A publication of Diabetes Kenya
Travelling
Diabetes with
Is Diabetes Affecting
Your Sexlife?
Pg 14
Dr. Abbas Gullet
TALKS ABOUT HIS BLUE LIFE Pg 6
EAT HEALTHY
Mediterranean Diet 3rd Edition - Oct 2014 KSH 200/-
Pg 18
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contents...
PAGE 6
Interview with Dr. Abbas Gullet He answers our Q&A and talks to us about this blue life ...
PAGE 8
Hypoglycemia Also known as low blood sugar. Why your body needs glucose ...
PAGE 16
PAGE 10
Travelling with Diabetes People with both Type 1 and Type 2 diabetes can travel all over the world ....
Foot Screening A one day foot screening event at the Kenyatta National Hospital grounds....
PAGE 18
PAGE 12
Mediterranean Diet
Psychiatric Disorders The consequences of not treating the disorders are themselves quite huge ...
PAGE 19
Recipe: Lentil Soup ...
PAGE 14
Erectile Dysfunction So why do men with diabetes have erectile dysfunction? ....
PAGE 15
The Blue Circle Why the blue circle for diabetes.
PAGE 20
World Diabetes Day What is the event all about and what can you do to help ...
PAGE 21 Healthy Games
Gold Sponsor
Chief Editor: Salwa Shahbal Graphic Designer: Nabeel Najib (bilobrown@gmail.com) Social Media Editor: Aggrey Shiundu Advertisement Manager: Dr. Gaman Mohamed Publisher: English Press Ltd Kisukari Magazine is a quarterly magazine (4 times a year). The main objective of this innovative informative magazine of Diabetes Kenya is creating diabetes awareness, education and empowering the Kenyan public. Contacts Phone: +254 722 297 071 Email: kdiabass@yahoo.com Facebook: facebook.com/Diabetes.Kenya Disclaimer: The information in this magazine is for information purposes only. Diabetes Kenya makes no representations or warranties about the accuracy and reliability of any content in the magazine. Any opinions expressed are those of their authors and do not necessarily present the views of Diabetes Kenya. Through this magazine you may link to third party websites that diabetes Kenya has no control over. Inclusion of such websites and/ or advertisements does not imply recommendation or endorsement by diabetes Kenya. Diabetes Kenya does not take any liability with regard of your accessing such sites. Information in this magazine is about medical issues but should not be construed as medical advice.
Celebrating Our 5
We at Pathologists lancet Kenya are -A branch network of over 20 servi -SANAS accreditation of our main la -We have innovative ICT solutions -Regional footprint with branches ac -Wide test menu extends beyond 3
-Strategic business partnerships tha -Diverse intellectual capital including the company. -We have embraced PPP initiatives the citizenry.
5th Year Anniversary
e celebrating out 5th year anniversary, we are proud to announce the following milestones: ice points country wide ab and KENAS accreditation in our Mombasa branch e.g. lancet mobile app for Android and Apple platforms, pathportal and carecard. cross East Africa i.e Uganda,Tanzania and Rwanda. 3800 routine to specialized tests.
at have transformed the business relations perspective. g pathologists and young, energetic work force that has been instrumental in the growth of
to strengthen relations with the government and assist in providing affordable healthcare to
Message
From the
Chairperson Dear Readers, Welcome to our third edition of kisukari. We sincerely hope you have enjoyed reading our previous 2 editions. In our previous edition we covered Ramadhan. We have many exciting events on the horizon to look forward to, diwali, world diabetes day on 14th November and Christmas. How time
all year round as the threat of diabetes and non communicable diseases continue to grow in magnitude. We are grateful to our supporters, pharmaceutical industry and well-wishers. We welcome your contributions, questions, articles and hope we continue to grow together to make our blue circle of care wider. Happy word diabetes day.
The IDF theme for this year WDD day is a blue breakfast. There will be a global initiative for all supporters of people living with diabetes to Endeavour in any small or creative way to enjoy a blue breakfast. You can choose to use a blue table cloth, napkins, condiments or dress in blue. There will be national screening and awareness activities as usual and we hope it won’t stop at world diabetes day but continue
From the
Chief Editor
Dear Readers,
14th November is around the corner and everyone is gearing up for World Diabetes Day. We from Diabetes Kenya decided to dedicate an article on the blue circle to enlighten readers and the public on the symbol that unites every diabetes hero and soldier out there. I urge all of you to go paint your town blue in support of this day.
quite helpful in assisting diabetic patients plan for safe travels and avoid any unnecessary complications during their holidays. We hope the article on the Mediterranean diet can prompt people to a much healthier choice of foods not only during the holidays but daily. Last but not least, I would like to send my sincere gratitude to Mr.Abbas Gulet, secretary general Kenya Red Cross society, for opening 4 ⁄ Kisukari magazine
up to kisukari and sharing his diabetes journey with all of you. “When we give cheerfully and accept gratefully, everyone is blessed” Maya Angelou.
2nd Annual
Health Festival Aug 2014
O
rganized by Iris Kenya Management, the 2nd annual health festival took place on the 22nd and 23rd of August 2014 at All Saints Cathedral, Nairobi. It was an event organized with the aim of inspiring, motivating and educating people of all walks to embrace healthy living. The event started off at 9am with a good number of stakeholders and participants. It brought together several stakeholders in the health sector ranging from hospitals, insurance firms, fitness centers, health food providers, wellness centers, manufacturers among others. The stakeholders, among them being Diabetes Kenya Association, Medswift, Liverpool Healthcare, Nairobi Premier Health clinic and the Kenya Society of the Blind joined hands in offering various services to
ensure that the objective of the event was met. All the participants were entitled to free services such as medical screenings, education sessions and demonstrations. Diabetes Kenya Association took part in the event by offering free blood sugar screening services, blood pressure measurement, consultation and basic education about Diabetes. A total of 45 participants were screened and informed about diabetes because it was clear that most of them lacked full awareness of diabetes and its causes. Other activities that the participants took part in were: Healthy cooking demonstrations from Sheena, a relationship talk from DR. Chris Hart on fitness exercises from Africa Yoga Project among others. After a vote of thanks from Iris Kenya management and the stakeholders, the event came to an end at 4.pm on Saturday the 23rd. From the faces of the participants, you could easily tell that they enjoyed and learnt a lot from the festival. It was a worthy event for a worthy cause.
interview
Dr. Abbas Gullet talks about his blue life OCCUPATION: Secretary General at Kenya Red Cross Society . BORN: February 18, 1959 AWARDS: Secretary General at Kenya Red Cross Society . He is the UN Person of the Year (Kenya) 2007. The Awards was given for his exemplary leadership in making Kenya Red Cross Society the leading Humanitarian Organisation in Kenya. Photo by: Mauroof.Khaleel
6 â „ Kisukari magazine
Q&A 1 What type of diabetes do you have Type 2 diabetes.
2 When were you diagnosed In the year 2003.
3 What medication are you currently on Diamicron, Galvusmet, Scard, Rozavel and Micardis.
4 Describe your feelings when you were first diagnosed with diabetes
When I was first diagnosed with diabetes, my feelings were mixed, on one hand I thanked God as he is the one who gives and takes at the same time. My daughter Hawa was already diabetic and had an understanding of diabetes but nonetheless it was not a happy moment to change life styles.
5 If you were to go back, what in your lifestyle would you have done different to prevent diabetes
Taken better care, taken less sugar in all my eating habits, less stress, better life style, exercise, walk, run, swim, etc
6 What do you think of the level of awareness about diabetes in the country
I believe it is not sufficient and more awareness should be undertaken in schools, universities and work place.
7 How can this be improved As above. Seek funding from the County/Central Government and Private Sector.
8 You lead a busy life, tell us how you manage to include exercise and healthy eating in your daily routine
I must admit that I do not do enough exercise as I should but try very much to eat a healthy diet in my daily routine. I do walk a lot when I have the time.
9 How has diabetes affected your life Well, it has helped me to be better organized where I can, made me appreciate life every day, take my medication regularly and empathize with those who positively live with this condition and other medical conditions.
10 What advice would you give fellow Kenyans To check their status. Once you know your status make sure you keep it under control. For those who do not have diabetes make sure you do not get it and those who have it, live positively, exercise, eat healthy and live healthy. Take your medication regularly and enjoy life. Kisukari magazine â „ 7
Blood sugar
Hypoglycemia ( Low Blood Sugar )
Source: adrianjwalker.com
Hypoglycemia means low blood sugar. Your body needs glucose to have enough energy. By: Atieno J’alango
H
ypoglycaemia also known as HYPO refers to a critical drop in blood sugar usually below 3.9 mmols. However if your blood glucose is generally poorly controlled and range above 10mmols you can get a feeling of hypo at even higher blood glucose level. It is therefore important to note this, since we will treat symptoms of hypo and not just rely on the sugar level. Hypo symptoms must be treated as hypo even when blood sugars may be slightly higher than usually expected rates. You must therefore understand, be able to identify and manage hypos.
You will not be able to function well, so driving and operating dangerous equipment is a great risk. In a child when hypo occurs they may go too low and pass out, particularly in sleep. They make also exhibit strange behaviors and may some adults.
If you use insulin or tablets for control of diabetes you are at higher risk of hypoglycemia. The tablets either help increase your insulin production or increase the body’s sensitivity to Insulin. Insulin helps control blood sugar by lowering it, sometimes it may go too low and this is dangerous to your brain, organs and can be fatal. If you have diabetes and don’t eat enough food, take excess diabetes medication or you take extra exercise, a hypo may result.
The following can cause hypoglycemia:
8 ⁄ Kisukari magazine
Most people recognize the symptoms and are awakened if asleep, but some people over time can have “hypoglycemia unawares” or are insensitive to the effects of hypoglycemia and do not have these physical warnings. They may then go into hypoglycemic coma which can be dangerous to life.
Too much insulin or oral anti-diabetic medication. Insulin injected at the wrong time . Insulin injected in an active limb ( increases its absorption). Not eating enough food or having late meals. Skipping meals.
More than your usual exercise or physical activity. Drinking alcohol. If you “do not feel right”, it is important to test your blood sugar immediately! If you do not have a blood glucose meter, take a teaspoon of sugar or glucose, it you feel better then most probably it was a hypo. Then you have to treat if fully. If you do not feel better, seek medical attention at once. How do you manage hypoglycemia or low blood sugar? a form of sugar as an emergency. Below are some simple steps to guide you. 1.
If you just sense hunger alone, stop everything check your blood sugar and go eat a light meal at once or if it is meal time, eat at once. (If blood sugar is below 4 mmols follow rule of 15 below, if above it eat at once).
2. 3.
If you have more symptoms and feel “off balance” you need some form of simple sugar, fast. You can use a simple guide called the rule of 15. 15 Gram Emergency Foods include First take your blood sugar. If your blood sugar is 70 mg/dl (3.9 mmol/L) or less, and with symptoms, treat with 15 grams of simple carbohydrate.
½ glass (150mls) fruit juice 1 glass skim milk 6-8 Lifesavers (chew) 3tsp sugar 3 tsp glucose 3- 4 glucose tablets (dextrosol) 4 Patco sweets 1 small box of raisins/ sultanas (2 Tbsp.) 10 chewy candy such as gummy bears 1 tube of glucose gel ½ glass of regular soda 1 tube of glucose gel Do not use chocolate candy, toffee or peanut butter because the fat content will prevent the blood sugar from rising quickly, which is your goal at the moment. The glucose gels and tablets are fastest acting because they are absorbed in the mouth, while the other foods need to be digested by the stomach and liver. Wait 15 minutes and retest the blood glucose. If not up to 4 mmols, re-treat with a second dose of 15 grams emergency food. Repeat in small increments. When blood glucose is above 5mmols, have a substantial snack or meal, such as a sandwich or cheese and crackers; make it a meal with protein. If after two treatments the low glucose levels remains, then urgently seek medical attention. The glucagon Kit This kit is important if one becomes unconscious due to hypo. The relatives or a friend can inject the glucagon and it can help
raise blood glucose as you arrange to have them taken to hospital. Otherwise if one is down on the ground, remove any objects that through the mouth as they can choke. You can lay them on one side of their body; draw the lower hand behind their back to maintain this position (recovery position). You can then give them glucose into the mouth between the cheeks and teeth on the side closer to the
symptoms
place in the glucose powder or tablet. Do not attempt to unclench their teeth or give it onto the tongue you can choke them. The cheek is able to absorb the glucose fairly well, meanwhile arrange for transport to a nearby health centre where glucose can be given through the veins.
It is important that schoolmates, workmates, friends and family know you have diabetes and what to do in case you pass out. Hypoglycaemia can damage your brain or threaten your life, every minute counts. Make sure you always carry some form of glucose or sweets with you at all times. You should also have meal replacement bars with you at all times should an emergency arise. Meal replacement bars are such as Granola, Alpen, Simsim bars, Oatsli etc. They are well packaged and easy to carry. Above all use your medication carefully and do not delay or skip meals. When you exercise or do more physical activity ensure to eat abit more or inquire with your health care provider on how to adjust your medication. Hypo can be prevented or managed early if you have good diabetes education, are motivated and are able to do good diabetes self-care. Hypo can be fatal, every second counts.
Kisukari magazine ⁄ 9
Source: Novo Nordisk Pharmaceuticals, Inc.
DIABETES Foot screening
SCREENING E
By: Miriam Muteti Diabetes Specialist, KNH
T
he Kenyatta National Hospital Diabetes team, in conjunction with Diabetes Kenya Association and the local foot care specialists, held a one day foot screening event at the Kenyatta National Hospital grounds, on 14th of June 2014. This was a follow up of the International Diabetes Federation- DAFI (Diabetes Africa Foot Initiative) program currently on going in 10 African countries courtesy of Saby several stakeholders in the diabetes world. The screening had a holistic approach to diabetes mellitus but with emphasis on foot-care and footwear. Among other activities done were diabetes education, blood sugar check, nutritional assessment and counseling, eye and dental check-ups and consultations. The turn-out was good with approximately 280 people screened, out of those, 125 had diabetes and their feet were screened. Among the feet issues screened for, were skin wounds, gangrene, tinea pedis, bunions, Charcot’s joints, foot deformities and peripheral pulses. Foot wear was also assessed. The foot callus removal among other procedures. A foot-care kit comprising of a soft stone, to every foot screened person. Healthy snacks and bottled water were also served in the event to refresh participants. The event was graced by among others Dr. Nancy Ngugi, Head Diabetes Clinic KNH, Dr. Kirtida Acharya, Chair DKA, Ms. Atieno Jalang’o Secretary DKA and IDF Diabetes Education Coordinator – Africa Region, Mr. Fabian Collis and Sally Kariuki Harman who are Podiatrists. Dr. Silas Radet, Loch labs, the product manager Harleys Ltd among others 10 ⁄ Kisukari magazine
F O OT
Source: 4monthsinafrica.com
EVENT
Kisukari magazine â „ 11
Psychiatric disorders
PSYCHOLOGICAL ASPECTS OF DIABETES By: Dr. Kirtida Acharya
The consequences of not treating the disorders are themselves quite huge. Psychological disorders associated with diabetes include anxiety, panic attacks, depression, eating disorders (both bulimia and anorexia nervosa) and even suicide. According to diabetes UK, people living with diabetes are
20%
more likely to experience anxiety disorders than non diabetics. The main contributor is worry about hypoglycemia.
Also post traumatic stress disorder can result as a consequence of repeated hypoglycemia episodes especially those requiring hospitalization or leading to seizures or loss of consciousness. Depression is also double the rate than in the general population. 15% of people with diabetes experience a major depressive disorder at some time in their life according to the Canadian diabetes association. Depression leads to poor clinical outcomes, more 12 â „ Kisukari magazine
complications, worse control (higher HBA1c) can precede the diabetes or can result from it (chicken or egg!). Depressed people with diabetes are less compliant with medication and lifestyle. Treating depression improves diabetes management and outcomes. Elderly males especially those that live alone and with complications have higher rates of depression. Impotence or erectile dysfunction in men is another very common understandable cause of depression in men that needs to be addressed and with proper management of blood sugars, changing of some contributing medications, stopping alcohol or smoking and using medications( phosphodiesterase 5 inhibitors), vacuum pumps, penile prosthesis or psychotherapy and couple counseling. This problem can satisfactorily be overcome! All it requires is for the male patient to open up and talk and a patient sympathetic doctor to listen and act Eating disorders are common in teenage type 1 girls who cut down on insulin therapy due to the associated weight gain with dire consequences! Hyperthyroidism is associated with manic psychotic states, hyperirritability and mood disorders which often settle with antithyroid treatment. Hypothyroidism mimics depression, with lethargy, somnolence, sluggishness, weight gain, low mood, social withdrawal. Many of the anti-depressants themselves like lithium etc cause thyroid abnormalities so it is recommended that patients with psychiatric disorders should get routine thyroid function tests done. A holistic multi-care giver approach is required in providing utopian care for the
psychological well being for the person living with diabetes. It is important to pick up symptoms of depression, anxiety or eating disorders as early as possible and manage appropriately. Some of the symptoms include: changing eating habits, sleep patterns ( sleeping too much or too little, early morning awakening) , irritability, anger, outbursts, social withdrawal, lethargy, panic attacks expression of suicidal intentions, hearing voices etc, not taking medications, lack of self care. Physical health health risks risks for for people people with with Physical severe mental mental health health problems problems severe
DDIIA ABBEETTEESS
P
eople living with diabetes grapple with varying degrees and aspects of psychological disorders on a daily basis. Many of the psychological disorders associated with or arising as a consequence of the stress and the chronic nature of diabetes are often unrecognized by medical care providers and the patients themselves and so are not adequately addressed or treated.
general general population population
people with with mental mental people health problems problems health
Optimal management of sugars, blood pressure other parameters, empowering the patient through good education, nutrition, timely referral to other specialists (ophthalmologist, dentist as appropriate) to prevent complications will all help to prevent depression as a healthy patient is a happy patient. However, if a patient presents with a psychological disorder early recognition, intervention, referral to a psychologist and or psychiatrist treatment with psychotherapy, counseling sessions, support group if need be anti-depressant drugs, anxiolytics e.t.c. should be considered for the total well being of the patient. The mental health of the patient is often overlooked at a busy medical practice and we have to keep reminding ourselves of the need to look at the patient in totality.
The Pharmaceuticals Division of Novartis is recognized worldwide for the innovative products, services and solutions we provide to patients, physicians and healthcare organizations. This growing business works to change the way medicine is practiced by following the science to deliver the right treatment to the right patient at the right time. The Pharmaceuticals Division researches, develops, manufactures, distributes and sells branded pharmaceuticals used to treat diseases and conditions across a variety of therapeutic areas, including: autoimmunity, cardiovascular, dermatology, infectious diseases, metabolism, neuroscience, oncology, ophthalmology, respiratory, rheumatology, and transplantation. The Division is organized into global business franchises and an Oncology business unit responsible for the commercialization of various products:
The current product portfolio includes more than 50 key marketed products, many of which are leaders in their respective therapeutic areas. In 2012 we received a total of 13 approvals in the United States, Europe and Japan. The product development pipeline has 144 projects in various stages of clinical development, including potential new products as well as potential new indications or formulations for existing products.
www.novartis.com Kisukari magazine â „ 13
Erectile dysfunction
Source: Syda Productions - Fotolia.com
Is Diabetes Affecting Your Sexlife? By: Dr. Priscilla Ngacha
E
rectile dysfunction also called ED or impotence is the inability to achieve or sustain an erection for satisfactory sexual activity and is common in most diabetic men. The symptoms may include: 1.
Trouble getting an erection.
2.
Trouble keeping an erection.
3.
Reduced sexual desire.
It is different from other conditions that interfere with male sexual intercourse, such as lack of sexual desire (reduced libido) and problems with ejaculation and orgasm (ejaculatory dysfunction). How common is it? It is said that men with diabetes tend to develop ED 10-15 years earlier than men without diabetes. It is estimated that about 35%-75% of men with diabetes will experience at least some degree of erectile dysfunction during their lifetime. In men above the age of 50 the tion occurs in approximately 50%- 60% of men with diabetes. Above the age of 70 years there is about a 95% likelihood of having Many men are reluctant to discuss erectile dysfunction with their doctors due to embarrassment and thus the condition is under diagnosed and seldom investigated by the general practitioners and specialists. What are some of the risk factors of erectile dysfunction? The common causes of erectile dysfunction include; Diabetes mellitus, advanced age, cardiovascular or heart diseases, high blood pressure , High cholesterol, cigarette smoking, recreational drug use, low testosterone levels, nerve or spinal cord injuries, depression or other psychiatric diseases. 14 ⁄ Kisukari magazine
So why do men with diabetes have erectile dysfunction? The causes of erectile dysfunction are complex and involve impairments in nerve, blood vessel and muscle functions. The ability to achieve and sustain erections requires: A healthy nervous system. Healthy arteries in and near the corpora cavernosa (this is part of the penile anatomical structure). tissue` within the corpora cavernosa. Adequate levels of nitric oxide in the penis. Adequate levels of the male hormones. A desire to be sexually stimulated. This diabetes is known to damage the blood vessels and nerves that control an erection. Therefore although a man has adequate amounts of the male hormone and a normal sexual desire one may still not be able to This affects patients’ lives in different ways, including disorders in interpersonal relationships, interference with sexual life, problems with partners and an increase in mental stress and this has caused erectile dysfunction to be a major quality of life issue. A diagnosis of erectile dysfunction is made in men who have repeated inability to achieve and/or maintain an erection for satisfactory sexual performance for at least three months. Truthful communication between the patient and the doctor is important in establishing the diagnosis of erectile dysfunction, assessing its severity and determining the cause.
What treatments are available for men with diabetes and erectile dysfunction? Recent pharmacological advances have stimulated a great interest in erectile dysfunction due to its effect on the quality of life. Men suffering from erectile dysfunction can (stendra). However people with diabetes tend to have problems with their hearts therefore the medications may not be appropriate and can cause dangerous interactions with your heart medicine. Other treatments that are also available for men with diabetes include- intracarvenous injection therapy, vacuum constriction devices, intraurethral therapy and sex therapy. It is therefore advisable to consult with your physician before starting any treatment so as to determine what treatment is best. Lifestyle improvements is also advised like quitting smoking, regular exercise, loosing excess weight, curtailing excessive alcohol consumption, controlling high blood pressure and optimizing blood glucose levels in the diabetics. Some studies have shown that men who have made lifestyle improvements experience increased rates of success with treatment. What treatment is best for me? Well it depends on many factors including a man’s health and his ability to tolerate a specific type of treatment. For diabetic patients though key is ensuring good glucose control.
The circle
THE BLUE CIRCLE By: Dr. Salwa Shahbal
I
n medicine, most groups have symbols to represent different diseases and disorders for uniformity and ease of reference. For diabetes, the symbol is the blue circle. This circle is the universal symbol for diabetes and was developed in 2006. The main aim of the circle according to the international diabetes federation is to: Support all existing efforts to raise awareness about diabetes Inspire new activities, bring diabetes to the attention of the general public. Brand diabetes. Provide a means to show support for the The symbol was passed during the United Nation resolution marking world diabetes day and the circle represents more than anything unity. In many cultures, a circle is a sign of continuity representing life and health. The colour blue is the colour of the sky and the United Nations happiness and health for most.
Source: pictures.4ever.eu
The owner of the symbol is International Diabetes Federation (IDF) and whosoever wishes to use it can send a request to communications@idf.org. The IDF has also developed a mobile phone application to help promote awareness of the symbol. Kindly visit www.idf.org for more details. With the World Diabetes Day (WDD) round the corner, I hope we are all going to paint the country blue! Kisukari magazine â „ 15
TRAVEL & Diabetes
Travelling
Diabetes with
Source: aimcentre.com.au
By: Aggrey Shiundu Phamaceutical Technologist
16 â „ Kisukari magazine
“
People with both Type 1 and Type 2 diabetes can travel all over the world, Diabetes is no barrier. Make the right preparations and you should be able to minimise any potential problems.
A good DIABETES TRAVEL PACK should include: Enough insulin, syringes, needles, etc. to last the entirety of the trip (and some extra, just in case) BGM (blood glucose monitoring) testing strips and extra batteries for your meter Any other medications you take, with an extra supply Paper copies of all of your prescriptions (just in case), a letter from your doctor describing your condition, and labels on all of your diabetes products and medication sure everything has either the manufacturer label or the pharmacy label on it). Rapid-acting glucose sources (juice-boxes or hard candies are great for this), as well as a more substantial, but portable snack (like energy bars).
With proper planning, you can still enjoy the experiences of traveling to new places or visiting family and friends. Part of that planning includes: Discussing your travel plans with your doctor Asking your doctor for written prescriptions for all your medications and diabetes supplies Getting a travel letter from your doctor describing your diabetes plan. This is optional, not required by airport security. Packing the proper amount of diabetes supplies that you’ll need for your trip. You need to carry syringes or needles for insulin pens and lancets as part of your insulin injection therapy. Having this will be helpful if your luggage is examined at airport security checkpoints. Be sure to keep your syringes, needles, pens, and lancets in the same boxes that they came in with the original Rx label on them. Below is a list of some of the supplies you may need depending on Type of diabetes; Lancets, blood glucose meters, blood glucose meter test strips, alcohol swabs, meter-testing solutions. Insulin and insulin loaded dispensing products (vials or box of individual vials, jet injectors, pens, infusers, and preloaded syringes).
Insulin in any form or dispenser must be properly marked with a professionally printed label identifying the medication or manufacturer’s name or pharmaceutical label. Unlimited number of unused syringes when accompanied by insulin or other injectable medication. Insulin pump and insulin pump supplies (cleaning agents batteries, plastic tubing, infusion kit, catheter, and needle). Insulin pumps and supplies must be accompanied by insulin with professionally printed labels identifying the medication or manufacturer’s name or pharmacy label. Glucagon emergency kit.
Pack everything in clear plastic ziplock bags, in an easy-to-access part of your carry-on baggage.
Take Special Care of Your Diabetes Medications and Supplies
What to Bring & How to Pack `
Bring at least double your usual amount of medication needed for the amount of time you will be away (to avoid running out or misplacing). Carry insulin and diabetes supplies with you in your carry-on bag (Storage on planes or trains can be above or below ideal temperature. Checked luggage can be lost or delayed). Take a list of all your medications include generic name, trade name and manufacturer (company web site may be useful resource during travel, especially outside the country). Plan for syringe/lancet disposal some airport rest rooms now have sharps containers (needle disposal units). Carrying a small individual sharps container
NOTE: Notify screeners if you are wearing an insulin pump. Kisukari magazine ⁄ 17
EAT WELL
mediterranean
Source: zameencuisine.com
DIET By: Ranjan Patel Clinical Nutritionist Diabetes Educator
T
he Mediterranean diet is inspired by the traditional dietary patterns of Crete, Greece, Southern Italy, and Spain. The diet is predominantly vegetarian with moderate consumption of fish and dairy (mostly as cheese and yogurt). The healthy aspect of the diet is the fact that there is very low consumption of meat and meat products. Total fat in this diet is 25% to 35% of calories, with saturated fat at 8% or less of calories. Olive oil is the principal source of fat. Olive oil is mainly monounsaturated fat - a type of fat that can help reduce low-density lipoprotein (LDL) cholesterol. The inclusion of red wine is considered a factor contributing to health as it contains flavonoids with powerful antioxidant properties Strong evidence for a beneficial health effect and decreased mortality after switching to a largely plant based diet comes from studies of the Mediterranean diet. According to a 2008 study published in BMJ (Bristish Medical Journal), the traditional Mediterranean diet provides substantial protection against type 2 diabetes. The study involved over 13 000 graduates from the University of Navarra in Spain with no history of diabetes, who were recruited between December 1999 and November 2007. A high adherence to the diet was associated with an 83% relative reduction in the risk of developing diabetes.
KEY COMPONENTS OF THE MEDITERRANEAN DIET: t
A meta-analysis published in BMJ in 2008 showed that following strictly the Mediterranean diet reduced the risk of dying from cancer and cardiovascular disease as well as the risk of developing Parkinson’s and Alzheimer’s disease.
t
A 2011 meta-analysis published in the Journal of the American College of Cardiology analyzed the results of 50 studies (35 clinical trials, 2 prospective and 13 crosssectional) covering about 535,000 people to examine the effect of a Mediterranean diet on metabolic syndrome. The researchers reported that a Mediterranean diet is associated with lower blood pressure, blood sugar, and triglycerides.
t
18 ⁄ Kisukari magazine
t
t t
Eating primarily plant-based foods, such as fruits and vegetables, whole grains, legumes, seeds and nuts. Replacing butter with healthy fats, such as olive oil. Using herbs and spices instead of salt to flavor foods. Limiting red meat to no more than a few times a month. Eating fish and poultry at least twice a week. Drinking one glass of red wine (optional).
The diet also recognizes the importance of being physically active, and enjoying meals with family and friends.
Greek
LentilSoup(Fakes) QUICK INFO: “Fakes” (pronounced ‘Fah-kehs’) is a staple meal. It is traditionally served with a drizzle of olive oil and lots of vinegar. Though the vinegar is of course optional, try it. It lifts the Leftovers, GERD-Friendly, Heart-Healthy, Diabetes-Friendly.
INGREDIENTS Original recipe makes 4 servings 8 ounces brown lentils 1/4 cup olive oil 1 tablespoon minced garlic 1 onion, minced 1 large carrot, chopped 1 quart water 1 pinch dried oregano 1 pinch crushed dried rosemary 2 bay leaves 1 tablespoon tomato paste salt and ground black pepper to taste 1 teaspoon olive oil, or to taste 1 teaspoon red wine vinegar, or to taste (optional)
PREPARATION 1. 2.
3.
Place lentils in a large saucepan; add enough water to cover by 1 inch. Bring water to a boil and cook until tender, about 10 minutes; drain. Heat olive oil in a saucepan over medium heat. Add garlic, onion, and carrot; cook and stir until the onion has softened and turned translucent, about 5 minutes. Pour in lentils, 1 quart water, oregano, rosemary, and bay leaves. Bring to a boil. Reduce heat to medium-low, cover, and simmer for 10 minutes. Stir in tomato paste and season with salt and pepper. Cover and simmer until the lentils have softened, 30 to 40 minutes, stirring occasionally. Add additional water if the soup becomes too thick. Drizzle with 1 teaspoon olive oil and red wine vinegar to taste.
Kisukari magazine ⁄ 19
WORLD DiabeTES DAY
WDD By: Dr. Farah Sherdel
I
WORLD DIABETES DAY
t is a globally celebrated event to increase awareness about diabetes and is celebrated every year on November 14th. It is
year, World Diabetes Day, which is coordinated by the International Diabetes Federation (IDF), carries a particular theme. The theme for 2014-2016 is ‘healthy living and diabetes’. Why is November 14th chosen as World Diabetes Day? This date is very important because it is the birthday of Frederick Banting. The man who, along with Charles Best, discovered Insulin in 1922. The logo of World Diabetes Day is the blue circle. It is recognized by the diabetes community globally in response to the increasing incidence of diabetes.
Organize a diabetes walk. You can invite your neighbors, family members and friends to join in. Organize sporting events like bicycle races, football matches, swimming events. Diabetes fun weekend like hiking, camping or just a day trip Make a healthy breakfast for your parents, siblings Go blue by wearing blue t-shirts, hang blue circles on your balcony or just put something blue on your Facebook page!
Remember you can make a difference, so go out there and celebrate World Diabetes Day!!
So, what are some of the fun ways of celebrating WDD?
a fun group photo! Diabetes awareness quiz all week in school 20 ⁄ Kisukari magazine
Source: idf.com
Diabetes day in school- organize different games related to diabetes and healthy lifestyle, have educational sessions where you can share your personal experiences as well as have someone speak about diabetes, short walks with your fellow students and teachers. Distribute educational
Download the WDD Selfie app
Healthy GAMES BLUE MAZE Solve the Maze by finding a route through the maze from the start to Diabetes Symbol.
START
CROSSWORD Across
Down
1. ____________discovered Insulin 6. The blue ___________ is the WDD logo 7. The theme for WDD 2014 is __________ living and diabetes 8. __________ is also important for good sugar control
2. 3. 4. 5.
A well balanced meal must include ___________ ____________ was discovered in 1922 WDD is celebrated in ___________ _____________ is used to measure bloos sugars
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dk OVERVIEW
VISION: Excellence in the prevention and management of diabetes! MISSION: A Diabetes Free Kenya! MOTTO: “An Anchor of Hope” against the rising tide of the diabetes epidemic in Kenya. OVERVIEW: Formerly called the Kenya Diabetes Association
(KDA), the association was first registered in 1972 by the late Dr. Eric Mngola. A change of name and new registration was necessitated towards the end of 2009, leading to the birth of Diabetes Kenya Association (DK) on 11th March 2010. A duly elected National Executive Committee team, under the Chairmanship of Dr. (Mrs.) Kirtida Acharya, Physician, Endocrinologist and Diabetologist run the day-to-day activities of the association on a purely voluntary basis. Diabetes Kenya Association is a non-governmental, non-profit organization, officially registered with the change of name in March 2010, working and lobbying to better the lives of people affected by diabetes. Diabetes Kenya, the national representative body for diabetes in Kenya, is the sole accredited associate member - in Kenya - of the International Diabetes Federation (IDF), which is the umbrella organisation of over 200 national diabetes organizations in over 160 countries, representing the interests of a growing number of people with diabetes and those at risk. DK representatives are actively involved in a number of working committees of the International Diabetes Federation. Our association works closely with the Ministry of Health, global and major local pharmaceutical companies as well as corporate sponsors who have already awoken to the devastating effects of diabetes and other Noncommunicable diseases; mainly cardiovascular diseases, cancers and chronic respiratory diseases. They have made diabetes education and prevention a major part of their corporate social responsibility programmes. Diabetes Kenya Association rolls out a yearly calendar of events, which involves free blood sugar screening, educational and prevention camps as well as other diabetes related activities to bring to light the diabetes epidemic in our country. Diabetes education is important and accounts for 50% of diabetes treatment.
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MANDATE: t t t t t t
Promoting public awareness of diabetes, its symptoms, risks, prevention and control. Supporting and organizing of training for people who live or work with diabetes. Lobbying for better understanding of patients’ needs and for affordable care and medication Fostering enabling partnerships and linkages for the fight against diabetes Enabling diabetes related research Addressing issues related to and including Epidemiology of Diabetes and its complications
OUR NETWORK: Diabetes Kenya Association works closely with Kenya’s Ministry of Health. Our National Office in headquartered in Nairobi and includes branch offices countrywide, enabling rapid dissemination of information and resources within State and Provincial Health Facilities. THE NATIONAL EXECUTIVE COMMITTEE OF DIABETES KENYA IS ACTIVELY INVOLVED WITH: t t t t t t t
University medical departments State and provincial health departments Doctors specializing in diabetes in Kenya Specialist health care workers Private medical practitioners and other diabetes related health care workers Non-government organizations working in related fields within the primary health care sector. Industry, including global pharmaceutical companies and other companies servicing people with diabetes.
Diabetes Kenya is primarily a volunteer organisation and relies heavily on people with diabetes and their families, who pool their talents, share their knowledge, resources and experience and give of their time to help each other. As we all know – to do nothing is no longer an option. We no longer have the luxury to afford having bystanders. It is time to give diabetes and other NCDs the attention they deserve. Diabetes has many faces but few voices. We hope to encourage as many people to come together as possible in eradicating diabetes from our country.
Let Us Unite in the Fight Against Diabetes!
Friends of Diabetes Kenya Dear Readers, find below different categories of supporting Diabetes Kenya by being a friend of Diabetes Kenya.
a) Individual category Minimum Donations - 500 ksh per month, payable quarterly b) Corporate category Minimum Donations - 5000 ksh per month payable quarterly Benefits - free copy of our quarterly magazines - Regular Information on Diabetes from diabetes Kenya on email - Acknowledgement in our magazine (Kisukari)
Corporate Sponsorship for Diabetes Kenya Bronze sponsor Ksh 100,000/- per year Benefits - 5 free copy of our quarterly magazines - Regular Information on Diabetes from Diabetes Kenya on email - Acknowledgement in our magazine with appearance of logo Silver sponsor Ksh 250,000/- per year Benefits -10 free copy of our quarterly magazines - Regular Information on Diabetes from Diabetes Kenya on email - Acknowledgement in our magazine (Kisukari) with appearance of logo - Acknowledgement during DK functions, banners during DK functions -25% discount on advertising in Kisukari magazine Gold sponsor Ksh 500,000/- per year Benefits - 20 free copy of our quarterly magazines - Regular Information on Diabetes from Diabetes Kenya on email - Acknowledgement in our magazine (Kisukari) with appearance of logo - Acknowledgement during DK functions, banners during DK functions - Acknowledgement plaque at DK office -50 % discount on advertising in Kisukari magazine
We look forward to your continued support. . . Kisukari magazine â „ 23
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