodenoscopy showing she had picked up a viral infection which had left her with hundreds of ulcers from the mouth down into her stomach, another complication of diabetes. Once again, loads of meds and a struggle to get her to put on the weight which she desperately needed to gain her strength.

Friends were understanding and eager to learn how to deal with her should her levels drop and were a constant by her side throughout. My frustration was immense, I was so mad at the world, at my Creator, for allowing this to happen to my once super-healthy and fit daughter who had the world at her feet. How could this be happening and why could I not fix it?

child with diabetesMothering a child with diabetes

 

I battled every day to put on a smiling face so that she could not see my worry, I would spend hours sitting in her room at the dead of night praying and watching her just to make sure she did not slip into a coma, I had prayer circles going all over the world for my girl and yet no answers were coming. I realized that God had placed my son (who has Aspergers) in our care because he thought that we could deal with it. He had now obviously decided that we did that job well as Kirsten’s sickness had to be dealt with by us too.

I felt that somehow, somewhere, I had to find the inner strength to show Kirsten that she was still the beautiful daughter I always had, except now she was more special as now it meant that we would have to care for her daily, in all walks of her life. I prayed for the strength to guide me to help her in every way that I could: my shoulders are broad and would surely bear the load.

Not a day goes by that I don’t wonder what her levels are, what she is eating or how she is feeling, if she is not with me it takes everything in my being not to reach for the phone to check. The expense of the last years has been immense, but being her constant carer and companion throughout this ordeal has changed me for the better.

Diabetes brought us closer

 

We are aware of everything that we eat. This is usually the stage in a teenager’s life that they tend to drift away from the parents, but we have become more united. I still allow her freedom but help by providing pre-packed meals knowing that she can enjoy herself without having to worry about where her next meal is coming from. As a family, we have always been close but this disease has brought us closer. We are always on the lookout and we stand together and work through it so that she feels that she is never alone in this lifetime fight with diabetes. We take a small step each day learning and knowing more. Her smile is constant even through all her worries and ill health and this keeps us going.

My daily thoughts revolve around Kirsten and my prayer is for a cure for diabetes to help, not only my daughter, but the millions of people living with diabetes all over the world.

– Sue

PS: Kirsten is now a successful mountain climber and blogger – follow her adventures on Instagram: cape_town_adventurer

 

Type 2 Diabetes Chat on Expresso

Bridget McNulty, editor of Sweet Life diabetes community, was recently interviewed on the Expresso show on SABC3.

The segment was about what Type 2 diabetes is, how it is caused, what to do to prevent Type 2 diabetes and how to live a healthy, happy life with diabetes.

Take a look at what Bridget had to say about how to live well with Type 2 diabetes – what would you add?

 

 

Prefer reading to watching? Here’s a breakdown of the information in the video.

 

What is diabetes?

There are three types of diabetes: Type 1, Type 2 and gestational diabetes. They are all related to how insulin is used in the body. In people without diabetes, when you eat your pancreas releases the perfect amount of insulin to match the food you’ve eaten. In Type 1 diabetes, the pancreas releases very little (or no) insulin so insulin injections are necessary. In Type 2 diabetes, either not enough insulin is being produced or the insulin that is being produced isn’t being used properly – the body is insulin resistant.

Insulin is so important because it acts as a key that unlocks the cells. When you eat, food is broken down into glucose, which is absorbed into your bloodstream. Insulin transports the glucose from the blood to the cells of the body, where they are used as fuel – as energy. People with diabetes have impaired insulin function, which means that if they are not in good control. their blood glucose gets higher and higher – this can lead to complications like blindness, amputation and kidney failure. But only if you don’t look after yourself! It is possible to live a perfectly happy, healthy life with diabetes.

What causes Type 2 Diabetes?

There is a strong genetic component, but Type 2 is often called a lifestyle disease because it is strongly linked to a poor lifestyle – being overweight (particularly around the belly), eating the wrong kind of food (junk food, lots of refined carbohydrates, fizzy drinks etc) and not exercising. If caught early enough, Type 2 can be reversed with a healthy diet, weight loss (if necessary) and exercise. (Type 1 can never be reversed). If lifestyle modifications don’t help, the treatment is generally insulin pills and eventually insulin injections. But the earlier you are diagnosed the better it is, because your body has not been damaged – that’s why we always promote getting your blood sugar checked. It’s a simple, fingerprick blood test at your local clinic or pharmacy.

Is stress a contributing factor – and how?

We all know that stress is bad for us. When it comes to diabetes and how the hormones function in the body, stress releases stress hormones like cortisol which raise blood sugar to give you an energy boost in times of danger (I’m not a doctor, but I’ve experienced this a lot myself). There are a lot of studies being done at the moment about prolonged stress, anger, anxiety, depression, poor sleep and how they relate to diabetes, but nothing has been proven yet.

What diet and lifestyle changes need to be made to fight diabetes?

Funnily enough, the kind of diet and lifestyle changes we should all be making – whether or not we have diabetes. A balanced diet with lots of fresh food and no refined carbohydrates (white bread, white rice, cakes, biscuits, etc), no juice or fizzy drinks, no fast food. Plenty of water, little alcohol, no smoking. Regular exercise – the recommendation is 30 mins 5 times a week, and it doesn’t have to be anything hectic, it can just be walking around the block and getting faster as you get fitter. And losing weight if necessary. Also regular sleep and keeping your stress down. It’s a recipe for health for anyone!

Diabetes and diet is a hot topic at the moment because of Banting and the wonderful results many people with Type 2 diabetes have had on it. At Sweet Life we don’t recommend a particular diet, we give everyone the facts so that they can decide for themselves. What works for one person may not work for others.

Lifestyle changes to manage Type 2 diabetes

It’s one of the questions we get asked at Sweet Life all the time. Do I have to change my lifestyle – and my diet – to manage Type 2 diabetes?

diabetes diet

Lifestyle disease

Well, that depends. Most of the time, Type 2 diabetes is caused directly or indirectly by issues of diet and lifestyle – it’s sometimes called a ‘lifestyle disease’. That said, there is a strong genetic component, so it’s not helpful to think that you ‘gave yourself diabetes’. That kind of attitude isn’t going to help you live a healthy, happy life with diabetes.

Take a close look at your lifestyle. Do you think it’s one of the reasons you were diagnosed with Type 2 diabetes? Do you eat a lot of fried, fatty food? Is there enough fresh fruit and vegetables in your diet? Do you eat a lot of processed food or refined carbohydrates? Do you eat large portions, even if you’re no longer hungry? If so, it might be time for a lifestyle revamp. Take a look at Sweet Life’s Ask the Dietician articles for advice on a healthy diabetes diet.

Family with diabetes

One of the hardest things for newly diagnosed diabetics is making the changes necessary for their health, while still being part of the family. For many people, family meals are an important part of the day, and having to either eat a different variety of a meal or eat at different times or in a different way (a plate of food instead of sharing from communal plates, for example) is a difficult adjustment. Some families are fantastic at supporting the newly diagnosed, others find it too much of a challenge. Sweet Life has written about the challenges of family life with diabetes in our Partner’s Corner articles – you can find out more about families with diabetes here.

Remember that it’s important to sit down and explain to your family why you need to make certain changes, and how they can benefit from them too. Those who have adopted a healthier lifestyle – one that’s rich in fresh food and regular exercise – not only see the effects in their blood sugar results, but in their overall wellbeing.

Have you had to change your lifestyle because of diabetes?

Photo by Dan Gold on Unsplash

 

The carbs-fat-protein debate

Ask the dietician: Genevieve Jardine

From the community: “I don’t understand the whole ‘low carbs high fat or high protein’ idea – how do carbs, fat and protein work together? Is there a happy middle ground, or does it need to be all or nothing?” Wessel Jones

To understand what all the fuss is about, we need to look at the history of diabetes treatment. Treating diabetes (both Type 1 and Type 2) by lowering carbohydrates (carbs) has come and gone out of fashion over the last century. This debate is not a new one and it is probably not going to go away.

Before the invention of insulin, the only way for a diabetic to survive was to cut out the foods (carbs) affecting blood glucose. With the advent of insulin, the focus switched from lowering carbs to lowering fat to help reduce heart disease. Fast forward a couple of decades and we can see that we have failed in reducing obesity, diabetes or heart disease. It’s not as simple as just diet: it’s about physical activity, stress, diet and environment.

How do carbs work in the body?

What is quite simple is that carbs cause blood sugar to rise and the more carbs you eat, the higher the blood sugar goes. If a person wants to control their blood sugar, it’s a very good idea to reduce carbs. The big question is: how low do you go? A “low carbohydrate diet” can have anything from 20g to 130g of carbohydrate per day.

Remember: One portion of carb (a medium apple, a slice of bread) = 15g carb

The amount of carbs depends on the individual, their control, their medication and their weight. There is a growing amount of scientific evidence that low carb diets improve glucose control and help with weight loss.

Where do fat and protein fit in?

When carbs are cut, the amount of protein or fat (or both) go up. And this is where the debate heats up. The concern is not the low carb, but the increase in saturated fat or fat in general. Remember that not all fat is the enemy and there are good fats that play a very important role in the body.

A benefit of protein and fat is that in the immediate, they do not cause the same spikes in blood sugar. When you lower carb intake you have an immediate blood sugar lowering effect. When this happens, and you have fewer spikes and dips in blood sugar, your appetite is better controlled. The fuller you feel, the less likely you are to snack and the fewer kilojoules you consume. The fewer kilojoules you consume, the more likely you are to lose weight.

The problem with the low carb approach is that, like everything else, it needs to be a lifestyle. When you add carbs back into your diet you will put on weight, especially if you have increased your fat and/or protein. You can’t have it all: full fat products and also carbs. The most important goal is to increase your vegetable intake and try to eat as close to nature as possible. Eat foods in their most original form.

When it comes to deciding on the right ratio of carbs : fat : protein, work with a dietician. It may take time to find your correct balance and you need to be monitored properly with blood tests and possible medication adjustments.

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.

Making the right food choices (at work)

Ask the dietician: Cheryl Meyer

From our community: “I get invited to lots of business meetings and workshops that are catered… Needless to say, none of the catering is healthy! What do I choose or how do I deal with this situation?” Rene Prinsloo.
Many of us consume at least half of our meals and snacks during work hours, which makes our food choices in catered meetings and workshops very important. Here are three steps to consider:

Step 1: Build your plate

  1. Aim to fill half your plate with vegetables or salad. Look out for vegetable skewers, veggie sides, crudités (chopped raw veg), soup or salads.
  2. Next, add a healthy carbohydrate: either a wholegrain/high fibre starch or a piece of fruit.

Look out for:

  • Wholewheat bread
  • A seeded roll
  • Wholewheat pita
  • Wholewheat pasta/noodles
  • Wholewheat wrap
  • Brown or basmati rice
  • Fresh fruit
  1. For long-lasting brain and body power, add a source of protein.

Some good protein choices:

  • Lean cold meats
  • Grilled chicken
  • Mini meatballs
  • Legumes like beans or lentils
  • Fish like tuna, sardines or pilchards
  • Cottage cheese
  • Boiled eggs

Sauces like low-fat mayonnaise, sweet chilli sauce, hummus or guacamole are optional but not essential.

Avoid:

  • Deep-fried foods (like samoosas, spring rolls or vetkoek)
  • Sausage rolls and pies
  • Croissants, muffins or other pastries

Step 2: Choose portions with caution

  1. Be sure to start the day with a balanced breakfast and keep healthy snacks or a packed lunch on hand to avoid arriving at a meeting hungry.
  2. Use smaller plates and serving utensils to help manage how much you dish up.
  3. Sit far away from the food to avoid “picking”.
  4. Use the size of your hand to determine sensible and healthy portion sizes and curb overeating:
  • A fistful is equal to one cup and can be used to estimate the portion size for carbohydrates (starches and fruits).
  • The size of the palm of your hand can be used to estimate the portion size for protein. For a stew, curry or casserole this would be about half a cup.
  • The tip of the thumb is equivalent to one teaspoon and can be used to estimate the portion size for all oils, butter or mayonnaise.
  • The thumb can also be used to estimate the portion size for peanut butter or hard cheese.

Step 3: Carefully consider your choice of drink:

Some good choices are:

  • Still or sparkling water
  • Tea or coffee
  • Vegetable juice
  • Low-fat milk
  • Sugar-free fizzy drinks

Toddler son just diagnosed with diabetes

From our community blog:

Hi there,
I am new to this site.

Last night I was at the casualty section of Wilgeheuwel Hospital in Joburg because my 2 year-8-month year old son has been very listless and vomited and I thought he probably had gastro. He was diagnosed about 2 hours ago with Type 1 diabetes and was taken straight to ICU to be stabilised and to have tests done.

This was an overwhelming, terrifying moment for me — I know very little about Type 1 Diabetes and my OCD thinking went into a tailspin about “what if he is in a situation one day where there is no insulin available and and and…”

Forgive me for sounding so panicked, but I am utterly at sea and trying to come to grips with the news. I am writing in the hope that someone can tell me everything’s going to be okay – that the ‘episodes’ or emergency situations will be able to be handled with confidence and success, and that (bar all the huge adaptations we’ll make to our lives), he will be okay.

I’d really appreciate any comfort anyone can give to this totally inexperienced, upset mom.
Thank you!
– Hayley
Comments:

Hi Hayley,
My son is also a diabetic. He was diagnosed at age 12, nearly 6 years ago. I just wanted to say: hang in there. Your child will be okay. He will one day be able to cope with this all. Just remember that this is not your fault. Nothing could have prevented this. Do join our group on Facebook: Kids powered by insulin. This group has helped me through some tough times.
Remember there is light at the end of the tunnel. Keep the faith. It will get better, that I promise.
Rachel

Hi Hayley,
All will be okay as long as you take care of it and treat it accordingly.
Keep monitoring your son’s diabetes and it will be fine!
Randy

Oh my, I know the feeling of absolute devastation! I was diagnosed with Type 2 diabetes three years ago at an oldish age, and I live alone, and thought the world had come to an end. Obviously for such a little one it is very difficult… I’m very aware of what I eat. Living with diabetes is difficult, but doable.
Lynn

Diabetes-friendly kids menu

Ask the dietician: Genevieve Jardine

From our community: As the mom of a diabetic child, I’m constantly wondering what to make her that is delicious but won’t spike her blood sugar. Could you give me some basic guidelines please?” Bernadette Simons.

As a mother of three (constantly hungry) young boys I am kept on my toes when it comes to healthy eating. Although my children are not diabetic, I practice “diabetes-friendly” eating in my household. The bottom line is that you want your children to eat real, whole foods. This means no foods that are manufactured, processed and refined: time for a cupboard clear-out!

For children with diabetes, you need to make meals novel, colourful and exciting, while reducing refined carbohydrates and harmful fats. It’s important to break away from the rut of cereal for breakfast, sandwich for lunch and one-pot meal for dinner. Parents need to constantly focus on increasing fresh foods and not wait for dinner to try and make up the daily vegetable intake…
Here are some menu options:

Breakfast:

  • Bring back eggs for breakfast! Make eggs more interesting and nutritious by adding vegetables and baking in a muffin tray as mini crustless quiches. Serve with chopped strawberries or other brightly coloured fruit.
  • Try making your own cereal out of nuts and seeds, coconut shavings and some rolled oats. This can be eaten with plain yoghurt or milk. Use vanilla, cinnamon and half a grated apple to sweeten it naturally.

Lunchboxes:

  • Move away from a daily sandwich for lunch. Try choosing other low GI starch like baby potatoes or corn on the cob.
  • Add some protein – chicken drumsticks, hard-boiled eggs, meatballs, homemade fish cakes or cheese. Remember protein makes you feel fuller for longer and doesn’t spike blood sugar levels.
  • Add a small amount of colourful fruit like a fruit kebab or fruit salad.
  • All lunchboxes should have vegetables! If your child doesn’t like salad, give some cucumber and carrot sticks, baby tomato kebabs or cucumber sandwiches (two slices of cucumber with cheese or cream cheese in the middle).

Dinner:

  • Most traditional South African dinners are one-pot meals like curry, stew, cottage pie or spaghetti bolognaise that are high in starch and low in vegetables. Try adding more vegetables to stew, curries and mince. Make the mashed potatoes with added cauliflower, add lentils to brown rice, and use baby marrow or aubergine instead of pasta.
  • Always serve dinner with vegetables on the side. Raw carrot sticks, sliced cucumber or snap peas are kid-friendly. Children need to get used to eating vegetables that are not hidden in food but out in plain sight!

Remember: Children learn eating habits from their parents so you need to set the example. Tastebuds are influenced early on by processed foods with hidden sugars and fats, so it’s up to you to encourage your kids to eat – and love – real food.

The secret to a happy life with diabetes?

From Facebook (Diabetic South Africans):

What’s the secret to a happy life with diabetes?

To not make it an issue. Treat it and forget it. Life is too short.
Louis

Most people suffer some type of illness, but we all have to just deal with it and get on with our lives.
Erika

Sorry to all those optimistic people out there… but there is no happy life with diabetes 🙁
Lisa

Finding the right balance… While diabetes is not a good thing to have, one certainly does still have a happy life. Be informed… and that goes for your spouse and family members too.
Lynnae

Support and understanding from the people closest to you makes it easier to live with.
Adele

Top tips for a pregnancy diet

Ask the dietician: Cheryl Meyer

From the community: “Being both diabetic and pregnant makes it difficult to know what to eat – there are so many things I have to avoid! And I’ve been craving sweet things. Any advice?” Sameshnie Naidoo.

The diet for pregnant women with diabetes should be a healthy, well-balanced eating plan aimed at supporting the pregnancy and promoting blood sugar control. This is essential for the wellbeing of both mom and baby.

Of course, pregnancy and diabetes means that there are more foods on the “Do Not Eat” list, as your normal diabetic diet has a new list of things to avoid. But bear in mind that it’s only for nine months, and that it’s for the best possible cause: your healthy child.

Foods to avoid:

Here’s a list of foods that you shouldn’t eat when you’re pregnant because they pose a potential food safety risk and might make you ill or harm your baby.

  • Soft cheeses e.g. brie, camembert, and blue-veined cheeses unless the label says they are made with pasteurised milk.
  • Processed cold meats or deli meats unless they are reheated until steaming hot.
  • Refrigerated paté or meat spreads (canned options can be eaten).
  • Refrigerated smoked seafood unless as an ingredient in a cooked dish e.g. a casserole.
  • Raw or partially cooked eggs and dishes that contain these e.g. homemade mayonnaise.
  • Raw or undercooked meat and poultry
  • Unpasteurised juice
  • Raw sprouts
  • Raw or undercooked fish or shellfish
  • The American Academy of Nutrition and Dietetics (AND) recommends pregnant women avoid fish high in mercury e.g. shark, swordfish, marlin. And limit intake of fish and shellfish lower in mercury e.g. prawns, canned light tuna and salmon, to 360g or less per week.

The good news? You don’t need to give up caffeine entirely. The AND recommends keeping your intake below 300mg/day, which is about one or two servings of coffee or tea. And of course rooibos is naturally caffeine free, so you can have as much as you like!

Being both diabetic and pregnant can feel restrictive from a diet point of view… When you’re lacking motivation, just remember that everything you eat your baby is eating too: so put down the junk food and pick up a carrot!

A note on cravings:

Whether it’s pickles and ice cream or other odd combinations, both cravings and food aversions are common during pregnancy. Although the exact cause is unknown, taste perceptions may change with hormonal changes. Cravings are generally harmless*, unless foods you crave replace more nutritious foods, or all you want is junk food. If broccoli loses its appeal, for example, substitute another vegetable that you enjoy and tolerate.

*Cravings for non-food substances like sand or chalk (a condition called pica) can be dangerous as they contain lead or other toxic substances. If you’re craving non-food items, consult your doctor.

Yoga and diabetes

Yoga is not only a fantastic form of strengthening exercise, it’s also great for calming the mind – something most of us with diabetes need to do! Bridget McNulty finds out more.

As a diabetic, the one thing I hear over and over is that exercise is good for me. And it is! But sometimes exercise feels a bit too much like… well… hard work. Not so with yoga. I started doing yoga a few months ago and I’m totally hooked – it has just the right balance of strengthening, balancing and heart-racing poses, and I love that we get to meditate after each class. I asked yoga teacher Tasha Saha why she thinks yoga is particularly good for diabetics.

“As well as better fitness and cardiovascular health, yoga massages and stimulates the function of the internal organs, balances the endocrine system and has measurable effects on the release of stress hormones,” she says. “All of these are factors that affect blood sugar, so it’s no surprise that several major studies have shown that regularly doing yoga can significantly reduce blood sugar levels.” Another aspect of yoga that sets it apart from other exercise is that it increases body awareness, which makes it easier to maintain a healthy weight and to make wiser food choices.

But which yoga to choose? In general, hot yoga (Bikram) and flow yoga (Ashtanga) are more demanding, so it’s better to begin with a slower practice like Hatha or Iyengar. Some poses (especially those that are active in the abdominal area and lower back) are particularly good for diabetics because they target the pancreas, promoting better function and helping to lower blood sugar levels. “But a balanced yoga session will work holistically on every system in the body,” says Tasha, “as well as the mind and emotions too – lowering stress levels and helping the whole person towards balance.”

I can honestly say that my yoga practice has helped me feel not only stronger and fitter, but calmer and more able to take on the daily challenges of diabetes.

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

Find a yoga teacher in your area
Or visit Tasha Saha

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.

Exercise classes for diabetics

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


Latha Singh: Chatsworth, Durban

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

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

My classes are currently at:

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

Email Latha to find out more.

 

Kayla Murphy: Randburg, Johannesburg

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

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

Email Kayla to find out more.

Download (PDF, 1.05MB)

10 Fast facts about diabetes as you get older

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

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

Yoga may help reduce heart disease risk

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

Heart disease a risk for people with diabetes

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

Yoga as a means to reduce cardiovascular disease risk

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

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

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

Yoga and aerobic activity a winning combination

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

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

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

Reflexology and diabetes

Bridget McNulty finds out what reflexology is all about, and if there’s any chance it can help those with diabetes.

Before I went for a reflexology session, I didn’t know much about it. I knew it was more than a foot massage, but didn’t really see how pressing a few points on my feet could affect my health and wellness.

Reflexology, it turns out, is a therapy that uses specific finger, thumb and hand pressure techniques on the different reflex areas, or zones of the feet, to correlate with different organs of the body. A reflexologist can tell you a lot about your body by feeling for congestion and imbalances in the feet, which show up as tightness, sensitivity or grainy areas. They can also ‘read’ the feet: the shape of the feet, the valleys and peaks, and how they respond to pressure.

The South African Reflexology Society has been recognized by the medical profession, and all reflexologists have to register with the Allied Health Professions Council. But what does a reflexology session actually feel like? Well, at first it is a little uncomfortable. The therapist looks for areas of tension or imbalance, and these are rubbed or pressed until they loosen. It’s like having a really firm massage: not painful, but not necessarily soothing. It is deeply relaxing, though, an hour of having your feet worked on feels like a few hours of sleep, and Lulu Beyers, the therapist I went to, says she has a lot of insomniacs as patients!

Reflexology, like most alternative therapies, has to be given on a regular basis to really see the results and changes in the body – the changes are slow but can be very positive, especially when it comes to treating complications of diabetes, like numbness in the feet. There have been a number of studies done on diabetes and reflexology (including self-reflexology, like the example below). The studies are mainly in Korea and China, as reflexology is an accepted form of healing in the East. (It began in 2330BC in Egypt, then spread to India, and from there to China and Japan.) Many of these studies show that reflexology is helpful in improving peripheral neuropathy, especially tingling sensation and pain, as well as slightly lowering blood sugar – perhaps due to a reduction in stress from the relaxing nature of the treatments – and an improvement in fatigue and mood.

Whether this is because of the nurturing nature of the treatments, an improvement in blood circulation from the massaging movements of reflexology or because of the endocrine system (especially the pancreas) being activated through pressure points is still to be discovered. But there is certainly no harm in having reflexology as part of your diabetes programme. Think of it as putting your feet up on the diabetic table, made up of the right medication, a healthy diet and regular exercise.

Try out this simple self-reflexology at home:

Press on each of these glands of the endocrine system (pictured below) with the base of a ball point pen for a few minutes at least once a week.

Ask the expert: Andy Blecher, podiatrist

“In my opinion, having time out to put your feet up and have them massaged can be good for your overall wellbeing – and if there’s some evidence that it helps with circulation and peripheral neuropathy in diabetics then patients should give it a try.”

Find a reflexologist in your area: www.sareflexology.org.za
Or visit Lulu Beyers in Cape Town: www.white-lotus.co.za

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

Diabetes dietary tips

Ajita Ratanjee is a registered dietician on the Sweet Life Panel of Experts. She shares some of her diabetes dietary tips with us today.

Blood sugar control is of the utmost importance for a diabetic. To date, many diabetics have a challenge keeping their glucose levels controlled. A combination of the following 3 factors ensure good glucose control:

  1. Use of medication (oral meds or insulin injections)
  2. Diet
  3. Exercise

Foods to avoid

Most diabetics I meet are familiar with the “AVOID” list of foods. These are the obvious sugars e.g. Sugar, sweets and chocolates, sugary cooldrinks, cakes, pastries, biscuits, ice-cream, puddings etc. If you’re a diabetic and continue consuming the above list, then you are literally accelerating the chances of complications of diabetes: nerve damage, blurred vision, kidney failure, sores on feet etc.

However there are many who are compliant with the “AVOID” list yet may still find that their blood sugar levels remain elevated. Many years of clinical experience working with diabetics has allowed me to create a shortlist of other foods that are most likely spiking your blood sugar and you’re not even aware they are the cause. They are “healthy” food choices; however they tend to spike blood sugar and are not the best choice for a diabetic.

Other foods that spike blood sugar

These foods should also be avoided:

  • any 100% fruit juice,
  • dried fruit,
  • energy drinks,
  • flavoured bottle water,
  • energy bars,
  • muesli (containing nuts and dried fruit),
  • popcorn, and
  • rusks.

100% Juices and dried fruits are a concentrated source of natural sugar resulting in blood sugar elevation. Most energy drinks are loaded with sugar and are not suitable for diabetics. Energy bars tend to be marketed as low-fat, however that is not the same as sugar free (at all!)

The important thing to remember is that a diabetic should be aware of all foods that elevate bloods sugar levels. Grains, fruit and vegetables are all healthy but they need to be eaten in the correct portions to keep sugar controlled. Protein helps to stabilize sugar and thus an extra serving of meat / fish / chicken / egg etc. will not elevate glucose as much as an additional slice of bread / rice / potato.

The magic diabetes diet lies in the correct proportion of carb to protein at meals and snacks, and the correct portions at every meal and snack.

Choosing the right food

Fatty fish are high in omega 3 – tuna, sardine, salmon and mackerel are high in essential fatty acid. These are protective towards cardiovascular health and have anti-inflammatory properties. Diabetics are at high risk of heart disease thus omega 3 supplements are highly recommended. Make sure that you use good quality omega 3 that is heavy metal free.

Alcohol is metabolized as a sugar so plan in your glass of wine (preferable red and dry) or whiskey.

My key message in a nutshell would be it’s not just about “no sugar” but rather getting the carbohydrate and protein balance. Test your glucose regularly; at different times of the day. This enables you to monitor your control throughout the day. Test your sugar before a meal or 2 hours after a main meal. Keep a record of your blood sugar readings.

At Easy Health Wellness we assist our clients by teaching them how to exchange carbs and how to count carbs to ensure that they always are in balance at each meal and snack, and they can enjoy variety in their eating plans. We also stock a fabulous range of sugar-free products to support our diabetic’s client needs.

The diabetic way of eating is a very healthy way of eating. We can all do with avoiding the refined carbs and eating regularly.

Find out more at www.easyhealthwellness.com or call 012 997 2783.