diabetic advice

Diabetics ask others with diabetes for advice.

10 Fast facts about blood sugar testing

If you’re diabetic, you probably know all about testing your blood sugar… But are you doing it the right way? Here are some top tips.

  1. The goal is always to keep your blood sugar in a healthy range: not too high and not too low.
  2. Checking your blood sugar often makes it easier to understand the relationship between blood sugar levels and exercise, food, medication and things like travel, stress and illness.
  3. Blood sugar readings also give your doctor, diabetes nurse educator or clinic sister information to help you adjust medication and food, if your numbers are often too high or too low.
  4. Modern blood sugar meters only take 5 seconds and need just a tiny drop of blood.
  5. Pricking the tip of the finger is the easiest place to get the drop of blood.
  6. Before you test, it’s important to wash your hands with soap and water and dry them properly.
  7. Type 1 diabetics should test before every meal, to decide how much insulin to take.
  8. Before a meal, blood sugar readings should be 4 to 7mmol/l*.
  9. Two hours after a meal, blood sugar readings should be 5 to 10 mmol/l*.
  10. Keeping a blood sugar log is a very helpful tool for all diabetics. Write down your blood sugar test results, along with the date, time and what food you ate. This can make it easier to see if there are patterns in your blood sugar readings.

Advice for parents of Type 1 diabetic kids

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.
Wayne

Allow your kids to have a say and let them see the effects. Never wrap them in cottonwool! Let them live, learn and experiment!
Isabella

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.
Kerry

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
Natasia

Hi there my daughter is 3 years old and Type 1 diabetic, she was diagnosed last year two weeks before her 2nd birthday.
Anthea

Belinda there are LOTS of us – join the Facebook group Kids Powered by Insulin.
Tiffany

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.
Elmarie

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.
Georgina

Thank you everybody for the reply. I am feeling much better that there are so many parents that are prepared to give me advice!
Belinda

Spreading the word about diabetes

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

How long have you been diabetic?

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

Was your diagnosis a surprise?

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

Are any of your family members diabetic?

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

Do you ever talk about diabetes on air?

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

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

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

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

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

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

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

What advice would you offer to diabetics who are struggling?

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

What makes your life sweet

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

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

Your insulin pump questions, answered

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:

 

  1. 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.
  1. 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.

  1. 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.

  1. 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.

  1. 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.

  1. 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

  1. 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.

  1. 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.

  1. 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.

  1. 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.”

 

Keeping diabetics inspired

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

What got you interested in diabetes at first?

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

How did you start your community group?

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

What keeps you inspired?

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

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

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

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

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

How do you make diabetes inspiring?

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

What makes your life sweet?

Carrying out our mission, vision and outcome.

S – be sensitive towards all

W – warn people about the consequences of not being compliant

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

E – be empathetic and empower people with knowledge

T – to be trained, to train others

Outcome:

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

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

Ice skating with diabetes

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: ray.durban@gmail.com  

All about insulin

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

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

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

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

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

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

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

Are there any benefits to starting insulin sooner?

 

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

Can’t get blood sugar down?

From our community blog:

Hi!
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?

– Kerissa

Comments:

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:

  1. 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.
  2. 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!

Elrica

Hi Kerissa,

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.

Morne

Diabetes in the community

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

What does the Department of Health offer those with diabetes?

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

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

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

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

Why is diabetes a priority in South Africa?

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

What makes your life sweet?

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

The challenge of brittle diabetes

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

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

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

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

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

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

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

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

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

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

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

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

– Rencia Gabriel-Phillip

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

Crazy blood sugar fluctuations?

From our community blog:

Good morning,

I am in urgent need of assistance to help me get my diabetes / blood sugar levels in control and I’m actually almost on the brink of losing it… I’m struggling with sky high sugar levels and very low sugar levels, but it’s never between 4 and 6, it’s either lower, very low, or very-very high! I don’t know what to do anymore…

Please give me some advice. I am 28 years old, and have been diabetic since I was 9 years old.

Please help!

– Vasti

Comments:

Do not give up. If you are in a position to visit a Provincial Hospital do so. I want you to see a doctor please, for expert advice, as you need to undergo tests.
Krish

Dear Vasti
Sorry to hear that you are struggling with your diabetes. It is difficult to know how to help unless I have some information about types, doses and frequency of injections as well as some glucose values. You need to test and establish a pattern as to when the problems occur and in relation to what. Blood sugars that swing up and down cause more problems than those that are more stable. I suggest you establish a testing profile and then post again.
Regards
Lyn

Hi Vasti,

I have been a diabetic for 9 years as well and I am also 28 years old. You need to take a look at your diet and your lifestyle. From your email you sound like you are under a lot of stress and that is not helping your diabetes. With your sugar levels being so out of control your moods get affected badly. So strange how sugar levels have this effect on us but very true. You need to eliminate as much stress from your life as you can. You can get back to where you need to be as long as you take the day by day steps.

Your eating is very very very important and if you can try to exercise you must. When I was first diagnosed mine used to sit in the 30′s NOT GOOD! But now I am between 5-8 most days. I know that there are days when it is hard to keep your sugar levels under control but YOU CAN DO IT!

Please let me know if I can help with anything!
Thanks
Angela

Using laughter as medicine

You would never guess that Trevor Davids, a business consultant, film and TV producer and biker filled with the joys of life, has Type 2 diabetes. That’s because he’s managed to take diabetes in his stride.

When did you find out you were diabetic?

Six years ago, in November 2010. I had all the usual symptoms – constantly thirsty, needing to urinate a lot – and I looked them up on the internet. Up came: diabetes. I read up on the condition before going to the doctor, and then announced, “I have diabetes.” We took the necessary tests and my blood sugar was really high (18mmol/l), so I was put onto insulin tablets immediately. Diabetes doesn’t run in my family, I’m not overweight and I do a lot of exercise, so I’m not a typical Type 2 case. I do have high blood pressure that runs in the family. When I was diagnosed with diabetes I had already given up alcohol ten years before, but I was smoking 40 cigarettes a day, so I had to give that up too. After 31 years of smoking, I quit on the first try. Once I make up my mind about something, there’s not much that can move me.

How has diabetes changed your daily life?

I’m a lot more conscious of my eating patterns now. I never used to eat breakfast – I’d grab something on the run, snack in the afternoon, and then eat a big plate of food in the evening. I had to learn to be less flexible about food. Eat a regimented breakfast, lunch and dinner, look at my intakes and learn about low GI. I couldn’t have done it without my family – my wife Norma and son Danté have been the most amazing support.

How do you manage to focus on the lighter side of living with a chronic condition?

I never focussed on the darker side of diabetes! I’m a very positive person, I like being focussed on doing something well. In challenging times, I just take it in my stride and deal with life’s knocks as they come.

Is there anything diabetes has stopped you from doing?

No. Only smoking! I’ve actually been able to take on more daily life challenges since being diagnosed, because I restructured and reorganised my life, so I now have more time.

What advice would you offer to other diabetics?

If you’ve just been diagnosed, don’t worry – it’s not as daunting as you think. It can become a lifestyle condition, you just need to adapt your lifestyle. Diabetes is part of who you are now, and denying it doesn’t make it go away.

What makes your life sweet?

Life itself! And my family, of course. And laughter: the ability to laugh and create a laugh. I believe that people can live a long time if they can learn to laugh in the face of adversity. I like to use laughter as part of my medication.

Maintaining a healthy weight with diabetes

Whether you battle to lose weight, or struggle to gain it, maintaining a healthy weight is a constant battle for many people with diabetes. Joanne Lillie explains how to make lasting changes.

Putting on weight

Controlling blood sugar levels is the starting place for achieving your target weight with Type 1 diabetes, as high blood sugar levels will cause glucose to be lost in the urine and result in weight loss, says dietician Genevieve Jardine. Many people find that once their glucose levels are under control, weight management becomes much easier.

Top tips to build mass:

  • Go for low GI: To balance your glucose levels, lower-GI carbs such as wholegrains, beans, sweet potatoes and some fruit (like plums and apricots) are great choices, as they are less likely to spike your blood glucose. Milk and yoghurt also have a low GI. Just remember that low GI food still has to be eaten in the right portion.
  • Eat more often: Rather than three meals a day, eat six smaller meals a day. Check your blood sugar more often and inject accordingly if you decide to try eating this way. Don’t skip meals as you will miss opportunities to increase your calorie intake.
  • Fat has more calories than carbohydrates or protein: fat contains 9 calories per gram, while carbs and proteins contain 4 calories. So it makes sense to eat more fat when you’re aiming to put on a few pounds. Just be aware that you need to choose healthy fats. Cook with more olive or canola oil, get plenty of nuts and seeds, and add avocado and olives to salads.
  • As long as your kidneys are in good shape, you can add protein powder to yoghurt or smoothies. This helps you gain weight as lean muscle mass rather than fat.


Losing weight

A normal body mass index (BMI) is vital for people with diabetes. “As the BMI increases, the amount of insulin required to maintain a normal glucose level also increases because patients become more insulin resistant,” explains endocrinologist Dr Joel Dave.  An elevated BMI is also associated with high blood pressure (hypertension) and high cholesterol (dyslipidemia).

Healthy eating, regular physical activity, and medicine (if prescribed), are the key elements of Type 2 diabetes management. For many people with diabetes, the most challenging part of the treatment plan is working out what to eat.

Top tips to lose mass:

  • Aim to reduce your energy intake while sticking to a healthy eating pattern. This means getting all the nutrients you need, in as few calories as possible. How? By focusing on nutrient-dense foods such as green vegetables, some fruits (especially berries) and beans.
  • Carbohydrates from vegetables, fruits, wholegrains, legumes and dairy products are better than from other sources, especially those with added fats, salt and sugar. The most carb-dense foods include those with refined white flour: breads, biscuits, pastries, cakes, as well as white rice and potatoes. Limit these as much as possible!
  • A Mediterranean-style diet may boost weight loss and benefit blood sugar control and cardiovascular risk factors. This means:
  • Eating mostly plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts
  • Keeping carbohydrate levels as low as possible
  • Using healthy fats, such as olive oil
  • Using herbs and spices instead of salt to flavour foods
  • Limiting red meat to no more than a few times a month
  • Eating fish and poultry at least twice a week

Ask the expert: Genevieve Jardine, dietician

“Learn to respond to hunger and not appetite. Often a high carbohydrate diet makes people hungry whereas enough protein and healthy fats helps make people feel fuller for longer.”

How to eat seasonally

I don’t know about you, but I love the idea of eating only what’s in season. Fresh fruit and vegetables are obviously at their most abundant when they’re in season, and I like to only eat what’s local and fresh (don’t we all?!) It’s not always that easy to know what’s in season, though, and what to look out for. That’s why I love this seasonality calendar we were sent – take a look below and download a PDF if you’d like to keep it.

Happy cooking – and eating!

Seasons change, and so should the fruits and veggies you put onto your plate. Eating seasonally is tastier, more cost effective and sustainable. Chef James Diack, one of South Africa’s pioneers of provenance, has taken the concept of seasonality even further by producing a Seasonality Calendar for South Africans as a guide on what to eat each season, and what they can expect to see on his plates during the months and weeks of the year based on the produce from Brightside Farm.

“Seasonality and sustainability are all about protection – protection of the environment, protection of our diners’ health and not least of all protection of animal health. All of our practices are geared toward these goals,” James says.

Download the calendar to keep on your fridge!

Download (PDF, 1.08MB)

Type 1 diabetic going through puberty

From our community blog:

Hi,

My son was diagnosed with Type 1 Diabetes about a year and a half ago.  His HbA1c hasn’t been great for the last few months – sitting on about 8. We seem to do everything “right” but for reasons we cannot understand we go through days with sugar levels that just won’t come down.

I now think that he is often injecting into scar tissue… He uses pretty much the same area to inject. I think he is finding it hard to inject anywhere else as it is a bit painful (he had a slight phobia of needles before being diagnosed). He is now 12 years old and is going through puberty so his body is changing and will need more insulin.

Any advice?? I’m feeling a little helpless at the moment.

We see his doctor every 3 months, but does anyone know of a nurse in the Fourways Johannesburg area who deals with Type 1 diabetics who we can perhaps see monthly to check his readings and perhaps guide us on eating, etc.

Thank you so much.
Warm Regards
– Candice
Comments:

Jen Whittall is in Bryanston
Kimberley

Hi Candice
You are quite spot-on with your own findings concerning your son. If he is currently injecting into the stomach, challenge him in injecting into the upper outer thigh. He should try to do this fast (like throwing a dart – playful challenging). When I changed my technique from a slow approach to the dart action, I never looked back. Just take note that the legs are active and blood glucose levels might drop faster than expected, especially if you are correct with your diagnosis of him injecting into scarred tissue.
Kindest regards
Marelize

Making diabetes delicious

It might seem as though being a restaurant chef would be too tempting a job for a Type 1 diabetic, but 30-year-old Vanessa Marx has made an art out of making healthy food delicious – and accessible.

When did you find out you were diabetic?

I was about sixteen and in high school – seriously bad timing! I had all the usual symptoms. I was drinking about four litres of water a day and falling asleep during class because I was so exhausted. My mom eventually suspected diabetes and I had to be hospitalised. It was a traumatic experience. I’ve always loved food, and I remember lying in my hospital bed naming all the foods I could never eat again… It was a long list!

How has diabetes changed your daily life?

That’s a hard question, because it’s so much a part of my daily life. It can be difficult, sometimes, explaining to people who don’t have diabetes how you’re feeling. If I wake up with low blood sugar, for example, I’m exhausted before the day begins. People understand a throat infection, but they often don’t understand what waking up low feels like. As a head chef, I need to be alert every day, taking charge of the kitchen. There’s no room in a busy kitchen for feeling tired or unwell because of high blood sugar or needing time out to have something sweet because of low blood sugar.

Isn’t it difficult to be around food all day? How do you resist sweet treats?

It is quite tricky! Often just the act of making sweet treats for someone else satisfies the urge for me but other times I’m pretty tempted: what puts me off is that I know how I’ll feel later. I do believe in “everything in moderation”, so I allow myself a treat now and then. As long as it’s a once-off, and I’m not doing it every five minutes!

What advice would you offer to other diabetics?

Be disciplined! Pay attention to your diet: what you eat plays a huge role in how you feel. Also don’t feel like you’re on your own, don’t be afraid to ask for help – talk about your diabetes, and explain to those around you what it feels like. There’s still a stigma around diabetes, that it’s only people with weight problems who are diabetic. But the only way we’re going to change that is by talking about it.

What makes your life sweet?

My family and friends, and my work.

Get in touch with Vanessa: @vanessajaynem on Twitter and Instagram

Candy Tsamandebele: living with Type 2 diabetes

Indigenous Afro-Soul artist Candy Tsamandebele talks to us about living with Type 2 diabetes.

When did you find out you had Type 2 diabetes?

After the death of my son through an accident. It was unexpected to say the least.

Was it a shock?

Yes it was.

How did you have to adapt your lifestyle?

I started with what I ate and drank. It was difficult at first, but with time I got used to it.  Secondly, my lifestyle all together.

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

Sticking to a strict diet. Also understanding the consequences of ignoring that diet.

What advice would you offer to those living with diabetes?

Just take it one step at a time. Take your medications on time and eat healthy.

What makes your life sweet?

Music. It really does.

Some background on Candy and her outreach work:

August 2, 2011 was one of Candy Tsamandebele’s most trying times in her life when she lost her son in a car accident. Six months later she was diagnosed with Type 2 diabetes. Not one to be kept down, two years after the trauma, Candy garnered strength to launch CANDY TSAMANDEBELE FOUNDATION. She uses the foundation to teach young women and the youth in general about values and it is her vehicle to drive and leave behind a legacy as she continues to grow in the music industry.

The main aim of the Candy Tsamandebele Foundation was to teach kids about music, the importance of culture, significance of language, youth development, medical assistance, helping with school uniforms to needy, and several other initiatives that are close to her heart.

Every year Candy Tsamandebele dedicates her time to carry out community building initiatives such as visiting schools and donating school uniforms, as well as motivating the youth both in and out of school. She encourages young people to use their natural abilities and talents to make it through life. During her motivations, she always talks about the importance of getting tested for diabetes and other chronic conditions and adhering to taking treatment once diagnosed.

Since she was diagnosed with diabetes, Candy Tsamandebele has made it her mission to be a national diabetes warrior. She is a force to be reckoned with and she will stop at nothing for as long as she is needed to make a difference.

Find out more at www.candytsamandebelesa.com

A happy life with diabetes

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

When did you find out you were diabetic?

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

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

How has diabetes changed your daily life?

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

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

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

What advice would you offer to other diabetics?

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

What makes your life sweet?

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

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