type 1 diabetes
Information and questions about Type 1 diabetes.
Today, our guest writer Maryna shares some tips and advice from her travels… Specifically, travelling with diabetes. She’s outlined 8 helpful tips for travelling with diabetes. Do you have anything to add? Comment below, or on Facebook!
Adventures with diabetes
I love travelling. I’ve travelled overseas, I’ve travelled to remote places in the country with no facilities, I go camping a lot – especially in summer. I love seeing new places, meeting new people and just basking in a foreign sun. Insulin and glucometer in tow, I’ve spent ten days in the middle of the Karoo without electricity or running water. It wasn’t an easy task and required a lot of planning on my part, but it’s an experience I wouldn’t exchange for anything.
Going on holiday should be an exciting adventure filled with laughter and fun. Unfortunately, if you have diabetes it comes with its own set of troubles. Besides that annoying feeling that you forgot half of what you should have packed, you have a few extra factors to consider when packing that suitcase.
Easier to travel with diabetes now
Travelling as a diabetic has become much easier than it used to be. In 2002 when I went to the UK for the first time, I was still using syringes and vials and the ensuing three-hour debacle at customs left me crying and embarrassed in a busy corridor in the middle of Heathrow Airport. I had a doctor’s letter, I had a letter from the medical aid, but trying to get boxes of syringes over the border ended up being far more difficult than expected.
In 2018, Customs isn’t a worry anymore, in most cases authorities don’t even notice the pens in my hand luggage and when I declare my medicine, most flight attendees are too scared to take my insulin away from me and keep it in the cabin like they are supposed to. I don’t really need a doctor’s letter anymore since it’s now a rarity to be asked for one, and even the strictest airports don’t seem to bat an eyelid at my luggage.
There are a few tricks to making your travel experience as easy as possible. Here are my top eight tips for travelling with diabetes:
1. Travelling with insulin
Firstly and most important comes the insulin. The ins and outs of travelling with insulin can be a bit tricky, especially keeping your insulin cold enough. My solution came from the fitness industry: www.sixpackbags.com. These bags are made for bodybuilders to keep and carry their eight meals of the day. The bags are sneakily lined with small pockets for ice-packs, you can line the whole bag with icy goodness, and the bags are insulated very similarly to a coolerbox. It’s saved my insulin on numerous occasions, especially during long-haul flights or long road trips.
Always remember to take extra insulin! This I learnt long ago when I went on a sandy beach vacation. I never considered that sea sand is fine enough to slip between the seals in my epipen, which in turn makes the pen useless as it can’t turn anymore. Lesson learnt! The panic was very real and only after a whole day of going from pharmacy to pharmacy and eventually the hospital, was my problem solved… At a price. Always take extra needles with you and keep a doctor’s letter on you for overseas trips to satiate that one-in-a-thousand strict Customs employee.
2. Remember your water bottle
Secondly is water, always have water with you. It doesn’t matter if it’s an eight hour drive, 12 hour flight or a leisurely stroll on the beach. Water is a great way to help your insulin do its work. Since diabetics dehydrate faster than the norm, it’s important to have your liquid backup prepared.
3. Watch what you eat
Take into account that sitting for prolonged hours is most probably throwing off your daily routine, so check what you eat and drink while travelling. I usually eat far less while on the road or on a flight or I’ll pay the price later with a high blood sugar reading. Once you arrive, it’s important to watch what you eat as well – especially when you travel overseas. Foreign food is one of the best things when travelling, I love tasting new dishes and experiencing local food customs, but don’t be shy to ask what is in your delicious food and how it was made. You’ll regret it later if you ate something that doesn’t play well with your diabetes.
4. Be aware of water retention
Holding back water is normal when travelling for long hours. It can be uncomfortable and at times even painful. Personally it affects me for a couple of days when I’ve travelled for long and I’ve had some instances where I would have made balloons jealous with my puffiness. Invest in compression socks, which you can get at any Clicks or Dischem. Trust me, the last thing you want is huge “cankles” when you get off the plane, waddling like a duck for the first two days of your holiday.
5. Be (medically) prepared
Always make sure that your medical information is readily available. It sounds obvious, but I have been surprised by the amount of people that don’t have any type of indication of their diabetes on their person. Get that MedicAlert bracelet and wear it.
6. Pack carefully
Comfortable, worn-in shoes are a must. It doesn’t matter if your holiday includes a lot of walking or not, make sure those sensitive feet are comfortable. Combined with the water retention that you may experience, you might have less feeling in your feet, so make sure to check your feet more regularly, especially for blisters. In the last couple of years I’ve also started covering my lower legs when camping in the veld or places with rough terrain. The last thing you want is scratches and scrapes on your legs.
7. Test your blood sugar more often
This is not a must, but I find that my routine is completely topsy-turvy on holiday. I eat differently, my activities are different, sleeping patterns are strange, so I test my blood sugar more often. I carry my glucometer on me at all times during my trips. Depending on how sensitive your body is, even a slight difference can affect you. So listen to your body and make sure you are always ready for highs or lows or just a crazy surprise sunburn.
8. Enjoy yourself!
Possibly one of the most valuable tips I can give here is to enjoy yourself. If you are prepared, there is nothing stopping you from having a fun-filled, adventurous experience. Be vigilant, but not obsessive about your condition. Enjoy the sites, smells and surroundings, meet new people, experience something different. Travelling is an enriching experience, make sure you get as much as you can from it!
It sounds like a lot of effort, many things to remember and just a plain inconvenience, but trust me: being prepared will make your holiday and travelling so much more pleasant.
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.
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?
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.
PS: Kirsten is now a successful mountain climber and blogger – follow her adventures on Instagram: cape_town_adventurer
Our regular guest writer Maryna has some advice to share today about work stress and diabetes. How do you cope with work stress? Maryna shares some helpful tips that have made it easier for her to stay calm.
Stress and diabetes
Life is stressful. In my experience, diabetes and stress don’t play well together.
There are many factors that cause stress, some of them we have no control over, but other factors we can control. Personally, work life is my largest source of a clenched stomach, short breath and continual headaches. Gone are the days when loyalty and hard work paid off: this utopia that my parents so often talk about, I have never encountered.
In my youthful ignorance I chose to pursue a career in advertising. Now, I can’t speak for other industries. But I’ve certainly spent my last fifteen years working eighteen hour days, sleeping badly, drinking too much coffee, fighting stomach ulcers and being guilted into working weekends and holidays.
Constant work pressure
Rising up the ranks didn’t make things any easier, as the work and hours didn’t get any less, but the pressure and stress multiplied exponentially.
Don’t misunderstand me: I love what I do and I’m good at it. Most of my fellow creatives are amazing, brilliant people and the fact that I can wear what I want to work is a massive plus in my eyes! I’ve achieved what many others in the industry never do and enjoyed a career that has given me many opportunities to grow, but what did I sacrifice in the process?
It’s difficult coping in these high stress, high output environments, both physically and mentally. Adding diabetes to the already toxic mix makes it even harder. Looking back at the last couple of years, I can’t say that I would do everything over again and not regret it. My body and soul have taken a beating in so many ways and I certainly have the scars and stories to prove it.
Stress coping mechanisms (for a diabetic)
How do you cope in this crazy stressful world as a diabetic?
It’s taken me many years to learn this, but firstly: come to terms with your condition. I have this innate drive to not admit that anything is wrong with me. I spent years thinking that my diabetes was a weakness. Many of the things that my co-workers do effortlessly leave me in a near catatonic state for days. I have to sleep, I have to eat, some days I’m exhausted beyond measure, I get headaches, my ankles swell up, the list goes on and on, but it doesn’t make me a lesser employee.
Yes, I have issues, just like every other person around me. You have nothing to prove if you work at your best and deliver good work.
The secret here is that you can’t work your best if you feel like a half-asleep zombie all the time, and that’s a message that needs to come across to your superiors. Don’t let anyone guilt you into over-stretching yourself, don’t let anyone tell you that your diabetes is a problem. You can be just as productive as anyone else if you are responsible and give your body what it needs.
Be responsible for your diabetes
That brings us to point number two: be responsible. You, and only you, know your limits, and it’s different for all of us. Say STOP when you need it, and if your boss has a problem with that, then he’s most probably not a very good boss.
Look after your well-being, not only physically but mentally, I have found that your mental health has a lot more to do with healthy blood sugar levels than we are led to believe.
I am a strong believer in meditation and it has helped me to control my raging stress and emotions over time. This might not be true for you, it could something as simple as going to the gym every day or as complex as building a ten thousand piece puzzle. Find that thing that makes you calm. Find the space that gives you time to contemplate, analyse and solve your problems.
Educate others about diabetes
Thirdly: make sure those closest to you at work can recognise the signs when you lose the plot. Over the years I have become a master in casually talking about my diabetes, not in an aggressive or “feel sorry for me” way, just a casual chat. Educate those around you about your symptoms. I’ve found that at times I get so distracted by my work or a specific problem, that I don’t notice what my body is telling me. We’ve all had that unpleasant surprise hypo, that sneaks up from behind and leaves you a blubbering, confused mess.
Fortunately, or rather unfortunately for those around me, I turn into the proverbial bear with a thorn in its paw, so it’s obvious when my blood sugar is on the low side. Always make sure that there is at least one person who can recognise the signs and make you aware of them before you get into trouble.
Lastly: if your gut is telling you something is wrong, there’s most probably something wrong. Go to the doctor if you feel anything odd is going on in your body. Stress does strange things to you: I’ve had everything, from odd circular dry patches on my skin to a septic ulcer that landed me in hospital with a sugar count of 48 mmol/L and a near-death experience. Needless to say, that experience taught me that you can never be too careful or vigilant when it comes to your diabetes.
Our bodies tend to react a lot more violently to issues that most non-diabetic people just brush off as nothing. Learn to know your body and how it reacts to different situations.
There is no right or wrong way to deal with stress. Be aware of what your body is telling you and take responsibility for that. Learn what helps you deal with your circumstances and practice that. Don’t be afraid to stand your ground and defend your own health. Care for yourself and your work will surely flourish.
Victoria wrote to me last week with this glimpse of life with a Type 1 diabetic husband…
“Diabetes…. Uugh.” That feeling pretty much sums up what diabetes burnout is all about: the feeling that it’s too exhausting / frustrating / unpredictable / impossible to manage your diabetes, so why even try? Diabetes burnout is common in people with diabetes (both Type 1 and Type 2) and for good reason – it’s a chronic condition. Chronic as in forever, never giving you a break, never giving you a holiday, never giving you a moment’s rest. Add to that the fact that diabetes is an ever-changing condition, with blood sugar fluctuating depending on everything from your diet and exercise to hormones, weather, sickness and more, and it’s no surprise that people with diabetes sometimes feel exhausted by it all.
When you need to worry about diabetes burnout
“Diabetes burnout is a normal emotion for diabetics to feel at any given time,” explains Gabi Richter, a Type 1 diabetic and counsellor in Cape Town. “It occurs when you are fed up with the routine and lifestyle that being diabetic entails, and you just want to forget it all. This is fine to feel once in a while – and can even be healthy to some point. But it needs attention when the feeling stays for a long time and your routine diabetes care stops.”
This, of course, is the warning sign. If it feels like there’s no point taking care of your diabetes because you have no control any more, that’s when you stop paying attention to food and medication and self-care. And that’s when blood sugar levels can get wildly out of control. Extended periods of high blood sugar (hyperglycemia) lead to diabetes complications, and in Type 1 diabetics, low blood sugar (hypoglycemia) can be extremely dangerous.
So what do you do if you’re experiencing diabetes burnout? Reach out. Connect. Realise you’re not alone. “Diabetes burnout is a very real issue for all the people I am privileged to educate and spend time with,” explains Kate Bristow, a diabetes specialist nurse in Pietermaritzburg, KZN. It’s a combination of the frustration of things: Never having a day off from diabetes. The guilt of not sticking to the right eating plan or forgetting to take medication or check blood sugar. The relentlessness of never being able to take time off from managing diabetes. “Burnout is often accompanied by stress and anxiety and sometimes depression or guilt – all negative emotions,” says Kate.
5 tips for diabetes burnout
Here are 5 pieces of advice Kate Bristow offers her patients.
Share your frustrations with someone – a family member, or diabetes nurse or educator. See if there are ways to decrease your burden for a while.
Try new diabetic-friendly recipes – a change is as good as a holiday.
Try practicing mindfulness – a practice based on learning to become aware of how you are feeling emotionally in a non-judgemental way. It has been found to be effective in supporting diabetes management and the general stress of everyday life. Eating mindfully has been shown to improve diabetes control.
Life is busy – stress is a way of life – defined as a state of emotional tension elicited by the pressure of everyday life. Diabetes is probably only one of those stresses. Exercise has been shown to reduce stress levels and alleviate depression as much as some medications used for the same purpose. Exercise is also good for our physical health – blood pressure, weight, cholesterol, and diabetes. So perhaps another way of dealing with burnout is to get an accountability exercise partner and start getting physical at least 3 times a week (even if it’s only for 20 minutes at a go, or at work).
If you really feel like you are not coping – ask for help. This is why you have a health care team and a diabetes community. Ask your doctor, your diabetes educator, your diabetic community. You’re not alone in this.
Diabetes burnout is a reality for many of us with diabetes, but it doesn’t have to be a long-term reality. With the right help and care, it can be a phase we move through – just another part of living with this chronic condition. How do you cope with diabetes burnout? Do you have any tips to share?
Meet Michael Marnewick, a Type 1 diabetic and active member of the Diabetic South Africans community. Michael has an inspiring take on living with diabetes, and shares some of his advice here. He’s also the author of a new book: “Coach: The life and soccer times of Clive Barker.”
“Although diabetes has the potential to be life threatening if not managed well, it also has the potential to create better awareness about our bodies and our health. I accept that I have a condition but I do (almost) everything I can to live a life free from fear. But ultimately a combination of diet (first and foremost), regular physical activity, a wonderful endocrinologist and my awesome diabetic nurse (Fiona Prins), the fear of the consequences of not managing it properly and the willpower to follow a lifestyle that works for me is what keeps me positive.”
What was your diabetes diagnosis like?
I was quite unaware of my so-called ill-health when I went for a routine test and my blood sugar was in the mid-teens. I put it down to the coke and chocolate I had enjoyed earlier. The frequent night visits to the loo were explained away with advancing age (early 40s). In short, I was in complete denial.
Do you know many other people with diabetes?
I don’t know many, but my brother was diagnosed Type 1 diabetic some years ago following a massive trauma (shrapnel through the brain while on active service duty for the SADF in 1986). So, while there might be a genetic link, both of us had trauma that may have had a hand in this. For me, it was a sedentary lifestyle, bad eating habits and the stress of divorce that led to the diagnosis in 2012 – six years ago.
When (and why) did you change your diet?
When I posted something on Facebook about it, my GP called me up and suggested I look into the low carb, high fat lifestyle. I don’t call it a diet, because it isn’t a short-term intervention. So I’ve been living the low carb lifestyle for about six years. Initially I lost about 8kgs and dropped to a low of 55kgs (I am 1.7m tall). A year ago I went for a health check and with persistently high and uncontrolled BG ranging from 6 – 18 (and a high of 27), was hospitalised. My initial diagnosis in 2012 proved to be incorrect, I was not Type II but Type 1 (Actually, Type 1.5 – LADA which is Latent autoimmune diabetes of adults). My endocrinologist gave me the diagnosis and since working with her and my diabetic nurse, my HBA1C has improved every four months since then.
Could you tell us a typical day’s food?
Typically I wake up at 5am for work and eat breakfast at 9am. Generally I’ll eat some bacon, two eggs, half an avo, cream cheese or other cheese, and some leftover cheesy roasted veg. Lunch is a smoothie at about 2pm. Double cream Greek yoghurt with added cream, chia seeds (soaked in water first), frozen strawberries, almond nut butter, cinnaon and ice. Dinner at about 6.30pm will be roast / pork rashers / chicken dish / curry / zoodles (zuccini noodles or konjac root noodles) with a creamy sauce and bacon or salami / generally with veg. If I eat out, it will be mostly chicken with veg or salad.
What exercise do you do?
I do a lot of physical exercise – when time affords. Some parkrun or else a jog, mountain biking action cricket in season, swimming, badminton, tennis, gym. I am also outside and on my feet most days, often 12-18 000 steps worth.
How is your health?
My health, despite the diabetes, is probably the best since I was an active teenager. I eat zero sugar, I exercise 3-5 times a week, and I am rarely sick with colds, etc. My TomTom sports watch gives my physical age as 25 (I am currently 49).
What advice do you have for diabetics who are struggling?
My advice is to find a reason to stay healthy. I live an active lifetsyle that I want to continue. I want to walk my daughters down the aisle one day, not from a wheel-chair. My brother has no control because he is in denial and has ended up in comas and in hospital numerous times. My inspiration is not to be like him.
What makes your life sweet?
I try to avoid sweet things as much as possible – as far as substitutes go. Sugar addiction (and it was), is what I believe made me diabetic. But I feel like diabetes has given me a new lease on life. I want to be setting sporting world records in my 80s and I feel strongly that I am in the kind of good health now that will realise that.
Any final advice?
We are all led to believe that the food pyramid is the bible on nutrition when vast numbers of studies are proving the opposite. We’re told to eat carbs for energy, when fat is a much denser fuel but isn’t stored as fat in the cells like glucose is. We’re told to “Eat “healthy” things like fruits, but when fruit juice contains more sugar than coke, something is very wrong. I’ve read the testemonies of sick people who no longer suffer from PCOS, high blood pressure, high blood glucose, and they’re winning the war on obesity.
Hippocrates wrote: “Let food be thy medicine and medicine be thy food” – how true!
I’d like to introduce Maryna Prins, a new contributor who will be sharing her thoughts on living with Type 1 diabetes every month. Would you like to contribute to the Sweet Life diabetes community blog? Send us a mail to share your thoughts with the community!
The one thing that truly bothers me about diabetes
I’ve had Type 1 diabetes for most of my life, 27 years to be exact.
I’m fortunate enough to not have any complications and I’ve never found my diabetes to be a setback or an obstacle in my life. I’ve always taken pride in myself, I’ve faced the world head on and have been quite successful – I’ve achieved many things that my small, terrified ten-year-old self would never have dreamed possible. Everything seems to be pretty good as far as things go, but are they really?
I was sitting in the waiting room at my doctor’s office, bored, and picked up one of the many old magazines that are always associated with the stuffy surroundings of a doctor’s office. It was an older issue of the CDE magazine. I hesitantly flipped through it, too stubborn to admit to myself that I have a condition that affects my life.
Then, there it was. One page that listed do’s and don’ts for parents with diabetic children.
I skimmed through the list, still not willing to fully commit to reading and understanding the words. Then I really read it, and the one thing that truly bothers me about diabetes jumped right from the page into my heart. Diabetes inadvertently destroyed my relationship with my parents, especially my mother.
Do not become obsessed with the diabetes
Sometimes a condition, a disease, whatever you want to call it, brings a family closer together; but at times, the opposite happens.
“Remember that your child is still a human, do not become obsessed with the diabetes.” The quote isn’t exact, but in my head, that’s what it said.
I can distinctly remember myself crying as a young fifteen- or sixteen-year-old, telling my mother that I have feelings, that everything is not always connected to my diabetes. I also had my heart crushed by the handsome, popular boy in class, I also felt the pressure of fitting in and being a “cool kid”, I was a normal teenager, with normal problems. To my mother though, I was a condition, the only thing she was concerned about was my blood sugar levels and why they weren’t perfect. A 6.5 blood sugar level wasn’t good enough, even a 6 wouldn’t do, she wanted a 5.8 and only then would it ever be good enough.
A rollercoaster ride of highs and lows
Now if you’ve gone through puberty as a diabetic, you will know that the war inside your body with a million hormones practically makes a perfect blood sugar reading impossible. Your body does strange things at that age, even if you don’t have a chronic condition. When you add diabetes in the mix, it’s just a rollercoaster ride of highs and lows, most of the time not explainable.
I can’t wholly blame my mother though, it was very different back then.
Diabetes was rare, Type 1 diabetes even rarer, and no-one really knew what it was. The last 30 years have seen a massive leap in our knowledge and treatment of the condition. In 1992, diabetes was practically a death sentence. There were no epipens, the glucometers were larger than bricks and cost a fortune, the tests took ages and weren’t necessarily very accurate, I used a normal syringe and vial for ages before I got my first pen to use. Sugar was the devil, and I came out of my first three months after diagnosis believing that I would go into hyperglycemic shock if I even looked at sugar.
My mother was afraid that I would die. It’s something I only came to understand many years later, and surely not something I can hold against her: she loves me. Her desire was to not let me die, but right there she lost something very valuable: we both lost our relationship as mother and daughter. My mom became my police officer and prison guard, someone that did not care for things like feelings and aspirations, she only cared about that perfect score.
We fought, a lot, and even today I often have to remind my mother that I’m not a disease. I felt like a disease for too long and the silent rebellion that came from that feeling is not something I am proud of.
No matter how hard I tried, I always failed
I started smoking at a very young age, not for the same reason many other teenagers do. Someone once told me that it suppressed your appetite. I’ve always had an appetite like a bear, I’m always hungry. In later years I found out that I have a very fast metabolism and that’s the reason I have an unending hunger, but my 15-year-old self knew nothing about metabolisms and believed that if I could eat less my blood sugar would surely be more controllable. It worked, for about 3 months until I was addicted and it was too late to just stop.
When I realised I could get away with occasionally having sugar, the rebel dial went in the complete opposite direction, and I remember sneaking off to the shop to buy handfuls of sweets and sitting in the large tree in our front yard gorging on chocolates and ice-cream.
I felt isolated and scared a lot of time, terrified of disappointing my mother, terrified of dying or losing a leg. My mother, unknowingly, had threatened me many times with those outcomes. “If your blood sugar is high you will lose a leg.”
Mostly I felt like a failure. I couldn’t live up to the standards that were expected of me and no matter how hard I tried, I always failed. Inadvertently that feeling affected my whole life and I spent years not believing in myself: if I couldn’t do something as easy as control my diabetes, how could I succeed at anything else?
We are all different
It took me years, stubbornness and a lot of growing up to realise that, actually, I can do anything and controlling diabetes is not an easy task with set rules. We are all different, our bodies weren’t created out of a mould and we can’t treat any condition with a mentality like that.
I learnt to understand my mother’s way of showing her love and concern, and that her words were harsh out of love. I mourn the fact that we never built a relationship that so many other mothers and daughters share, we never built trust or a way to communicate that showed that we were interested in each other’s lives.
I hope that other parents with diabetic children will read this article and not make the same mistakes we made. Your child might be diabetic, but that should never overshadow the fact that they are human, with human feelings and experiences, dreams to become more and be their best.
Encourage and praise them for their efforts and never distance yourself from their lives.
Are you a runner? Do you have Type 1 diabetes? Share your advice, tips and lessons learned below…
I have been a Type 1 diabetic since 1984. I have been running fairly regularly, but recently decided I need a new challenge. I have done half marathons with no significant problems and managed my sugar levels throughout without gu or syrups. I used regular sips of Coke and mini energy bars.
My new challenge is a full marathon. I need advice on carbs or gu while running, without rocking my blood sugars too much. I am not on a pump, which I suppose makes it slightly more challenging.
Anyone who has done this before and can offer advice?
Psst! Have a question for the South African diabetes community? Email us and we’ll get it answered.
Read more about trail running with diabetes and a few fun trail runs in South Africa for diabetics to try.
I’d like to introduce a new contributor to Sweet Life: one of my favourite Instagram feeds, Tracy Sanders. Also known as @type1tracy. Tracy has Type 1 diabetes, but that doesn’t stop her from doing anything in life… Check out what she has to say, below, on a solo trip to Italy.
H O N E S T Y 💭H O U R: Firstly, I just want to say whatever you want to do, whatever you dream of, or whatever adventure you seek. You can do it. With diabetes. Without diabetes.
Secondly, this isn’t an inspirational “Diabetes can’t stop you from living your dreams” message, let’s be potently honest, it sure as hell can. If you choose to passively sweep through this life ignoring diabetes, your body, it’s messages, type one will create walls and obstacles.
You have to be practical💪. You have to take charge💥. You have to apply yourself and take responsibility. Take on responsibility WITHOUT resentment. 🙏Without wishing otherwise, “I wish I didn’t have diabetes, I wish I could be lucky like my friends who don’t have to inject”. It is important to acknowledge these thoughts💭, be intensely curious about them and their origins, and let them go.
Taking responsibility does not mean aiming for perfection (it does not exist). It’s about refusing to let numbers define you🚫, putting effort 💪🏼into working FOR your numbers and looking after your mental health too: patience, self-love and kindness, forgiveness, gratitude.
Being alone in Italy, it dawned on me the kind of responsibility that I was carrying with me.🙈 If I had a low, the only person I could rely on was myself.
The thoughts of mid-sleep hypoglycemia developing into seizures did creep into my mind. 🤔I have never had such before, but this does not mean it’s not possible. It just means I better make 100% sure it doesn’t happen as there will be no one to run into my room to help me. Careful bolusing, dinner well before I sleep, glucose sweets🍬 always on hand & at my bedside. Small practicalities that make all the difference. But I had gelato🍦, I had pasta🍝, I skipped dinner, and ate until my tummy was bursting😂 I had some nasty BGs and a lot of good ones
Yes you can be free, you can explore, you can run that event, you can lower your HBA1C, you can have a beautiful healthy pregnancy. But you first need to have a RAW and HONEST conversation with yourself. How can you make a change, take charge and free yourself of any little bits of a victim mentality that can lurk in the setting of chronic disease?
I got this amazing email from one of our community members last week and had to share it. Would you like to share your story with the Sweet Life community? Email me – we’d love to hear it.
What an absolute treat to read your magazine and continually refer to it.
I have been Type 1 diabetic for 14 years. As much of a roller coaster ride as it has been, I would not swop being diabetic for anything in the world.
The people you meet along this journey, the knowledge you gain about how your body functions and responds, the prior knowledge you get from high glucose readings before you get ill and a complete understanding of the people I meet who possibly battle with elevated glucose levels or hypoglycemia.
Being Type 1 diabetic makes you aware on every level – spirit, body, mind, soul, feelings, thoughts, allows for wise choices (although if not wise then the consequences that accompany these – you have actually just got to smile, knowing that this is within your control), tolerant and respectful of others.
It is without a doubt, a gift.
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.
Hypoglycemic episodes (hypos) can be a scary experience for all involved: here’s what you need to know to deal with one.
- A hypo is a sudden low blood sugar episode.
- The optimal blood glucose range is 4 to 7mmol/l. With a hypo, blood glucose levels are usually lower than 3mmol/l.
- Initial symptoms are nervousness, sweating, intense hunger, trembling, weakness, palpitations, or trouble speaking (depending on the person).
- The best thing to treat a hypo is fast-acting carbohydrates: 15-20g of sugary carb (a few sweets, 2 tablespoons of raisins, a tablespoon of honey or half a cup of fruit juice).
- The key is to catch low blood sugar early – as soon as it starts dropping – and treat it with a small dose of something sweet.
- If blood glucose drops too low it can get to the stage where the brain is not getting enough glucose.
- Symptoms of this are confusion, drowsiness, changes in behaviour, seizure and eventually coma.
- In case of a severe hypo, a glucagon emergency kit may be necessary. This once-off injection instantly raises the blood sugar, and is particularly useful when the person with diabetes is unconscious or unable to swallow.
- Notify all those close to you what to do in an emergency and how to use a glucagon injection.
- Test often to keep your levels as well controlled as possible.
Meet Shane Casserley: a Type 1 diabetic who is also juggling coeliac disease and ADD… while living his best life.
When were you diagnosed with Type 1 diabetes?
When I was 8 years old years. I am now 22.
Was your diagnosis a shock?
A huge shock. I was completely freaked out. I was hospitalised straight away and had to stay in hospital to learn to give my own injections and I was visited by a dietician to adjust my diet. After the initial shock wore off I went into depression.
When were you diagnosed with coeliac disease and ADD?
In 2011, when I was 16 years old.
How do they affect your diabetes?
They don’t affect my diabetes in any way but it was another huge diet adjustment because when you have coeliac disease you are not allowed to eat anything containing wheat or gluten. The ADD also does not affect the diabetes directly but indirectly it is a lot more difficult to remember to check your sugar regularly and give insulin when you eat.
How did you become interested in fitness?
When I was going through a rough time, a friend offered to take me with him to gym. It made me feel so good that I have been hooked ever since.
Why do you want to be a personal trainer?
Going to gym and changing my diet greatly improved my health and self image, and gave me the confidence that I lacked. I would like to do the same for other people, especially for diabetics who are battling.
How do you think regular exercise helps people with diabetes?
It has a big impact on stabilising sugar and thereby lessening the risk of future complications. At the same time, it increases your endorphins, which makes a person feel good psychologically and decreases depression.
What advice do you have for other diabetics who are struggling?
The most important thing is to accept that you have it and you can’t change it and rather learn to adapt to it. Once you have accepted it and you start eating right, exercising regularly and keeping a good check on your sugar readings, then you can lead a normal life. It is always good to get support from other diabetics.
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!
It’s the highest mountain in Africa, but that didn’t stop Neil Rae – a Type 1 diabetic for 50 years – from wanting to climb it. We chat to Neil, 63, about his preparation, the climb itself, and life with diabetes.
How long have you been diabetic?
I was diagnosed on the 13th December 1964: over 50 years. I’ve seen a lot of changes for diabetics in my time – there’s a lot more we can eat, the technology to monitor blood sugar levels is a lot more advanced and the insulin pen sets are much more convenient. We’ve come a long way since the gas cylinder with a tin cup that I used to sterilise my glass syringes when I was at university!
What made you decide to climb Kilimanjaro?
I grew up in Lesotho and I’ve always had a love for mountains. I don’t know how many decades ago, I said to myself I wanted to set a goal for my diabetes: to climb Kilimanjaro when I’d lived with it for 50 years. About 18 months ago I contacted Novo Nordisk, the people who manufacture my insulin, to ask if they’d like to partner with me. They were very excited to join the challenge. As you can see it’s been a long-term goal of mine…
What did you do to prepare?
I’ve always been a relatively fit person, and I do a lot of walking with my wife Shaye, in and around the streets of Johannesburg and in the Drakensberg. I was walking between 30 and 40km a week and over weekends doing long walks in Westcliff – they have a flight of 222 stairs built into the rock face, and with a heavy rucksack on your back it’s good training! I did the climb with my doctor, Dr Bruce Ilsely and David Broomfield from Novo Nordisk so as a team we were well prepared.
How did you know what to eat and drink while climbing, and how to balance your blood sugar?
Balancing blood sugar was obviously going to be a challenge – spending between 7 and 8 hours a day climbing up and up and up all the time. It was tricky to balance that amount of exercise with the food supplied by the people who organised the walk – we didn’t take any food with us. Normally my sugar is very well controlled, so the plan was to do very regular checks of my blood sugar levels, see what we were going to be given to eat and then decide how much insulin to take. It turned out that I didn’t eat very much – I became nauseous quite early on, once we were over 3500m.
What was the hardest part of the climb?
The hardest part for me were the ascents and descents because you had to climb up mountains and then down into valleys, and there was a lot of very rocky pathways – walking from rock to rock. Some days we went up and down two or three times in a day. We left Moshi on the Monday and we summited on the Thursday night/Friday morning. Unfortunately I wasn’t able to make the summit – I got up to about 5000m and my altitude sickness was so bad that Dr Bruce said to me, “If you carry on, you’re going to die”. Once I got back down to the base camp at 4600m, then I was fine: it wasn’t diabetes related at all.
What advice would you offer to diabetics who are struggling?
In my opinion, every diabetic who’s struggling has got to develop a lifestyle routine: get up in the morning, check your blood sugar, decide how much insulin you need and what you’re going to eat for the day. You have to have a definite lifestyle routine, and stick to it every day. Discipline is so important to a diabetic. If you don’t have the routine and don’t have the discipline, you’re not going to live with it for 50 years!
What makes your life sweet?
I’m very fortunate: I’m married to a lovely lady and I have two daughters and four grandchildren now. My family, my life and everything in it makes my life very sweet.
Type 1 diabetes used to be diagnosed in the young; Type 2, mostly in older people. But the picture is changing. Why? And what can we do about it? Carine Visagie asks the experts.
Since the 1980s, diabetes has rapidly increased – so much so that the global prevalence has nearly doubled since 1980, rising from 4.7% to 8.5% in adults. Over the past decade, Type 2 diabetes has become a massive problem in low- and middle-income countries and, for the first time in history, it’s a significant problem among the world’s children. What’s more, Type 1 diabetes is also on the increase.
It’s estimated that about 1.396 million of South Africans with diabetes remain undiagnosed, which makes it hard to judge the scale of the problem here. “But diabetes certainly is on the increase here, too,” says Johannesburg-based paediatric endocrinologist Prof. David Segal.
While the worldwide increase in Type 2 diabetes can be explained by unhealthy, modern lifestyles, rapid urbanisation (linked to inactivity and unhealthy eating patterns), a wider spread of the genes linked to the disease, and an ageing population, the reason for the increase in Type 1 diabetes is less clear.
To complicate matters, an increasing number of adults are presenting with latent autoimmune diabetes (LADA) – a form of Type 1 diabetes in which the progression of the disease is slow. As such, many adults with LADA are misdiagnosed as having Type 2 diabetes.
Type 1 diabetes in adults and the very young
At the start of the 20th century, diabetes was rare in children. By the end of the century, it increased substantially in many parts of the world and, right now, many countries are documenting higher numbers of Type 1 diabetes than ever before. Plus, the profile of patients is changing.
Across the world, this autoimmune disorder now often strikes at a younger age. And while similar research hasn’t been done locally, research shows that 50% of people newly diagnosed with Type 1 diabetes in the United Kingdom are over 30. This turns the long-held belief that Type 1 diabetes develops only in childhood on its head.
It’s long been known that both environmental and genetic factors contribute to Type 1 diabetes, but the exact triggers remain unknown. One of the theories, according to Johannesburg-based endocrinologist Dr Zaheer Bayat, is the hygiene hypothesis, which suggests that exposure to a variety of pathogens during early childhood might protect against Type 1 diabetes. A second theory suggests that certain viruses may initiate the autoimmune process involved. Another is that vitamin D deficiency plays a role. And a link between Type 1 diabetes and early exposure to cow’s milk is being explored.
According to Segal, being overweight or following the lifestyle of an obese person (being inactive and following an unhealthy diet) may also be a trigger. The “accelerator hypothesis” argues that Type 1 and Type 2 diabetes are in fact the same condition, distinguished only by the rate at which the beta cells in the pancreas are destroyed, and the triggers (or “accelerators”) responsible.
Type 2 diabetes still on the increase
In South Africa, Type 2 diabetes remains a massive health problem that accounts for more than 90% of diabetes cases. This condition, in which the pancreas either doesn’t produce enough insulin or the body doesn’t use it effectively, still predominantly occurs in adults. “But, for the first time, we’re also seeing young adults and adolescents with Type 2 diabetes,” says Bayat.
Ethnicity, family history and gestational diabetes combine with increased age, overweight/obesity and smoking to increase a person’s risk. In this country, the high incidence of Type 2 diabetes is also closely linked to the rapid cultural and social changes we’ve experienced over the last 20 to 30 years. With them came physical inactivity and unhealthy eating – both important risk factors.
According to Fiona Prins, diabetes specialist nurse practitioner, researchers are also currently investigating how, genetically, some of us store fat differently – a factor that could play a role in diabetes risk and management. “Some people may have ‘thrifty genes’, which would allow them to cope better on meals that are eight hours apart,” she says. “But this goes against all our messaging of eating three meals a day (or six, in the case of diabetics).”
Part of the problem, adds Segal, is that many of us don’t quite know what obesity is – we think we’re just overweight when, in fact, we’re obese. His advice is clear: “You have to lose weight to halt the progression to diabetes. It’s the only way.”
Jenny Russell, support group expert, adds: “Go and see a dietician who specialises in this field. They can do a thorough history and advise on an eating plan that suits you. Then simply get moving – every bit of exercise counts.”
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.
- The goal is always to keep your blood sugar in a healthy range: not too high and not too low.
- 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.
- 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.
- Modern blood sugar meters only take 5 seconds and need just a tiny drop of blood.
- Pricking the tip of the finger is the easiest place to get the drop of blood.
- Before you test, it’s important to wash your hands with soap and water and dry them properly.
- Type 1 diabetics should test before every meal, to decide how much insulin to take.
- Before a meal, blood sugar readings should be 4 to 7mmol/l*.
- Two hours after a meal, blood sugar readings should be 5 to 10 mmol/l*.
- 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.
Of all the sports a diabetic could choose, ice skating – with its precision, edge of danger and need to be feeling 100% every time you take to the ice – isn’t the most obvious. But that didn’t stop KZN champ Rachel Lombard from competing.
Who did you skate for?
I was part of the Toti Seals Synchro Team, and we represented KwaZulu/Natal twice a year in the inter-provincial competitions, as well as the KZN championships.
How long have you been diabetic?
I was diagnosed about 10 years ago, when I was 7 years old. It was pretty traumatic, I was scared that I was dying because I was misdiagnosed – they thought it was cancer. It was a huge shock for my mom, but I just remember feeling relieved it was only diabetes and it wasn’t anything worse.
Is it difficult to compete when you have to worry about blood sugar levels on top of everything else?
I have an insulin pump, so that helps, but I still have to be very careful. I make sure my blood sugar is fine an hour or two before we’re due to go on the ice, because my pump is under my tights and my costume and it’s difficult to get to if I need to adjust my levels. I also test just before I go on the ice, because the adrenalin can do funny things to my blood sugar. And I make sure I always have fast-acting sugar on hand in case I go low.
What do you love about ice skating?
I love it mainly because it’s different, and because there’s a real community – especially with my team and the coach. I skate four times a week, so it’s also really good exercise.
What do you think the biggest challenge of living with diabetes is?
The testing – having to test all the time. And how you can never predict what your blood sugar is going to do: you’ll eat something and know how much insulin to take, and it works… And then the next time you eat exactly the same thing and take the same amount of insulin and it doesn’t work, for some reason.
What advice would you offer to diabetics who are struggling?
Get support: that’s the one thing you need, you can’t do it alone. Also be aware that parents go through the highs and lows of diabetes just as much – my mom does so much for me, I don’t know what I’d do without her.
What makes your life sweet?
Just my friends and family around me, helping me through any situation and offering support if I need it. That’s what makes my life sweet.
Get in touch with Rachel: email@example.com