LIFE CAN BE SWEET, WITH DIABETES
Issue 11
Spring 2014
A real sense of
community Also
Sweet Life’s
vasbyt issue!
PLUS: how to support your best friend
SLM11_Cover.indd 1
- fun ways to group exercise - baked goodies - easy diabetes management tools - And more!
Free! Take one now
www.sweetlifemag.co.za
2014/07/24 5:23 PM
Get Connected. Get Living.
Don’t let your life be ruled by diabetes. Use the power of your smart phone and the web to manage your diabetes so that you can get on with the job of living your life. • Transfer your blood glucose results wirelessly to the mobile app. • Get mobile and online reports of your blood glucose patterns. • Calculate how much insulin to take at mealtimes with the clinically proven Accu-Chek Bolus Advisor.¹ • Share your diabetes data online with your healthcare professional. • Automatically send test results to loved ones.
Experience what’s possible.
Get your Accu-Che k Connect Meter from lead ing pharmacie s
Reference 1 Ziegler R, Cavan DA, Cranston I, et al. Use of an Insulin Bolus Advisor Improves Glycemic Control in Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control: First results from the ABACUS trial. Diabetes Care. 2013;36:3613-3619.
To find out more, visit www.accu-chekconnect.co.za or call 080-Diabetes (Dial 080-34-22-38-37) toll free. Ref: ACUST 140718
2338_Accu-Chek - Connect Consumer Ad_Sweetlife.indd 1
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The hardest thing about diabetes, for me, was understanding that no matter how hard I worked at it, it would never go away. This isn’t a challenge that can be overcome, a task that can be accomplished or a prize that can be won… This is forever. But just because it’s a forever-condition doesn’t mean we should quit at it. The truth is that living a healthy life with diabetes means that the condition doesn’t get in the way of you doing anything you want to do – but not paying attention to diabetes means it will force you to sit up and take notice in the worst possible way. None of us want to suffer from complications, and if we look after ourselves and our blood sugar, eat the right way and exercise often, we won’t have to… But what about those days when it all seems too hard? That’s what this issue is about – what to do when you want to quit at your diabetes, and how not to. Remember that you are never alone in this journey: you have a community of other diabetics just waiting to connect with you, online or in person. Drop us a line if you have any questions (hello@ sweetlifemag.co.za) and don’t forget to join our Facebook page, Diabetic South Africans, where we hold weekly diabetes chats.
EDITOR Bridget McNulty
ART DIRECTOR Mark Peddle
PUBLISHER Claire Barnardo
ADVERTISING SALES TFWcc: Tessa Fenton-Wells
CONTRIBUTORS Andrea Jenkins, Caroline Gardner, Cheryl Meyer, Faaiza Paruk, Fiona Prins, Jeanne Berg, Kate Bristow, Leanne Tee, Lucia Viglietti, Nicole McCreedy, Rachel Lombard, Sarah Hall, Susan Erasmus. ADVERTISING ENQUIRIES Box 52301, Kenilworth 7745. Tel: 021 761 2840. Fax: 021 761 0442. Cell: 082 320 0014. Email: tessa@tfwcc.net
EDITORIAL ENQUIRIES PO Box 12651, Mill St, 8010. Tel: 021 469 4714 Email: info@sweetlifemag.co.za
COPYRIGHT
Even though diabetes won’t ever go away, we can live happy, healthy lives with it. Let’s all do that!
Published by The Editors Publishing House CC. Copyright The Editors Publishing House CC. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor.
Until next time,
COMPETITION RULES
Bridget McNulty Editor
Welcome
Hi there!
Winners will be randomly selected and notified by telephone or email. Prizes are not transferable and cannot be exchanged for cash. The judge’s decision is final and no correspondence will be entered into. Diabetic South Africans
PS: Want to make sure you get your free copy of Sweet Life? Find your nearest Dis-Chem store on page 4.
sweet_life_mag
The views and opinions expressed in this magazine are those of the contributors and not necessarily those of Sweet Life. Always consult a specialist before making any changes to your diet or medicine.
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Exciting news! Sweet Life is now available at all Dis-Chem stores nationwide! Pick up your FREE copy of Sweet Life from any Dis-Chem store in South Africa, or from your local support group or pharmacy.
SWEET LIFE AVAILABLE AT ANY DIS-CHEM!
Find your nearest Dis-Chem store:
www.sweetlifemag.co.za/dischem
Local pharmacies: Want to get Sweet Life in your area? Let us know where your local clinic or pharmacy is, and how to get hold of them, and we’ll send them free copies of Sweet Life. Email us on hello@sweetlifemag.co.za
Community
You can also read Sweet Life online at: www.sweetlifemag.co.za/magazine
Meet our diabetic experts: Sweet Life has a fantastic Panel of Experts who are all leaders in the field of diabetes. They give us advice on everything we publish so that you can be sure you’re only getting the very best information to help you live a happy, healthy life with diabetes. Here are the wonderful experts on our panel: ENDOCRINOLOGISTS:
Dr. Zaheer Bayat
MBBCh (Wits), FCP(SA), Cert Endo is a specialist physician and specialist endocrinologist working in Gauteng. He is the chairman of SEMDSA: the Society for Endocrinology, Metabolism and Diabetes of South Africa.
Dr. Joel Dave
MBChB PhD FCP Cert Endocrinology is a Senior Specialist in the Division of Diabetic Medicine and Endocrinology at the University of Cape Town and Groote Schuur Hospital and in private practice in Cape Town.
PROFESSORS
Timothy Noakes
MBChB, MD, DSc, FACSM, (hon) FFSEM (UK) is a Professor in the Discovery Health Chair of Exercise and Sports Science at the University of Cape Town. He is also cofounder with Morné du Plessis of the Sports Science Institute SA.
Wayne Derman
MBChB BSc (Med) (Hons) PhD is the Director of the Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of SA, where he is also Professor of Sport Science and Sports Medicine.
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Dr. Claudine Lee
is a family doctor (GP) with a passion for diabetes. She is based in Hilton, KwaZulu/ Natal and also runs an insulin pump centre.
SUPPORT GROUP EXPERT
Dr. Neville Wellington has been a
GP for 17 years and currently works at the Kenilworth Medicross. He has always had an interest in diabetes.
Dr. Gabaza Ngobeni is a GP based
in Soweto. She runs Dr Gabaza’s Healing Centre, a division of the CDE, and does a lot of community work.
DIABETES EDUCATORS
Jeannie Berg is the Chairperson of DESSA: the Diabetes Education Society of South Africa, and a registered pharmacist and diabetic educator.
Fiona Prins has been working with diabetics for 16 years. She is chairperson of DESSA KZN and a registered diabetes specialist nurse.
Kate Bristow is
a qualified nursing sister and certified diabetes educator who runs a Centre for Diabetes in Pietermaritzburg, KwaZulu/Natal.
registered dietician and member of the ADSA* who is passionate about diabetes and works in private practice in Bryanston.
Genevieve Jardine
is a dietician based in Durban who is registered with ADSA* and specialises in diseases of lifestyle, including diabetes.
PODIATRISTS
Andy Blecher is a podiatrist in Cape Town and currently runs the Western Cape Diabetic Foot Clinic with a team of other specialists.
Branch Manager of Diabetes South Africa Durban and is passionate about educating diabetics on how to lead a healthy lifestyle. She also holds the Community portfolio on the DESSA KZN committee.
OPHTHALMOLOGIST:
Dr. Dale Harrison
is an ophthalmologist in private practice in Cape Town, and a sessional consultant at Groote Schuur Hospital. His motto? Get your eyes checked annually.
DIETICIANS:
Cheryl Meyer is a
Jenny Russell is
Community
DOCTORS
Faaiza Paruk holds
a Bsc Dietetics (Hons) from the University of the Western Cape and is a member of ADSA*. She specialises in diseases of lifestyle.
*ADSA = Association for Dietetics South Africa.
BIOKINETICISTS
Anette Thompson
M Tech Podiatry (UJ) and B Tech Podiatry (SA) is currently Chairperson of the Footwear Committee of the SA Podiatry Assoc.
Sarah Hall is a Registered Biokineticist BSc (Med)(HONS) in Exercise Science (Biokinetics) UCT who works for Wellness in Motion in Parkmore.
Ilona Padayachee
is a biokineticist in private practice in Port Elizabeth. She studied HMS (Human Movement Science) Hons Biokinetics at NMMU.
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“Cheat”
treats
Ask the expert: Cheryl Meyer
From our community:
‘I
Ask the Dietician
know that as a diabetic I should always try and be good, but sometimes it’s hard… What can I snack on without feeling too guilty about it (but that will also be a treat)?’ Charne Smith.
A treat is something that tastes great, is normally high in fat and refined carbohydrate, and is eaten to either celebrate or make you feel better… But how do you have your treat and prevent it from totally messing up your blood sugar levels for the day? Treats are not forbidden, but they should not be too often or too big. It all comes down to self-control and portion control. The occasional block or two of chocolate should not mean disaster for your blood sugar: it’s when you eat the whole slab that things spiral out of control. Everything in moderation is the key. If you battle with cravings, you need
to understand that the last bite never tastes as good as the first bite. The feel good rush you get from the first bite of a treat starts to fade as you continue eating, but your blood sugar levels start to increase. What does this mean? You only need a small amount to feel like you’ve had a treat. You don’t need the whole slab, packet, bowl or slice…
Try our delicious chocolate birthday cake on page 34 for a real treat!
“The last bite never tastes as good as the first bite.”
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• Split a dessert with your partner. It might drive them nuts, but it will keep your blood sugar and weight down. Better yet, plan ahead and choose a light main course so that you can have a small dessert on those special evenings out. • Choose biscuits and cakes that don’t have icing, or remove the icing and jam from cakes. Icing has twice the amount of sugar as the cake or biscuit. • Choose a dessert like apple crumble (without the ice-cream or cream) or 2 small scoops of ice cream. Just remember to keep portions small. • Spoil yourself with some good diabetic friendly ice-cream (low
fat/low sugar), lite custard and diabetic friendly puddings. • Opt for small “bite” sized chocolates or chocolates with wafer inside (e.g. Kit Kat fingers). • Dark chocolate with a high percentage of cocoa is better for you as it is higher in antioxidants. Dark chocolate is also bitter so people tend to eat less of it: usually a block or two is enough. • Try snacking on salt and vinegar popcorn instead of crisps and you will keep your fat content low plus help with salt cravings. When going to the movies, choose a small popcorn and a diet drink.
Ask the Dietician
How to cheat:
Remember: Spoiling yourself on the odd occasion is allowed. Always test your blood sugar levels to see how they react and you will learn to better control these situations. 07
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10 fast facts about foot ulcers
Healthy Living
All diabetics know that foot care is really important, but do you know why? Preventing foot ulcers is an essential part of keeping your feet healthy. Here are some great tips from Smith & Nephew Woundwise.
Foot ulcers are skin ulcers where the skin has broken down under the foot and you can see the tissue underneath it.
15%
2
Diabetics are at greater risk of foot ulcers because high blood sugar for a long period of time can damage the nerves in the feet, which means you won’t be able to feel pain and might not notice a foot injury.
A diabetic foot ulcer can develop after even the smallest injury, like stepping on a little stone with bare feet. Ulcers are easily infected and can take weeks or even months to heal.
of people with diabetes may develop a foot ulcer.
6
More than half of all diabetic foot ulcers become infected.
Foot ulcers are the most common reason for diabetics needing to go to hospital.
Luckily, they are also easily prevented: by carefully controlling blood sugar levels to prevent nerve damage.
Keeping the feet clean and dry is essential – but do not soak them.
10
PIC
8
It is very important to check the feet, including the areas between the toes, for cuts and sores – every day.
Be sure to have your feet checked once a year by a doctor or podiatrist.
Ask the expert: Andy Blecher, Podiatrist “Diabetic foot ulcers are very serious and if left untreated can lead to amputation. Check your feet daily, wear the correct fitting shoes and have calluses removed regularly by a registered podiatrist, as calluses and corns are one of the most common causes of diabetic foot ulcers.”
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Partner’s Corner
“O
This is your space…
ne of my best friends is a Type 1 diabetic and she often skips taking her insulin to keep her weight down… I know this is going to cause her long-term damage, but I don’t know how to convince her to look after herself better. Any advice?” Sune Terblanche
Without insulin, the body cannot break down sugars from food to use as energy. So it breaks down fat already stored and flushes out the excess sugar through the urine. This leads to weight loss, but it also causes nerve damage, damaged
eyesight, kidney damage and osteoporosis, amongst other things. To be a good friend, you have to be honest about your feelings and her actions. That will open up direct lines of communication with her and help her talk to you about skipping insulin and how you can help her. Try not to nag or police her, but use opportunities to point out to her what she is doing to herself. Reinforce the fact that you care about her and ask her how you can help. Remind her that she is brave enough to face the challenge that diabetes has brought into her life.
Ask the expert: Jeanne Berg, Diabetes Educator “She needs to know that beauty comes from within. Being a healthy teenager with diabetes is a much better option than being an unhealthy thin girl. Help your friend see herself for the beauty that she is.”
Partners
Dear Sune, Teenagers are inclined to focus on one thing and not see the bigger picture. Your friend is most probably also feeling the peer pressure of other girls to be thin. Teenagers are sometimes just tired of medicine as well. They just decide to stop using insulin. Stopping insulin makes it easy to lose weight.
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Keeping others inspired
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WORDS: CLAIRE BARNARDO PHOTOS: MARK PEDDLE
2014/07/24 5:21 PM
What got you interested in diabetes at first? It all started whilst working in the vascular unit at Kingsbury Hospital. I realised that most people are not informed about managing diabetes after being diagnosed. So I became passionate in the control of potential complications of this disease if the patients become noncompliant. Kingsbury management identified my passion and allowed me to do the vascular course in London as it’s not offered here. On my return I did two presentations at the doctors academic meetings. At the time my husband had a myocardial infarction and had been diagnosed with hypertension and diabetes. The entire experience stimulated me to get involve with my community. Now my husband is one of the volunteers. I then started doing motivational talks at schools, groups, on radio and at our nursing college. How did you start your community group? How big is it? I joined the Strandfontein Health Forum and offered to do the diabetes awareness events as there was no project as such. With the awareness held at the Strandfontein Clinic I handed out questionnaires and a suggestion box. It was the requests of the community to have a diabetic support group that started it.
What was it like to begin with? Preparation was hectic, sponsorship poor then and still now. It’s difficult getting equipment and requirements as well as a problem with the availability of a suitable venue. What keeps you inspired? The positive attitude and enthusiasm of the volunteers, noticing the excitement and socialising of the attendees. When we take a break, people want to know when we will be starting again. The continuous support of ‘diabetes life’ (a diabetic clinic at Kingsbury hospital) under the management of endocrinologist Dr May, Dr Tracy van Rensburg and nurse educator Sr. Dee Ferguson (my mentor). Positive feedback from the doctors at the day hospitals where the clients attend keeps me going.
Inspiring
We chatted to community inspiration Veronica Vember about how she changes lives one step at a time.
You were voted WCape’s Lead SA hero - how did this make you feel? Surprised, shocked, emotional, confused and thankful towards the responsible person for the recognition. I’m very proud of the team of dedicated volunteer attendees as I can’t do this alone. It’s a team effort – unity is strength. What advice do you offer your support group members when they want to give up? To persevere, not to give up, not to give in, be compliant, to attend 11
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Inspiring
I realised that most people are not informed about managing diabetes after being diagnosed. the support group regularly. We do individual counselling and have a communication box available for constructive comments and replies. How do you make diabetes inspiring? Make the environment safe, easy accessibility, conducive, clean functional equipment and with competent staff creates a harmonious atmosphere. We vary programs, presentations, literature, topics, menus (soup in winter and tea and a snack for summer). We also combine our decision making with the volunteers.
What makes your life sweet? By carrying out our mission, vision and outcome. S - be sensitive towards all W - to warn people about the consequences of not being compliant E - to educate people regarding a healthy lifestyle and change of mind set. E - to be empathetic and empower people with knowledge T - to be trained, to train others Outcome: To ensure that all clients are well informed, have normal glucose levels reached and maintained.
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Discreet bolus delivery, and still stepping out in style.
The Accu-Chek Combo system. For discreet bolus delivery without touching the pump. ®
• By wireless two-way communication between the pump and meter • Supporting tighter control of post-prandial blood glucose values 1,2 • Sensitive occlusion detection provides additional safety 3 Operating your pump remotely with the meter means you don’t have to touch your pump to bolus or check the screen once it’s placed under clothes.
Experience what’s pos possible. For more information contact your Healthcare Professional 1H.Zisser et al. Clinical performance of three bolus calculators in subjects with type 1 diabetes mellitus: A head-to-head comparison. Poster presented at the 46th EASD Meeting, Stockholm Sep.2010. 2A.McDaniel et al. Differences in management of post-prandial hyperglycaemia by automated bolus calculators is due to distinct insulin on board algorithm. Poster presented at the 2nd international conference on Advanced Technologies & Treatments for Diabetes, Athens, Greece Feb. 2009. A237. ³”Andreas Buhr et el. Time delay to occlusion detection of insulin infusion pumps. Poster presented at the 5th International Conference on Advanced Technologies and Treatments for Diabetes Barcelona, Spain, February 2012”
Roche Products (Pty) Ltd Diagnostic Division PO Box 1927, Randburg Toll free: 080-Diabetes (Dial 080-34-22-38-37) www.accu-chek.co.za / www.diabetes.co.za Ref: COMB 140124
2343_Accu-Chek - Carbo & Cals Ad - Sweetlife.indd 1
2014/05/27 11:47 AM
Reduce salt for your health Your body needs only a small amount of salt to be healthy.
Eating more salt than you need can be unhealthy as it can increase your blood pressure.
Jou liggaam benodig slegs `n klein hoeveelheid sout om gesond te wees.
Om meer sout te eet as wat nodig is is ongesond omdat dit jou bloeddruk kan verhoog.
How much salt is too much?
How to eat less salt
Hoeveel sout is te veel?
• You should not eat more than 5g / 1 teaspoon of salt per day.
Jy moet nie meer as 5g /1 teelepel sout per dag eet nie.
Hoe om minder sout te eet.
• Don’t put salt on the table. Stop the habit of adding salt to your food at the table.
Moenie sout op die etenstafel sit nie. Stop die gewoonte om aan tafel sout by kos te voeg.
• Start using less salt when you are cooking.
Begin om minder sout te gebruik terwyl jy kook.
• Taste food while cooking before adding salt, as it may not need it.
Proe kos terwyl jy kook voordat jy sout by sit, dit mag dalk nie nodig wees nie. • If you have already added salty spices or a stock cube, you don’t need salt too.
As jy reeds sout speserye of aftrekselblokkies begevoeg het, is sout nie nodig nie.
www.westerncape.gov.za
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Less salt saves lives:
Use this instead of salt: Gebruik die eerder as sout: • Lemon juice or vinegar • Herbs: basil, sage, origanum, parsley, rosemary • Spices: curry powder, paprika or pepper • Garlic, ginger, chilli and onions • Add peppers, mushroom, tomatoes to meat
Minder sout red lewens:
7400
people per year in SA!
Lives saved by less salt in bread: Lewens gered deur minder sout in brood:
6400
per year in SA
Foods low in salt
Moderate salt foods
Foods high in salt
Eat more often
Eat sometimes
Eat less often
Foods prepared at home from fresh ingredients
Salted nuts
All types of salt
Cakes, pastries & biscuits
Fruit and vegetables (fresh, frozen & dried)
Table sauces (tomato sauce / mustard)
Seasoning salts like barbeque or chicken spice
Unsalted nuts and seeds
Salad dressings
Beans, lentils & peas
Mayonnaise
Mealie meal
Convenience meals
Pasta and rice
Burgers & pies
Plain popcorn
Soft tub margarine
Oats
Paté & hummus
Fresh fish Fresh chicken & meat Eggs Yoghurt & maas Plain cottage cheese Vinegar or lemon juice Spices & herbs (dried & fresh)
Look for lower salt options for these foods: Bread & bread products Breakfast cereals Baked beans
Stock cubes, gravy & soup powders Take-away foods, pizza & crumbed meat or chicken Crisps Salty spreads Worcestershire & soya sauce Processed meats like polonies, viennas, salami, ham, sausages & boerewors Cured meat & fish like bacon, biltong, bokoms, anchovies, corned beef & pickled tongue
Peanut butter
Cheese, butter & hard margarine
Tinned fish
Instant noodles Olive & pickles
Source: National DoH, Heart and Stroke Foundation SA (www.heartfoundation.co.za)
Top tips for flavouring food
1. Lemon: add a squeeze of lemon/acidic fruit
to bring out flavour
2. Own stock: keep juices from cooked food to use 3. Herbs: add herbs to create flavour 4. Basics: cook with garlic and onion for starters 5. Balsamic vinegar: really wakes up food flavours
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Keeping fit - Lotus River CHC An important part of managing your diabetes is exercise. But you don’t have to do it alone. Find a group in your community and you’ll soon be inspired. We chatted to Beverley Wilcox, Health Promotion Officer, who runs an exercise group at the Lotus River CHC. When do the group meet? We meet every Monday and Wednesday from 9-10am. How did this start? We started with a Lifestyle Intervention Group for chronic diseases 5 years ago. There were 10 members that had to answer ‘where do
you see yourself in 5 year’s time?’ and how they would personally take small steps towards changing habits. Many of them said it felt climbing a mountain. But together we took it one step at a time. What exercise do you do? We do aerobic exercises and if it’s rainy then we do mat exercises indoors. What is the diabetic program? We’ve just started a new diabetic group with a similar technique. It’s very effective and I can see how people make changes towards a healthier lifestyle.
Reader feedback
Thank you for telling us what you think of our magazine. Here’s what we’ve done this issue to make sure it’s what you want. - Content is easier to read - Our food is simpler - Focus on diabetic feet - Added portion sizes.
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Coming up we will be looking at diabetes and... - HIV/AIDS - Alcohol use - Pregnancy - Sexual health.
2014/07/24 5:28 PM
Community Focus questions: Name: Garret Coetzee Age: 64 Diabetes: Type 2 Clinic: Woodstock Day Hospital When were you diagnosed with diabetes? Last year, in 2013. How has diabetes changed your life? I had to change my eating habits and I had to start exercising. I had never exercised before and I was overweight. But within a year I had lost 16kg and I realised what a blessing it had been that I had started to live a healthier lifestyle. What did you know about diabetes before you were diagnosed? I knew nothing at all, it had never been in our family and so it was not something I had ever taken time to think about. I was shocked! Where did you get your information about diabetes? From my doctor and from the hospital. I spoke to a girl here at the hospital and she explained what diabetes is, how it will affect me and how it came to be in my body. I also attend a support group. What was the most difficult challenge? The diet. I use to love sugar and salt. I would eat very large portions of food with
plenty salt, drink no water and would eat at least two chocolates before bed every night - changing these habits has been difficult for me. How has adapting your diet and exercise changed the way you feel? Losing so much weight has really changed my life. I feel great now. A few months ago, I couldn’t even tie my own shoelaces without a chair or some kind of support, but now I do so with ease. I’m not sure I would be alive today without my diagnosis. Have there been any implications since you were diagnosed? No not really. The change in diet has been to include more veggies and eat less meat and starch. I use to eat both rice and potatoes but now I will choose to have either or. What’s the best advice you could give to diabetics at your age? That exercise is the most important. For me that is my priority. I exercise at least 3 times a week. At my age it can make an enormous difference in a person’s life, and it has become extremely important to me. www.westerncape.gov.za
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Easy diabetes management tools Making choices and decisions every day about life with diabetes can be tough... But luckily there are solutions to make it much easier. We’ve rounded up a few of our favourite tools for you to choose from. Each of us is different, so the methods and tools we choose to manage our diabetes need to be different too. The trick is to find solutions for self-management that work for you every day.
Here are some ideas to get you started: Become an expert on diabetes Gather as much information as you can on diabetes and how it affects your body. Make sure that your information is from a respected source, based on accurate scientific evidence. Ask your doctor to direct you to relevant books or websites.
overwhelmed, angry or sad when you’re living with diabetes. You may know the steps you need to take to stay healthy, but have trouble sticking with your plan over time. Try to make peace with your diagnosis and take control of your situation: eat well, exercise often and go for regular check-ups.
Understand the role that insulin plays in transporting glucose in the bloodstream to your muscles. This will help you to better know what impact foods such as carbohydrates or sugar will have on your blood glucose levels and how much insulin your body may need. With this knowledge, it does become easier to plan ahead and predict – to a degree – how your body will react.
Find ways to cope with stress and other factors Heat, sickness, exercise, your menstrual cycle and stress are all factors that need to be considered when managing your treatment. Recognise and address these factors as they arise. Stress, for example, can raise your blood glucose levels, so in times of stress you may have to monitor your blood sugar more often.
Lifestyle
1
2
Learn to live with diabetes It is common to feel
3
4
Be prepared and have a system If you inject insulin, ensure
Ask the expert: Dr Joel Dave, endocrinologist “Adapt your lifestyle and diabetes care to achieve good diabetes control and a good quality of life. This can definitely be done – try to include a multi-disciplinary team in your care to ensure balance in all areas.”
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Count your carbohydrates Carbohydrate counting is helpful as it allows you to figure out more accurately how much insulin to give yourself before a meal to keep your blood sugar under control. Get into the habit of reading labels on the foods that you eat, as it will teach you to better estimate quantities, which can help you to be more accurate.
5
Useful guides Buy The South African Glycemic Index and Load Guide on the GI Foundation website. The 2013 edition sells for R130. Get your hands on a local cookbook with diabetesfriendly recipes. Look out for Diabetes and Insulin Resistance and South African Cookbook for Diabetes on Kalahari.com Buy Your Journey with Diabetes by Sweet Life dietician Genevieve Jardine. The book costs R140 including postage – find out more on www.nutri-life.co.za Mobile apps There are a number of apps available for you to use on your phone: • Glucose Buddy stores the data you need to manage diabetes without a lot of hassle. You can input your blood glucose numbers, insulin dosages and how many carbs you eat at each meal. • Diabetes Buddy helps you manage your diabetes by tracking the factors
DOSE (UNITS)
SHOTS/DAY
ORAL DIABETES
DOSE
MEDICATIONS
that influence your blood sugar levels, monitoring the fluctuations, planning ahead and making it easy for you to share your data with your doctor. • ACCU-CHEK® 360° diabetes management app provides easy tracking of your diabetes data. A choice of graphic reports helps you identify trends and patterns in your blood sugar levels to support better management of your diabetes.
TIMES/DAY
INSULIN NAME
The Accu-Chek® 360° View 3-day profile is an easy-to-use tool that helps you and your doctor see how well your blood sugar is under control. You can see the effect of your meals on your blood sugar, and how well your diabetes medication is working. All it takes is 3 days of testing 7 times a day… Try it now! Download your free profile at www.accu-chek.co.za
PATIENT NAME
PATIENT PHONE
ay ® 360° View 3-d Accu-Chek
What did you
profile tool
learn from doing
this analysis
of your blood
glucose results?
Lifestyle
that you have a supply readily available on hand for when you need to take it. Plan ahead by storing pens at work and at home, remembering to keep them cool. Create a system that works for you and helps you to remember when to inject yourself. A missed injection can cause knock-on unwellness when you try to make up for it later.
˚ Diabetes u-Chek 360 Get the Acc t app. now! Managemen code to Scan the QR app from: download the
monitoring hek blood glucose and your Accu-C appointment. Bring this form re professional next healthca system to your
** American
2069_Accu-Chek
gy Consensus College of Endocrinolo
- Tool - Artwork
Statement on
Guidelines for
Glycemic Control.
2002.
2013/11/20
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GREAT REASONS why you should
1 2 3 4 5 6
Visit Dis-Chem 7 8
Get your repeat medication
at any of our 72 branches nationwide, thanks to our centralised database.
Save with generic medicines without reducing
effectiveness – talk to our pharmacists for expert advice.
Cut costs on chronic medication with preferential
dispensing fees, and assistance with chronic script registration to maximise your benefits.
Save valuable time with Call & Collect – just phone
and we’ll get your script ready for you to pop in and pick up.
Manage your repeat medication through our
Call Centre, who will contact you monthly, and arrange delivery or collection.
Get free chronic and prescription delivery
nationwide if you live in a 15km radius of your branch. Chronic medication can also be couriered by Dis-Chem Direct. direct@dischem.co.za
Earn Benefit points on purchases, to redeem as cash
on future visits – and contribute to the care of needy communities.
Stay Well Clinics in every branch are managed by
qualified nursing practitioners who provide a wide range of general health services, including: • Vitamin injections • Full Lipid profile and HbA1c • Blood pressure monitoring • Glucose, hypertension and cholesterol testing FLU VACCINES • BMI measurement NOW • Wound care AVAILABLE • Weight management • HIV screening and testing • Diabetic care • Professional advice and referrals
9 • • • •
Well Baby Clinics also offer a full spectrum of relevant services: Weight, measurement, milestone and development assessments All scheduled vaccinations Nutritional timelines Colic or breast-feeding problems
10
Widest OTC and self-medication range for everyday healthcare, with expert advice
offered by our experienced specialist staff in these departments.
GO Advertising 69533
GO Advertsing 69533
“Go on, ask us about diabetes.” Dis-Chem’s commitment to specific diabetes care now goes beyond offering vitamins and supplements, monitoring aids, prescribed medication and specialised foodstuffs at our legendary low prices: the nursing practitioners who run our Clinics have now all received training in this highly specialised field. This means that in every one of our 72 stores nationwide, you’ll find someone who can offer professional guidance and advice on every aspect of diabetes, including: • Lifestyle • Medication management • Nutrition • Overall management of your condition • HbA1c screening
Questions about diabetes? You can get all the answers at your Dis-Chem Clinic! Customer Careline 0860 347 243 www.dischem.co.za careline@dischem.co.za
Dis-Chem is a partner of the Centre for Diabetes and Endocrinology
Gather the group Struggling to get started on a fitness routine? Maybe you need to try exercising in a group… It’s far more fun, and just as good for you!
Work It Out
Boot camp While you can pay a lot to attend official boot camp classes, you can also set up your own boot camp with a few friends. Decide what areas of the body you specifically want to work and set out a four-week exercise programme. You might want to include things like sit-ups, push-ups, jogging around a track or on the spot, doing star jumps, short sprints, skipping and lifting weights. Just make sure everyone is in agreement with what the session looks like – and don’t leave anyone behind!
Walking group All you need is a pair of walking shoes and an adventurous spirit and you can start a walking group. Decide on a route that you want to follow, and start slowly – just a kilometre or two will do. It’s a good idea to have a goal in mind so that you can work up to longer distances. How about 10km by the end of the year?
5-a-side soccer Finding enough people for a full soccer team might be a challenge, but 5-a-side soccer only needs ten people to play the whole game, and ensures that everyone gets a real work-out. You can play on any field or in a garden (because there are fewer players, you need less space) and the game doesn’t last as long – generally an hour in total.
PHOTO: GALLO IMAGES/GETTY IMAGES/ALISTAIR BERG
There’s something about pounding the pavement on your own that is just no fun… Swimming lengths can also be lonely, and so can going to the gym. But who said getting fit had to be a solo exercise? Here are some of our favourite ways to get active with your friends and family members.
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Ilona Padayachee, Biokineticist The FITT principle is very helpful to keep in mind with walking:
Frequency Intensity Time Type
Frequency:
Time:
If you are a beginner try not to overdo it, start off slowly and progress to longer and faster walks.
A beginner walker should start out at 10 to 12 minutes, including 5 minutes warm-up. Then increase it to 20 minutes by adding 2 minutes to the walk every week.
Aim to exercise for 3 to 5 days a week.
Intensity:
This is very important in any exercise programme.
Walking at the correct speed can make a huge difference to how effective the exercise is.
Start slow and build up your time.
Type:
Choose the type or kind of activity that you enjoy. It’s always easier to stick to something you like doing!
Meet the Athlone Walking Group: Want to know how other diabetics are doing it? In Athlone in the Western Cape there’s a walking group that’s taking the streets by storm. Who started it? Mercia Valentine, a diabetic for over 33 years, came up with the idea after a Diabetic 101 support group meeting in 2012. Harriet Stewart now manages the walking group. When do they walk? Every Monday and Wednesday morning: 9am in summer and 10am in winter. Where do they walk? They follow a very structured walk from Athlone
Work it Out
Ask the expert:
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Work It Out
Pharmacy down Klipfontein Road towards the Red Cross Children’s Hospital and back again, sometimes extending their walk to Rondebosch Common. How long do they walk for? About two hours, at a medium pace so that everyone can stick together. What do they love about it? The walkers are very supportive and during their walks they will discuss diabetic matters like blood sugar levels and diet tips. The walks are relaxing and enjoyable, and the group of 28 walkers have become a close-knit family through walking.
Meet Patrick Holford! For anyone looking for motivation to get healthy, active and eating properly, Patrick Holford is the man you want to meet.
Diabetic foot care tips: No matter how much fun you’re having getting fit, don’t forget to look after your feet! As a diabetic, foot care is really important. Bad circulation in the feet and legs, often noticed as leg pain and leg cramps, is one of the problems facing diabetics, and can lead to chronic ulcers, numbness and even gangrene. Daily care for the feet is essential. Here are some great tips: • Exercise and regular movement is good for circulation. • If possible, raise your feet when you’re sitting down. • Check your feet every day for swelling, marks and red spots. • Check your feet for ‘cold areas’ (a sign of poor circulation) • Check your feet for ‘hot areas’ (a sign of infection) • Dry your feet well after bathing, showering or swimming • Apply a good natural cream to the feet every day • Wear comfortable shoes that do not pinch the feet or toes • Keep toenails trimmed and file sharp edges
WIN!
A copy of Good Medicine or Burn Fat Fast.
Author of Say No To Diabetes: 10 healthy ways to prevent or reverse diabetes; Good Medicine: Safe natural ways to solve over 75 common health problems and Burn Fat Fast: The alternate-day low GL diet plan, Patrick Holford is doing a South African tour from the 10th to the 19th October 2014. Book one of his talks in Johannesburg, Pretoria, Durban, Pietermaritzburg or Cape Town on Computicket, or visit www.holforddirect.co.za for more information.
Simply email win@sweetlifemag.co.za or write to us on PO Box 12651, Mill St, 8010 with your full contact details and what kind of diabetes you have.
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ADVERTORIAL
Preventing & Managing Peripheral Neuropathy in Diabetics Peripheral neuropathy is nerve damage caused by chronically high blood sugar and diabetes. It leads to numbness, loss of sensation, and often pain in your feet, legs or hands. The key to prevention and managing Peripheral Neuropathy is to effectively manage your diabetes. Balance Practicing balance and increasing the difficulty of certain tasks is beneficial for those with peripheral neuropathy caused by diabetes. Improved balance also allows one to exercise. Practice balancing on one leg, getting in and out of a chair slowly and unassisted, standing on tippy toes (and extending the time) and walking a fictitious tight rope are all good balance exercises to practice and repeat as often as possible.
Exercise Exercise greatly improves the condition so it is important to introduce it into daily life. Start slowly to overcome fear and to build up strength gradually. Also choose low impact exercises which improve balance and relaxation.
hydrates the feet Recharge your FEET is the only Herbal Foot Cream that is specially formulated for Diabetic Feet.
Foot Care Caring for your feet is one of the most important aspects in preventing and managing peripheral neuropathy. Ensure you wear a pair of goodfitting shoes to avoid foot problems such as cuts, abrasions, and/or blisters. Check your feet every day and apply a good natural cream such as Recharge your FEET designed specifically for Diabetic Feet, which a) increases circulation b) moisturises and
Recharge DIABETICARE, a vitamin, mineral and herbal supplement, takes care of the unique nutrient requirements of diabetics thus promoting wellbeing and assisting with the symptoms associated with diabetes For more information on Recharge your FEET and Recharge DIABETICARE visit www.rechargeyourlife. co.za, Phone 0861 477 915 or email info@rechargeyourlife.co.za
Recharge_SLM11_FA.indd 1
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Diabion A5 adv4.ai
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2014/04/10
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Baked
treats
Is there anything more comforting than the smell of something freshly baked coming out of the oven? Just because you’re diabetic doesn’t mean you have to deny yourself baked treats… Here are our healthy takes on some old favourites. FOOD EDITOR: CAROLINE GARDNER PHOTOS: MARK PEDDLE
Inspired by you
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breakfast
Foodie makes: 40 average cost:
R53
High fibre rusks protein
4g
carb
fibre
sodium
6g 16g
fat
3g
106mg
500g wholewheat flour 1t salt 1t baking powder ¹⁄³ cup brown sugar 1 cup oats 1½ cups bran flakes
per portion
energy
532kJ
1 cup sunflower seeds ½ cup pumpkin seeds 1 cup chopped almonds 1 egg 2 cups low-fat buttermilk ¹⁄³ cup butter
method:
Sieve flour, salt and baking powder, add all the other dry ingredients and mix. Beat egg and buttermilk, melt butter and add to the dry mix. Mix well. Spoon into a large deep baking dish. Bake at 180°C for 45–60 mins. Cool completely and then cut into rusks. Dry on baking sheets in a cool oven (80°C) overnight.
Inspired by you
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Budget
R12
energy
protein
562kJ
5g
fat
carb
fibre
sodium
4g 20g
2g
158mg
per portion
makes: 16 average cost:
Homemade wholewheat and oat rolls
½ cup low-fat plain yoghurt ¼ cup low-fat milk 1T sugar 2T canola oil 1 egg 1½ cups bread flour 1 cup wholewheat flour ½ cup oats ¹⁄³ cup pumpkin seeds, toasted and chopped 1t salt 1½t active dry yeast
method:
Mix yoghurt, milk, sugar and oil in a small mixing bowl. Mix in remaining ingredients and knead for about 10-15 mins or until soft and smooth. Shape dough into equally sized rolls, about 16. Place in lightly greased muffin pans or on a baking sheet. Cover the rolls with a damp dish-towel or cloth and leave to double in size, about 30-40 mins. Bake at 180°C for 15-20 mins or until golden brown. Serve warm, sliced in half, with scrambled egg and sliced tomato.
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lunch serves: 6 average cost:
R26
method:
Inspired by you
energy
protein
722kJ
9g
fat
carb
fibre
sodium
12g 9g
2g
127mg
3 large tomatoes, chopped in chunks 250g baby potatoes, cooked and sliced 3T olive oil 2 garlic clove, crushed 1½ large onions, peeled
per portion
Budget
Baked Spanish tortilla with tomato relish
and sliced thinly 2t chopped thyme Salt and milled pepper ½ packet baby marrows, thinly sliced ¼ cup chopped parsley 6 eggs
method:
Heat 1T olive oil in a pan and gently fry ½ a finely chopped onion until soft. Add tomatoes, 1 crushed garlic clove, salt and pepper and a splash of chicken or vegetable stock and simmer on a low heat for about 10-15 mins until cooked through – this is your relish. Heat 2T oil in an ovenproof frying pan. Add onions, thyme and seasoning and cook gently for 10 minutes. Add the potatoes and baby marrow, cover and cook for a further 5-10 mins. Beat the eggs and parsley together and season to taste with salt and pepper. Pour the egg mixture over the vegetables, cover pan and let the tortilla cook through for 5-10 mins. Place the pan under a preheated grill for 5 minutes or until golden brown. Slide omelette out onto a large plate, slice and serve with tomato relish.
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Mini baked tuna quiches protein
722kJ
8g
fat
carb
fibre
sodium
11g 12g
2g
265mg
Crust: 1½ cups wholewheat flour 1t finely chopped rosemary ½ cup melted butter ½t salt 2t low-fat milk
per portion
energy
Filling: ½ cup low-fat milk 4 eggs, beaten Salt and milled pepper Dash cayenne pepper (optional) 1 can tuna in brine, drained 250g baby tomatoes, halved ¼ cup grated low-fat mozzarella cheese
method:
Combine all crust ingredients and mix with a fork. Use your hands to finish the mixing and then divide into small balls. Press into greased muffin tray or mini quiche tins and pinch the top (with your finger or a fork). Mix the milk, eggs and seasoning together and set aside. Mix the tuna, tomatoes and cheese and fill the pastry-lined muffin cups. Divide the egg mix between the crusts and bake at 180°C for 2030 mins or until egg has set. Serve each quiche with a large side salad.
Foodie makes: 12 average cost:
R42
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dinner
½ pizza = 1 serving!
Homemade wholewheat pizza protein
fat
carb
fibre
sodium
19g
7g 48g
5g
663mg
Base: 1 packet instant dry yeast 1¼ cups lukewarm water 1½ cups wholewheat flour 2 cups flour 2t sugar 1T olive oil ½t salt
method:
Topping: 1 cup tomato relish (from tortilla recipe) 300g spinach, finely shredded 1t olive oil 1 crushed garlic clove Salt and milled pepper A little chilli (optional) 250g mushrooms, sliced
Mix yeast and water. Then mix yeast with flours, sugar, oil and salt. Knead dough for 10 minutes until smooth and elastic. Place in a large oiled bowl, cover with plastic wrap and let rise in a warm place for 45 minutes (or until doubled). Punch down dough, transfer to a floured board and knead briefly. Divide into 4 portions and place, covered, in the fridge for at least 2 hours (or overnight). Bring dough to room temperature, then roll and stretch each piece into a 7 to 8 inch circle. Preheat oven and pizza pan to 22O°C. Cook spinach with olive oil, garlic and seasoning. Divide and spoon spinach and sliced mushrooms onto pizza bases with ham. Divide cheese between the pizzas, add oreganum and bake for 8-10 mins or until cooked through and golden. Want more pizza topping ideas? Go to www.sweetlifemag.co.za/community
Inspired by you
per portion
energy
1378kJ
½ cup ham, finely sliced 2 cups low-fat cheddar, grated A pinch of dried oreganum
Budget makes: 4 average cost:
R55
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Lekker ‘lasagna’ protein
fat
carb
fibre
sodium
22g
6g 27g
8g
157mg
per portion
energy
968kJ
200g sliced peppers 2 garlic cloves, crushed 200g lean minced beef 100g red lentils 2t dried oreganum, plus extra for sprinkling 1 tin tomato puree 1 aubergine, sliced into 1½ cm rounds 4 tomatoes, sliced into 1cm rounds 2t olive oil ¹⁄³ cup low-fat cheddar, finely grated 1 cup low-fat Greek yoghurt Grated nutmeg Cook the peppers gently in a large non-stick pan for about 5 mins, then add the garlic and cook for 1 min more Add the beef, breaking up with a fork, and cook until brown. Tip in the lentils, half the oreganum, the tomato puree and a splash of water. Simmer for 15-20 mins until the lentils are tender, adding more water if you need to. Meanwhile, heat the grill. Arrange the aubergine and tomato slices on a non-stick baking tray and brush with the oil. Sprinkle with the remaining oreganum and some seasoning, then grill for 5-6 mins each side. Spoon half the beef mixture into an ovenproof dish, and top with half the sliced aubergine and tomato, then repeat. Spoon over the yoghurt topping and sprinkle with cheese, oreganum, and nutmeg. Grill for 6-10 mins or until bubbling. Serve with a large green salad.
Foodie serves: 6 average cost:
R62
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dessert
Chocolate banana birthday cake protein
1074kJ
6g
fat
carb
fibre
sodium
10g 37g
3g
293mg
2 cups wholewheat flour 2/3 cup cocoa powder 2t baking powder ½t bicarb ½t salt 100ml butter, room temperature 1/3 cup sugar 3 eggs 1t vanilla essence
per portion
energy
2 ripe, medium bananas, mashed 1 cup low-fat buttermilk Icing: ¹⁄³ cup cocoa 2t sugar 3T water 1/3 cup low-fat cream cheese
method:
Foodie? serves: 12 average cost:
R34
Preheat oven to 180°C and grease a 22cm ring pan. Sift together the flour, cocoa powder, baking powder, bicarb and salt. Cream together butter and sugar until light. Beat in the eggs one by one, then beat in the vanilla essence and bananas. Add half of the flour mixture to the butter mix and stir to combine. Add in the buttermilk, followed by the rest of the flour. Pour batter into prepared pan, and bake for 40-50 mins, or until the top springs back when lightly pressed. Allow cake to cool completely before turning out. Melt cocoa, sugar and water together in a pan, leave to cool and fold through cream cheese. Spread onto cake and serve. Enjoy your birthday treat!
Health hotline
Inspired by you
0800 11 22 88 healthhotline@pnp.co.za
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We consulted with Pick n Pay’s registered dietitian to compile these top tips for heart health: Increase your intake of vegetables and fruit
such as pastries, pies, salty crackers, sweet biscuits and many fast foods.
Eating a diet that is rich in a variety of fruits and vegetables can help to lower your risk of coronary heart disease.
Increase your intake of essential fatty acids (omega 3)
Eat more legumes Beans, peas and lentils contain a valuable source of soluble fibre, which can effectively lower blood cholesterol levels.
Limit your saturated fat intake Follow a diet which is generally low in fat, and avoid animal fats wherever possible.
Increase your intake of unsaturated fats Replacing saturated fats with unsaturated fats has been shown to decrease your risk of heart disease. Examples include: avocados, olives, olive oil, canola oil, peanut butter, peanut oil and nuts such as almonds, cashews and macadamias.
Limit your intake of trans-fatty acids
Try to eat at least 3 servings of fatty fish per week such as sardines, pilchards, mackerel, anchovies, salmon or mackerel.
Increase your intake of whole grain cereals Whole grains will assist in optimising blood sugar control, which helps to maintain healthy arteries and supports weight management.
Consult a registered dietitian
Heart Month
September is National Heart Awareness Month!
Consulting a registered dietitian is the best strategy to lower your cholesterol levels and/or body fat. Contact the Association for Dietetics (ADSA) www.adsa.org.za for a dietitian in your area.
Trans fatty acids are found in many convenience foods Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian, Leanne Tee, to provide food and nutrition-related advice to the public.
For your nutrition and health-related queries, contact Leanne >> healthhotline@pnp.co.za >> Toll free on 0800 11 22 88
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THE PRO FE
NAL’S CHOI
C
E
IO SS
THERE IS NO COMPROMISE WHEN IT COMES TO A LOVED ONE For Cuts, Grazes & Stitches • • • • • •
Bacteria-proof Waterproof Easy to remove Allows skin to breathe Long wear time Hypoallergenic
Logon to: www.woundwise.co.za for more information. V12OPS.01
Word search: Be a diabetic detective and find the 8 hidden words. They can be backwards, forwards, up and down or diagonally‌ Can you find all (ten?)
AMT X D F I S U K S CWA R O P X E EGR E E NO I X T QW I E R Y U E E U I VW I N J RB F D E P A T S CA Y C S P R I N I I HC V E C T O S D I E T U KWZ E Y B T L ROE T RU T GP I AUK N EWO S A OMO Grab your crayons & start colouring!
G V N I E V G H D T Z N
Download
this colouring in picture at: www.sweetlifemag. co.za/kids
D B S X C S C O P E T F
I E T NMU UN I T P Z T I S I R P O T R T NO H X U Y I T J T G UNQ
F T N V N A B Q V T P H
A J Q T K T X P B Q A T
Y A P L A I N V C E R P EG AH S T EM X D H F
5 1 23 4
Kids
Just for kids!
things to do outside: climb trees run around picnic
garden
5
do handstands
ANSWERS: spring / alive / outdoors / exercise / fun / green / sprout / new
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Last Word Last Word SLM11_Last_Word.indd 1
Survival can be summed up in three words - never give up. That’s the heart of it really. Just keep trying. Bear Grylls
“With the new day comes new strength and new thoughts.” Eleanor Roosevelt
2014/07/24 5:33 PM
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