diabetic advice

Diabetes and Alcohol

Do you drink alcohol? Do you know how it affects your blood sugar? Here’s some fantastic advice from community member Ane on how to deal with drinking and diabetes:

I’m a second year student in Stellenbosch, which is not very helpful with all the beautiful wineries etc here for a type 1. I do, however, prefer to either drink nothing or drink something I know will not have an impact on my sugars too much. The problem with alcohol is it makes your sugar drop rapidly when too much alcohol is in the blood without sufficient carbs to keep levels stable. This is a confusing concept since 275ml of beer = 5 slices of white bread = carb overload!
Do not drink cocktails. Nor shots. Ever. Try to avoid cloudy drinks as well.
I would recommend not drinking and drinking Coke Light or water (much much cheaper) or if you have to drink and want to, have some whiskey or champ. (Whiskey is your best option, and champagne is regarded the best type of drink for ladies with Type 1 diabetes.)
Always always have a friend with you that will not get drunk. In the (hopefully) unlikely event of a hypo, people will think you are drunk since it looks 100% the same in a club at 02:00..
Keep carbs with you at all times, and never drink on a empty stomach.
Set alarms in the morning to make sure that you don’t get a hypo. Rather little higher than too low.
Wear something to say that you have type 1 diabetes..
Remember, we are all curious at some point in time about alcohol (and a lot of other things that have an influence on our levels) We try things, make mistakes, learn and educate others. Everyone is different, this is my opinion since I have experience.. Hope it helps!

drinking and diabetes

Humans of South Africa

Hi there,

I am a writer, copywriter and journalist; I have been running Humans of SA for 2 years – we also have a Facebook page. I wanted to create a space where I could share South African stories. My aim has always been to open windows into worlds we might know nothing about. I interviewed a lady recently who lost her father to diabetes.

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She speaks about a lack of understanding in terms of care and treatment. I feel it is important to bring attention and help create more awareness by telling stories of people who are diabetic, of professions who can advice and help.

If you have a story you are happy to share, please get in touch by emailing me.

Thank you!

Sandy

Emotional Help for Diabetic Child?

Hi there,
My daughter has been a Type 1 diabetic for 2 years+ now. She is 10 years old.

Do you perhaps know of a natural product that I can give her to help her emotionally. She’s been very emotional the past couple of months (sometimes really mad and other times really sad). It really is sad and bothers me so much to see her this way, but I don’t like just giving any chemical medicine. I’d like to know which natural products have other mothers been using and obviously the ones which works the best without any negative results.

Would really like your feedback as soon as possible.
– Carolien

Spiking Blood Sugar Levels after Breakfast?

Hi,
Seriously confused.
I have Type 2 Diabetes and am on Lantus (12 units) and Galvusmet (50/100 twice daily).
My averages are okay (I think) – my range settings are Low: 5; High: 8.5.
Here’s my issue.  My postprandial levels after breakfast stay high, no matter what I eat.  I usually measure between 5.5 and 7 when I wake up and rarely see a jump of more than 2 after lunch or dinner.  After breakfast, however, my levels often jump to 9 or 10 or above.
What has me stumped is that this happens even when I have Greek Yoghurt (full fat), 24 Almonds & Glucerna powder.  Greek yoghurt has a GI value of 33, Glucerna about 53 and Almonds Zero!  The spike is less when I leave out the almonds, but those are supposed to have no impact on sugar levels at all.  Go figure.
Any ideas?
As an aside, when I complained about not being able to eat pizza, an old guy who has had diabetes forever suggested I drink a Hunters Dry Cider before I eat pizza.  No idea why, and I rarely succumb to the temptation, but it works.
Be well.
– Gideon

Diabetic Eye Problem

Hey,

I’m Nicolene from Bloemfontein, I’m almost 19.

I was at the doctor today for my eyes. I have bleeding in the back of my eye. Just want some advice how can I make this better?

The doctor said less sugar and sugar controlled. Just want to know who also has or had bleeding in the back of their eye on this page and what did they do to make it better etc.

Thank you,

– Nicolene

Diabetes Chats: Meet the Expert

Every Wednesday at 8pm, the Sweet Life diabetes community gathers together on Facebook (over at Diabetic South Africans) to talk about all things diabetic-related. Ever wondered who runs the chats? Meet Leandra Thompson, our wonderful diabetic chat expert!
Leandra

 

1. How long have you been diabetic?

I was diagnosed with Type 1 diabetes at the beginning of 2006. I also don’t really refer to myself as being diabetic. I know it is just a word, but I tend to feel that “being diabetic” makes it sound as though “diabetes has me” rather than the other way around. It almost makes me feel defeated. I like to think that “I have” diabetes. I control it, even though this is definitely not true a lot of the time.

2. What’s the most challenging part about diabetes for you?

The most challenging for me are those curve balls – you know how today your regime just works perfectly, and if you do it exactly the same on another day you get the complete opposite results. So I guess put simply I find the inconsistency of diabetes the most challenging.

3. What’s the best thing about being diabetic?

Eating speckled eggs when low and not feeling any guilt whatsoever!
But more seriously, there really is nothing I could say I like about diabetes. Having diabetes has made me more aware of my body and my health generally. It makes me eat healthier (more than I might have had I not had diabetes) and I am constantly aware of what I am eating (especially because of carb counting). I also try to be active, considering I work 9 – 5 (at a desk), so time is scarce. I can truthfully say that had I not had diabetes I would likely not have been as aware of these things, or considered them as important as I do now. Although, there is still a lot of room for improvement.

4. What do you love about the diabetic chats?

For me, connecting with other people with diabetes is important. Since I was diagnosed I sought peer support online. Mostly these are not local, and I always wished we had more local support – not medical support, just support from other who are going through the same thing and having similar issues each day. The friends I have made online have been awesome – from abroad I actually met a few for dinner about a year ago in Melbourne. And I also have a very close friend from NZ who I’ve never met – but we message one another and stay in touch all the time, even sending gifts to each other’s kids. There are certain things only someone else with diabetes “just gets”.

5. What makes your life sweet?

The most adorable, sweetest, funniest, and all-round best kid in the world, Cameron,  my only son (and only child).
Join Leandra for this week’s diabetic chat on Facebook at 8pm on Wednesday!

Pregnancy and Diabetes

We’ll be devoting a whole issue of Sweet Life magazine to pregnancy and diabetes next year, but for now here’s a taste of Sweet Life editor Bridget McNulty’s experience with Type 1 diabetes and pregnancy… Published in The Daily News newspaper last week.

Read the article online here.

 

Ready for an Insulin Pump?

insulin pump

In issue 12 of Sweet Life magazine we interviewed insulin pump expert (and user) Imke Kruger about her experiences with the insulin pump – and got her to answer your questions. Take a look at the article, here.

Here are some more of your insulin pump questions, answered by Imke, the Product and Sales Manager for Insulin Delivery Systems at Roche Diabetes Care.

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

The cost implications depend on a few aspects, one being the type of medical aid plan, and whether the particular medical aid covers the costs fully or partially. It would be best to discuss this with your healthcare professional or your medical aid. In order to buy a pump, 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.

How do I apply for a pump that I can afford?

You need to visit your doctor. If they agree that pump therapy is the best option for you, depending on your medical aid, the doctor will send an application to the medical aid. We at Accu-Chek® can also assist you with this process. You can contact me via email or alternately you can call the Accu-Chek® Customer Care line on 080- Diabetes/ 080-34-22-38-37

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

In short, insulin pump therapy improves metabolic control while giving you greater freedom and enhanced quality of life.
• Your metabolism stays more stable, with better HbA1c values and fewer episodes of hypoglycemia
• You may enjoy greater efficiency and more energy, even in times of stress or an irregular work schedule.
• 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
I would say the disadvantages are that you have too much freedom in making food choices. There is a risk of diabetic ketoacidosis (DKA) from pump malfunction or absorption problems.

Deciding on insulin pump therapy is not a simple decision and should be carefully considered with the help of your healthcare professional team. However, feedback from many pump users, physicians and other healthcare professionals show that they are very satisfied with the results of Insulin pump therapy.

How would the insulin pump be used for sports? Are there special casings made or will I have to play without it? For example, a cricket game with a long duration and the risk of the pump being hit by the ball.

You can engage in any kind of physical activity while wearing an insulin pump. However, for sports involving intensive body contact and water sports we recommend temporarily disconnecting the insulin pump, but not for longer than 1 hour. We have special cases and pouches that protect the pump that would enable you to play cricket with the pump. However, we do advise patients to insure the system, for 100% assurance.

What is the risk of infection?

If you follow the right hygiene steps, the risks are low. You should always disinfect your insulin pump site before inserting the infusion set. It is also critical to replace the infusion set every three days as per the package insert of the product. In rare cases, patients can be allergic to the adhesive plaster, and need to use a tegaderm plaster underneath the infusion set to prevent allergic reactions.

How do I know if I’m ready to pump?

Visit our website to find out all the details you need: from how pump therapy is different to multiple daily injections, to how pump therapy benefits your help, how to wear and handle the pump, what a typical day looks like, what features to expect and how they make your life easier. There’s also a questionnaire. some FAQ, and all the contact details you need. What are you waiting for? Find out if you’re ready to pump.

Blood Sugar Testing Tips

Blood sugar testing tips

In issue 10 of Sweet Life magazine, we give some great blood sugar testing tips… Here are some more tips to bear in mind from Diabetes Nurse Educator Kate Bristow:

  • Your blood sugar test is your day to day monitor – use it to test and understand your diabetes and the way it affects your body. Different people react differently to foods, illness and stress. Testing helps you understand how you as an individual deal with different situations.
  • When pricking your finger, the sides of the fingers towards the tip are less sensitive than the middle pad of the tip of the finger.
  • If you are on a long acting and rapid acting insulin (i.e. 4 injections a day) it is better to adjust your rapid acting insulin that is given with meals, according to the carbohydrates on your plate. This is called carbohydrate counting and your dietician can teach you how to do it. It gives you better accuracy and less risk of lows and highs in your blood sugar provided you are doing it right.
  • Diabetes Educators and some doctors can download blood sugar meters on to their computers giving an accurate pattern for interpretation. Of course this is only as good as the number of tests done. For example, if one is only testing at the same time every day we are not going to get as much information as someone who is testing before and 2 hours after every meal. Again your educator can help with a testing schedule which fits in with your lifestyle and is not too arduous.

Do you have any questions about blood sugar testing?

Two Meals Better Than 6 for Type 2 Diabetes?

Small meals

The latest diabetes-related research suggests that those who have Type 2 diabetes may reap more benefit from eating two large meals a day, rather than the traditional view of six smaller meals. Pippa Stephens from the BBC, reports that the new research from Prague was conducted using two samples sets of 27 people. One group was fed two meals a day – breakfast and lunch – and the other group was fed six smaller meals. The number of calories contained in both groups’ meals were equal. At the end of the study, the volunteers who had been eating two meals a day were found to have lost more weight and have lower blood sugar levels. Previous diabetic diet regimes were based on the assumption that eating small amounts of food regularly would be more beneficial in controlling levels of blood sugar. The Czech research calls this into question.

How the study quantifies the new claim

Kathleen Lees details the specific nature of the tests. The study was undertaken by researchers at the Diabetes Centre, at the Institute for Experimental and Clinical Medicine in Prague. Researchers selected “54 patients between the ages of 30 and 70. Participants were initially divided into two equal groups, and followed a diet that either consisted of six smaller meals or two larger ones, both containing around 1,700 calories, to include 50-55% of energy from carbohydrate and under 30% of energy from fat. Three months later, the groups switched their diet regimens.”  Diabetes.co.uk noted that although all participants lost some weight, “the 2 meal diet was more effective, resulting in an average 3.7kg weight loss compared with a 2.3kg weight loss on the 6 meal diet.” Those on the two meal diet also experienced greater improvement in fasting plasma glucose levels. The study also noted that “reductions in HbA1c were modestly improved in both groups by around 0.25% (3 mmol/mol).”

Drug assistance

In South Africa, this new research could be used to great effect following last year’s announcement that the canagliflozin drug would be made available to treat those suffering from Type 2 diabetes. Jo Willey reports that the drug, also known as Invokana, “cuts blood sugar levels in people for who diet and lifestyle measures or other blood sugar-lowering medicines do not work well enough” and “blocks the re-absorption of glucose in the kidneys, which is instead passed in the urine.” Whilst the drug’s availability in Africa, America and Asia was confirmed last year, it has only just recently been approved for use in the European Union, where it is being hailed as an important and welcome announcement for those with Type 2 diabetes. Center Watch reports that research is underway in multiple global locations, including several in South Africa, “assess the effectiveness of the co-administration of canagliflozin and metformin extended release (XR) compared with canagliflozin alone, and metformin XR alone in patients with Type 2 diabetes.” This study is sponsored by the drug’s manufacturer, Janssen, and aims to be completed in 11 months.

According to Diabetes.co.uk, “people who are diagnosed with a chronic physical health problem such as diabetes are 3 times more likely to be diagnosed with depression than people without it.” Prescribed anti-depressants are a common treatment for depression, but can have negative effects, including addiction. There is plenty of guidance available online to help friends and family find the right support and treatment for a loved one. Rehabilitation organisation, We Do Recover, run a number of rehabilitation centres across South Africa, including Johannesburg, Cape Town and Pretoria.

Whilst the new developments in the treatment of Type 2 diabetes is undoubtedly welcome news to those with the condition, as well as their friends and family. It should be borne in mind, however, that the research in Prague was undertaken with a relatively small sample set. A great deal of further study needs to be undertaken to refine what has been learned from that study. Likewise, although canagliflozin has been made available, research into its use, and its use as combined with other drugs is ongoing. Despite this, there is no doubt that treatment for Type 2 diatbetes is most definitely looking up.

– by Lily McCann

References

“2 larger meals beats 6 much smaller meals for type 2 diabetes.” Diabetes.co.uk. http://www.diabetes.co.uk/news/2014/may/2-larger-meals-beats-6-much-smaller-meals-for-type-2-diabetes-95702186.html (accessed May 17, 2014).

“Addiction, Durban.” Johannesburg Rehab Centre. http://wedorecover.com/sa-rehab-centres/johannesburg.html (accessed May 17, 2014).

“Clinical Trial Details.” A clinical trial to evaluate treatments using Canagliflozin 100 mg, Canagliflozin 300 mg and Metformin XR for patients with Diabetes Mellitus, Type 2. http://www.centerwatch.com/clinical-trials/listings (accessed May 17, 2014).

“Diabetes and Depression.” Diabetes.co.uk. http://www.diabetes.co.uk/diabetes-and-depression.html (accessed May 17, 2014).

Lees, Kathleen. “Could Two Large Meals Help Better Manage Type 2 Diabetes than Six Snacks?.” Science World Report. http://www.scienceworldreport.com/articles/14765/20140516/could-two-large-meals-help-better-manage-type-2-diabetes-than-six-snacks.htm (accessed May 17, 2014).

“News.” Latest Data for Type 2 Diabetes Treatment INVOKANA (canagliflozin) to be Presented at American Diabetes Association Annual Meeting. https://www.jnj.com/news/all/latest-data-for-type-2-diabetes-treatment-invokana-canagliflozin-to-be-presented-at-american-diabetes-association-annual-meeting (accessed May 17, 2014).

Stephens, Pippa. “Two meals a day ‘effective’ to treat type 2 diabetes.” BBC News. http://www.bbc.co.uk/news/health-27422547 (accessed May 17, 2014).

“Your Guide to Xanax Detox Centers and Programs” Detox.net. http://www.detox.net/articles/xanax-detox/ (accessed May 17, 2014).

(image from here)