Issue 05
Summer 2012
Life can be sweet, with diabetes
Celebrate
Diabetes Month Your quarterly dose of:
• Delicious healthy recipes • Useful diabetic info • Expert advice
Free!
Take one now Living with an
insulin pump
Festive eating Outdoor
family fun SLM05_Cover.indd 1
(tips)
www.sweetlifemag.co.za
2012/10/11 4:11 PM
t t e e r B , , B d est! o o G Win
1 of 2 value0 grocery d at R vo 1000 uchers each !
This Nanovember, things just keep getting better and better! The Good news is that Accu-Chek is running a promotion!
Better yet, when you buy 2 tins of Accu-Chek Performa strips, you stand to win 1
of 20 grocery vouchers valued at R1000 each!
Best of all, with every purchase, R1 will be donated to Diabetes South Africa. For more information contact your Healthcare Professional Scan this tag using your cellphone and follow the instructions on how to enter. Get your mobile app at www.trustatag.mobi
or
SMS the last four digits of the two barcodes on the packs to 32003, and follow the instructions on the SMS reply.
Visit www.nanovember.co.za for competition terms and conditions. Competition runs from 1st to 30 th November 2012. Only at participating pharmacies.
Experience what’s possible. 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 ACCU-CHEK PERFORMA NANO is a trademark of Roche. Š Roche Diagnostics Ref: PERF120811
1391_Performa Nano Advert 210x148 Sweetlife.indd 1
2012/09/07 8:38 AM
And a very Happy National Diabetes Month to all of you! What better month to celebrate living a healthy life with diabetes than in November, National Diabetes Month? I can’t wait for you to see what we have in store for you. This issue is all about easy ways to celebrate living with diabetes - from fabulous healthy recipes to expert tips and advice from our wonderful Panel of Experts (who make sure all the information we share with you is 100% correct) and a couple of really special features. One of the questions we always get asked is what life with the insulin pump is actually like - so we found out for you, by interviewing three happy insulin pump users. We also meet Shiara Pillay, an inspiring Type 1 diabetic, and give you some great ideas for getting outdoors and being active this summer. There are all kinds of events happening this month to celebrate diabetes, and we hope to see you at one of them! Have something you want to share? Come and chat to us on the community blog: www.sweetlifemag. co.za/community or send me an email: hello@sweetlifemag.co.za
EDITOR Bridget McNulty
ART DIRECTOR Mark Peddle
PUBLISHER Claire Barnardo
ADVERTISING SALES TFWcc - Tessa and Anthony Fenton-Wells
CONTRIBUTORS Alistair Palmer, Anette Thompson, Caroline Gardner, Dr Dale Harrison, Emile Scholtz, Gareth Murray, Genevieve Jardine, Jeske Wellmann, Jeannie Berg, Martin Salkow, Dr Neville Wellington, Nicole McCreedy, Sarah Hall, Shiara Pillay, Shirley Desmond. ADVERTISING ENQUIRIES Box 52301, Kenilworth 7745. Tel: 021 761 2840. Fax: 021 761 0442. Cell: 082 320 0014. Email: tessa@tfwcc.net
EDITORIAL ENQUIRIES
What makes the Sweet Life community so special is that we’re all in this together... Let’s celebrate that fact!
PO Box 12651, Mill St, 8010. Tel: 021 424 7470. Email: info@sweetlifemag.co.za
I look forward to chatting to you soon.
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,
Bridget McNulty Editor
PS: Want to make sure you get your free copy of Sweet Life every quarter? Find your nearest Clicks Clinic on page 4.
Welcome
Hello!
COPYRIGHT
COMPETITION RULES Winners will be randomly selected and notified by telephone or email, and must agree to have their names published online. Prizes are not transferable and cannot be exchanged for cash. The judge’s decision is final and no correspondence will be entered into.
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.
03
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Spring 2012
Life can be sweet, with diabetes
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Winter 2012 tes with diabe be sweet, Life can
Life can be sweet, with diab etes
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Summer 2012
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Sweet Life, now available at Clicks Clinics! It’s National Diabetes Month, which means that you’ll be able to get your copy of Sweet Life from a Clicks Clinic or support group near you.
sweet life available at clicks clinics
What to do Go to your nearest Clicks Clinic or your local support group and ask for a copy of Sweet Life. Your free copy of Sweet Life will be waiting for you in November, February, May and August. Simply ask the clinic sister or your support group leader for a copy, and you’ll be given your FREE Sweet Life magazine. Or you can read it online at www.sweetlifemag.co.za
Why don’t we post any more? We want you to get the support you need for your diabetes. Ask questions, have blood tests, get your feet checked and make sure you’re on the right medication - all of this can be done at a Clicks Clinic. So every 3 months we want you to take charge of your diabetes, march into a clinic or your local support group, and pick up your FREE copy of Sweet Life magazine.
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Western Cape
Gauteng
BLUE ROUTE Tokai CANAL WALK Milnerton CAPE GATE Brackenfell CAVENDISH CONNECT Claremont CONSTANTIA EDGEMEAD GARDENS GARDEN ROUTE MALL George GLENGARIFF Sea Point GOLDEN ACRE Cape Town GUGULETHU HERMANUS KENILWORTH CENTRE Kenilworth LANGEBERG MALL Mossel Bay LONG BEACH MALL Noordhoek MELKBOSSTRAND MOUNTAIN MILL Worcester N1 CITY GOODWOOD OUDTSHOORN PAARL PAROW PINELANDS PLETTENBERG BAY PLUMSTEAD PROMENADE Mitchells Plain SOMERSET MALL Somerset West SONEIKE Kuilsriver Stellenbosch Tableview TYGERVALLEY Bellville V&A WATERFRONT Cape Town VANGATE MALL Athlone VREDENBURG WEST COAST VILLAGE Tableview
Alberton ATTERBURY Faerie Glen, Pretoria Balfour Park Highlands North, JHB BROOKLYN MALL Niemuckleneuk, Pretoria CARNIVAL MALL Dalspark, Brakpan CENTURION CENTRE Centurion, Pretoria CLEARWATER MALL Roodepoort Columbine Square Columbine, JHB CORNWALL VIEW Elarduspark, Pretoria CRESTA CENTRE Cresta, JHB Eastgate Bedfordview Edenmeadow Edenvale Gezina Galleries Gezina, Pretoria JABULANI MALL Soweto, JHB JACARANDA CENTRE Rietfontein, Pretoria KRUGERSDORP KILLARNEY MALL Killarney KOLONADE CENTRE Montana, Pretoria Lakeside Mall Benoni Lambton Germiston MAPONYA MALL Soweto, JHB MENLYN RETAIL Newlands, Pretoria MONTANA CROSSING Montana, Pretoria NORKEM MALL, Kempton Park NORTHGATE Honeydew, Randburg NORTHVAAL ARCADE Pretoria RIVERSIDE BOULEVARD Vanderbijlpark ROSEBANK PHARMACY Rosebank, JHB SANDTON CITY Sandton, JHB SANRIDGE SQUARE Midrand, JHB Southgate Mondeor, JHB Springs The Glen Oakdene, JHB Village View Bedfordview, JHB WELTEVREDEN PARK WONDERPARK CENTRE Akasia WOODHILL Moreleta Park
Northern Cape DIAMOND PAVILION Monument Heights, Kimberley
Limpopo CYCAD Bendor, Polokwane STANDARD BANK SQUARE Polokwane POLOKWANE CBD Polokwane
Community
Find your nearest Clicks Clinic below:
Mpumalanga HIGHVELD MALL Witbank KLIPFONTEIN Witbank MIDWATER CENTRE Aerorand Middelburg
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KZN
Free State
BLUFF Wentworth Durban AMAJUBA Newcastle RICHARDS BAY GATEWAY Umhlanga Rocks Hibiscus Mall Margate LA LUCIA Durban LADYSMITH LIBERTY MIDLANDS MALL Pietermaritzburg MALVERN Queensburgh, Durban MUSGRAVE CENTRE Musgrave PAVILION Westville, Durban PINETOWN Pinetown, Durban Southway MALL Seaview SHELLY BEACH Victoria Road Pietermaritzburg Westville MALL Westville
BAYSWATER PHARMACY Bloemfontein BETHLEHEM GOLDFIELDS MALL Welkom LANGHOVEN PARK Bloemfontein LIBERTY MALL Welkom FICHARDT PARK PHARMACY Bloemfontein LOCH LOGAN Bloemfontein MIMOSA MALL Bloemfontein
Swaziland THE Gables Ezulwini BHuNU MALL Manzini SWAZI PLAZA Mbabane
Eastern Cape BEACON BAY East London GRAHAMSTOWN Grahamstown GREENACRES Newton Park, PE KING WILLIAMS TOWN KNYSNA SUNRIDGE VILLAGE Sunridge, PE VINCENT PARK East London Kabega Park PE WALMER PARK Walmer, PE
Community
North West KLERKSDORP MAFIKENG MOOI RIVER POTCHEFSTROOM WATERFALL MALL Rustenburg Wilkoppies Klerksdorp
Contact us:
Does your support group need copies of Sweet Life? Get in touch and we’ll make sure you get them.
Web
www.sweetlifemag.co.za
hello@sweetlifemag.co.za
Mobi
www.sweetlife.mobi
Postal:
Diabetic South Africans sweet_life_mag
PO Box 12651, Mill St, 8010, Western Cape
Meet some of our experts: Meet the whole panel at: sweetlifemag.co.za
Dr. Gabaza Ngobeni is a
GP in Diepkloof, Soweto.
Dr. Zaheer Bayat is a specialist
endocrinologist in Gauteng.
Faaiza Paruk
Dr. Joel Dave
is a senior Bsc Dietetics (Hons) is a dietician specialist at UCT & Groote Schuur in Joburg.
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Fun festive food from our community:
Ask the Dietician
“With Christmas coming up I know I’m going to want to eat what I shouldn’t… What are the ‘safe’ foods to snack on at parties?” Jabu Hlazo
Have a question for our dietician? Ask us on our website, Facebook page or mobi site and you could be in the next issue!
The festive season is a great time of year when the hard work is over and it’s time for fun and feasting. The question is, how do you celebrate with everyone else, but still maintain healthy blood glucose levels? Here are some holiday points to ponder. Watch your weight:
Most people tend to gain about 2-5kgs over the festive season only to make a New Year’s Resolution to lose it again. Prevention is better than cure, so make it your goal not to gain any weight this festive season.
Treat yourself:
Using your bonus money to buy special treats is tempting – nothing says Christmas like mince pies or brandy pudding. This year, why not use your money to buy healthy treat alternatives: exotic fruit, nuts, lean biltong or diabetic biscuits. Better yet, spoil yourself with non-edible treats like a magazine, a new recipe book or a pair of running shoes.
Get active:
Use your free time and the sunny weather to try a new activity. Play a game of tennis, hire a bike, do that hike you’ve always wanted to do. Take the focus off food and get adventurous. Touring a new city on foot or playing with the kids on the beach allows you to burn off kilojoules and improves your body’s ability to use insulin more effectively. The result? Better blood sugar control.
Re-gift the chocolates:
It’s the season of giving and granny’s homemade biscuits or that box of chocolates can become very tempting. The truth is that you don’t have to eat the whole box in order to celebrate or appreciate the gift. This year rather re-gift the biscuits and spoil someone else.
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During the festive season the social calendar fills up. Be wise and plan around your daily ‘eating commitments’. It’s still important to eat regular meals (even while on holiday) and you may need to adjust meal sizes and snacks around social engagements. For example, if you know that you have a family braai in the afternoon, you may want to plan a light lunch with a healthy snack just before you leave to help stabilize blood sugar levels and avoid binging on snacks. When invited out, offer to contribute to the meal and bring your own healthy alternative. You’ll be amazed how grateful people are when you arrive with an extra plate of fresh veggies and dip, or a fresh green salad or diabetic-friendly dessert.
Watch the alcohol:
Holiday celebrations often involve excessive drinking, which can send blood glucose levels soaring with an inevitable crash in the early hours of the morning. Be sensible and opt for alternatives like light beer or light wine, and watch how much you drink: the recommended amount is two alcoholic drinks per day for men and one per day for women. Never drink on an empty stomach and don’t drink and drive. There is more at stake than just your blood glucose levels.
Party tricks:
If the festive season means endless office parties and end of year functions, don’t hesitate to find out more about the food. Chat to the person in charge of catering the office party to ensure there will be snacks like chicken pieces, fruit kebabs, diced vegetables and sandwiches, as well as diet drinks and light alcohol. For restaurant dining, phone ahead for the menu and decide what to order so you’re not tempted when you get there. If you choose wisely and stick to reasonable portions, you’ll get through the festive season just fine.
Ask the expert: Genevieve Jardine
ional
ete Nutrit sicas
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From myself, Genevieve Jardine, I wish you and your family a fantastic festive season filled with flavour, fun and family.
Ask the Dietician
Plan ahead:
Win
One of 3 copies of this book! Want to win a copy of The Complete Nutritional Solution to Diabetes by Ria Catsicas? Send your full name and address to:
win@sweetlifemag.co.za
Post
PO Box 12651, Mill Street, 8010, Western Cape
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Now that we drink a shake before our sport events we find we have so much more energy and we don’t run out of steam.
DELICIOUS NEW RECIPE!
FRUITY FROZEN LOLLIES (SERVES 2) Ingredients: 600g of fresh strawberries 1 sachet (35g) Diabetic Plus, strawberry flavour 300ml skim milk Crushed ice cubes Preparation: 1. In a blender, mix the Diabetic Plus and water. Once well mixed, add the strawberries and blend until not quite pureed. 2. Pour the mixture into ice lolly mould and freeze until set. 3. You can add 600g of other fruit such as apples, pears, peaches and berries for a different flavour.
Visit diabeticplus.co.za to find a stockist near you. USE THIS VOUCHER TO RECEIVE A
10% DISCOUNT ON THE DIABETIC PLUS MINI-MEAL SHAKE! 9 909802 331361
Valid from 1/11/2012 to 31/01/2013
This voucher may be redeemed at any of our stockists and at selected Clicks stores. This voucher may not be redeemed for cash. Only one voucher per transaction is allowed. Misuse of this voucher in any way constitutes fraud. This voucher cannot be replaced if lost. For any queries please contact +27 82 555 9811.
Simplify your life. Low GI is low energy release. Low GI means:
Energy levels sustained for longer Feel full for longer No spikes in blood glucose
Wei gh Los t Mea s lP No. lan 4
BREAKFAST
CINNAMON AND ALMOND OATS
1 Protein of Dairy Unit
1 cup fat free milk (250ml), added to oats
1 Fruit or Starch Unit 1 Fat Unit Other accompaniments and suggestions
½ cup of cooked oats (120g) 4 almonds raw, unsalted Season the oats with cinnamon as desired
MORNING SNACK
SNACK
1 Fruit Unit
Mix 3 scoops (35g) of Diabetic Plus Vanilla shake with 300 ml ice cold water in a blender, together with a pear.
LUNCH
TUNA AND CORN SALAD
2 Protein Units 1 Starch Unit With Vegetables or Salads, unlimited 1 Fat Unit
1 tin tuna in spring water, drained ½ cup corn (90g), added to the salad mix lettuce, grated carrot, spring onions and red pepper 1 tbs of olive oil (5ml to dress salad)
Other accompaniments and suggestions
Dress salad with lemon juice and balsamic vinegar and season with black pepper and chilli flakes as desired
AFTERNOON SNACK
SNACK
1 Protein of Dairy Unit
1 Diabetic Plus fruity frozen lolly (recipe on opposite page)
DINNER
ROAST CHICKEN WITH ROAST VEGETABLES
2 Protein Units 1 Starch or Fruit Unit Vegetables or Salads as desired 1 Fat Unit
1 medium chicken breast (80g) skin removed ½ small sweet potato (90g) Butternuts, brinjals, onions, baby marrows and mushroom 1 tbs canola / olive oil (5ml)
Other accompaniments and suggestions
Combine vegetables and sweet potato Mix with oil and season with black pepper before roasting.
EVENING SNACK
SNACK
1 Fruit or Starch Unit
1 ½ cups popcorn (Air popped and Unsalted)
SPECIFICALLY FORMULATED FOR PEOPLE WITH DIABETES: Diabetic Plus Multivitamin Diabetic Plus Lifestyle Balance Complex Diabetic Plus Mini-meal Shake *This meal plan and recipe has been specifically formulated for Diabetic Plus by Anne Till & Associates.
Often foods
GI FOUNDATION
Partner’s Corner
“M
y husband is a diabetic, and I would like to know how long it takes before diabetes affects your liver? Should I be worrying about him?” Alicia Greenway. Other medical conditions related to diabetes — including obesity, high cholesterol and high blood pressure — also raise the risk of non-alcoholic fatty liver disease. Diabetes does not cause fatty liver disease, but the two tend to occur in the same people because the same conditions cause both problems. Good control of blood sugar, maintaining a healthy weight and having regular check-ups can help reduce the risk of liver problems.
Strategies for protection against fatty liver disease include: • Working with your health care team towards good control of your blood sugar. • Losing weight if necessary, and trying to maintain a healthy weight. • Reducing high blood pressure. • Keeping your cholesterol low. • Not drinking too much alcohol.
Then, let’s talk about worry. Having a partner with diabetes puts unique strains on a relationship, but it can also bring you closer together. Here are some golden rules for rising to the challenge: • Make room for negative emotions • Get support from others • Commit to nurturing your relationship • Set shared goals • Communicate • Listen
Partners
Dear Alicia, You’re wise to think about steps to protect your husband’s liver – diabetes is a lifelong condition that affects the liver and vice versa. Being informed is the first step towards ensuring good liver health. Those with diabetes are at higher risk of non-alcoholic fatty liver disease, a condition in which extra fat builds up in the liver even if you drink little or no alcohol.
You can do it if you work together.
Ask the expert: Dr Neville Wellington, GP Fortunately, diabetes in itself does not damage the liver, but the cause of Type 2 diabetes (usually obesity) can cause the liver to take up too much fat. This is damaging, but can be reversed with weight loss as well as diets with low GI carbohydrates and reduced fat.
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Two eager students from the University of Stellenbosch took Sweet Life magazine into new homes.
A
s part of their community project, Diana Griffiths and Lize de Klerk (both fourth year medical students) chose to look at Type 2 diabetes in the rural town of McGregor in the Western Cape. The area they looked at has 853 diabetic patients in the Langeberg District, and they used Sweet Life magazine as a way to inspire and educate patients. Diana and Lize interviewed
16 patients through home visits and handed out the magazine to promote good health. Their aim was to get to grips with exactly what patients knew about diabetes, as well as how their lifestyle choices had an impact on their illness. They assessed how a person’s lack of understanding about diabetes can lead to poor compliance, bad lifestyle choices and more complications.
What they found: • Most patients thought fast food had caused their diabetes. • Most had no idea of the possible complications of diabetes. • Most patients wanted to change their diet, but couldn’t afford healthier food options. • All patients confirmed that they were taking their medication. But
when compared to clinic records, it seemed that some had not even fetched their medication. • Few of the patients had glucometers and as a result waited months before checking their sugar. • All of them were thrilled to receive Sweet Life and were excited to try to make changes in their lives.
News & Views
Changing lives through awareness
The views and opinions expressed on this page are those of the interviewee and not necessarily those of Sweet Life magazine. Always consult a specialist before making any changes to your diet or medicine.
What to do this Diabetes Awareness Month: 28 October: Global Diabetes Walk Who? Diabetes SA What? 5km walk and wellness expo Where? Durban beachfront amphitheatre
www.globaldiabetesrunwalkdurban.blogspot.com/
8-10 November: Cycle 4 Diabetes Who? Dr Jacques Van Staden and a team will cycle from Joburg to George to raise funds What? A 48 hour cycle challenge fund-raiser Where? Joburg to George
17 November: Bongi Ngema-Zuma Foundation Walk Who? Bongi Ngema-Zuma Foundation Walk What? A fun 5km walk to promote positive diabetes awareness Where? Alexandra Township
www.teamc4d.co.za
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A happy life with diabetes
If you met Shiara Pillay, a happy, healthy and confident 17-year-old who loves Art and wants to study Law, you wouldn’t guess that she had a chronic condition. But Shiara is a Type 1 diabetic. She just doesn’t let it get her down. WORDS: BRIDGET MCNULTY
PHOTOS: MARK PEDDLE
When did you find out you were diabetic? When I was in Grade 4 and just about to turn 10. It wasn’t too horrible a diagnosis in comparison to some – my parents noticed that I was losing an extreme amount of weight, I was very dehydrated and waking up in the night to pee – all the classic symptoms. Then one morning I threw up and they took me to the doctor. I was in hospital for a week and since then I’ve figured out how to live as normal a life as possible with diabetes. The hardest thing to get used to was not being able to eat sweets! How has diabetes changed your daily life? I think I’m obviously way more healthy than I would have been because I have to watch what I eat. I have a great diabetes team, and they’ve helped me to adjust my medication and my meals so that it’s not too inconvenient
SLM05_Inspiring_Story.indd 1
at school. It’s also handy that sport is compulsory, so I have to exercise! I do netball in the wintertime and in summer I do tennis. I still get ups and downs, obviously, but I’ve just started carb counting and I think that should help. I like the idea of being able to eat everything in moderation. Can you tell us about your involvement in Youth Camps? Two years ago I became a helper leader at the Diabetes SA Youth Camps, I heard about them from the Red Cross Children’s Hospital. They hold children’s camps twice a year, and family camps too. It’s a great way for kids to meet other diabetics – I really enjoyed that. They called me back to do a family camp – they’re for new diabetics, so the whole family can go and talk about how to deal with diabetes. There are all kinds of fun activities and education and exercise and games.
2012/10/11 3:27 PM
Inspiring
I was there to help get group activities going, and make sure nobody felt left out, and to answer any questions the families had. How do you think these camps help those with diabetes? It helps to know that there are others in the same situation, it reminds you that you’re not alone. It really helped me to meet other people who have to think about the same things every day. I also think diabetes education is so important – new diabetics especially need to know what helps and what doesn’t, what you can eat, how you should exercise, how you feel when you’re low or high. It’s nice for me to share my experiences too. I do have bad days, it’s annoying to have to inject every day, but you just have to make the best of it. What advice would you offer to other diabetics? Just do it – you can’t get out of it. If you look after yourself it’ll be better for you in the long run, it’s for your benefit. And it makes you healthier too! What makes your life sweet? Just being happy – when things are going well and the sun is shining!
Diabetes Youth Camps Youth Camp is for children aged 13-18 and solely sponsored by Youth With Diabetes. There is sponsorship for children whose parents cannot afford the full amount. They also offer leadership training. When: 2013 dates to be confirmed
Family Camp is held annually for families of newly-diagnosed children. Parents attend workshops and there’s a programme for the kids. It’s subsidised by Diabetes SA and parents pay a nominal fee. When: 2013 dates to be confirmed
Contact: Allison on 011 712 6000
Contact: Margot on 021 425 4440 for info on both camps
Kiddies Camp is for children aged 7-12 and happens yearly. Organisations assist with a children’s programme. Parents join in on the Sunday for a braai. Sponsored by Diabetes SA and Reach for a Dream. When: 8-10 March 2013
15 11
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1/ 1
2 yrs
Shirley Desmond is a 29-year-old dietician from Durban, and has had Type 1 diabetes for 9 years. She uses the Roche Accu-Chek Combo system.
The insulin pump
We chat to three people who use an insulin pump every day, and find out what it’s really like to live with. What made you decide to switch to a pump? MS: After realising that I couldn’t get proper control with a basal/bolus insulin regimen (6 injections a day), I was offered the option to try out a pump. The results I had been trying so hard to attain were finally a reality! SD: I was not achieving optimal blood sugar control, even with a lot of effort on my part, and I decided I needed to make a change. I had been encouraged to use the pump earlier but at that stage couldn’t get my head around having to be continuously attached to a machine for 24 hours. I did a lot of research on insulin pumps and weighed up all the pros and cons for myself. I think
5
yrs
Gareth Murray is a medical sales rep for Merck pharmaceuticals. He is 22 years old and has had Type 1 diabetes for 12 and a half years. He uses the Medtronic 754 pump with continuous glucose monitoring.
4
yrs
Martin Salkow is a sales executive at Porsche Centre in Johannesburg. He’s had Type 1 diabetes for the past 22 years and uses the Accu-Chek Spirit Pump system.
it also helped that I was given a pump and infusion sets to try out, and I realized I could live with something attached to me 24/7 – I was hardly aware it was there and it was easy to hide in my clothes. GM: The flexibility of lifestyle with the pump convinced me to switch. I also had constant lows on injections (I hate high blood glucose levels) which made me hypo unaware (not knowing that my blood sugar was low). How has your life changed since using the pump? MS: It’s definitely changed for the better. My daily control is really good, I no longer
16
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What’s the hardest thing about living with a pump? MS: The initial adjustment. Having to wear something all day long and having to sleep with it – it doesn’t bother me now, though. Most of the time, I forget that it’s there. SD: This is a hard question to answer because going on to the pump was the best thing I did for my diabetes. But I will say: don’t expect perfect results as soon as you start using a pump. As much as it allows more freedom, it is also a lot of hard work and you only get the results you want with the effort you put in. It also requires working with your diabetic team and testing your blood sugar
a lot, especially in the beginning. GM: The hardest thing for me is how quickly you can develop ketones as the pump supplies you only with short acting insulin continuously (no long acting insulin as a background), so when you disconnect the pump, you have a 4 hour range to get insulin or risk ketoacidosis. Does your medical aid cover it? MS:My medical aid does cover it, but you have to be on the higher plans for them to do this. SD: Yes, this is a tricky one. A pump is expensive and monthly consumables are also very expensive. You’ll need a motivation from your doctor and the medical aid board will review your request. My medical aid eventually did cover it and all the consumables. It took a lot of fighting on my part, but it was what I wanted for myself so I was willing to put in the effort. You may have to be willing to cover some of the expenses if they don’t cover you fully. GM: Medical aid does cover it, but a higher priority scheme makes it a lot easier, alongside a recommendation from your doctor. It is expensive – around the R28 000 mark, so you need to make sure your medical aid covers it before you decide to go on the pump.
Special Feature
wake up with high blood sugars, and I can adjust my insulin when doing exercise or on sick days with ease. SD: I have much better blood sugar control and I feel much better since being on the pump – less erratic blood sugar levels do wonders for my energy levels and moods. I also find it easier to control my blood sugar levels before, during and after exercise as I can change my short acting basal rates and give less or more insulin as needed, rather than taking a long acting basal insulin once a day. It’s also pretty great only having to change my infusion set every 3 days: 1 needle every 3 days and my insulin is delivered at the touch of a button. GM: My mind is more at ease – if I suffer from hyperglycaemic episodes or hypoglycaemia, my sensor will sound an alarm and let me know what’s happening, almost through a real time experience (10-15 minute delay in blood sugar levels).
Questions: Questions about the insulin pump? Comments on this interview? Let us know on www.sweetlifemag. co.za/community
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10 fast facts about eyecare Eye disease is a major risk for people living with diabetes, so we asked Emile Scholtz to round up all the facts you need to keep bright-eyed and bushy tailed.
Healthy Living
Of the eye complications associated with diabetes, diabetic retinopathy is the most common, but cataracts and glaucoma are also possibly serious consequences of poorly controlled diabetes.
4
Glaucoma is caused by the excessive pressure of fluid inside the eye and leads to optic nerve damage. Diabetes makes you twice as likely to develop glaucoma.
2
Diabetic retinopathy is a condition affecting the retina (the light-sensitive area at the back of the eye) and is caused by damage to the blood vessels. People with both Type 1 and Type 2 diabetes need to be on the look-out, and the longer a person has been living with diabetes, the greater the risk.
Extra caution and additional eye exams are necessary for pregnant women with diabetes.
A typical eye exam is painless and usually involves viewing a chart to check your eyesight at a distance, testing the pressure inside the eye, and having drops placed in your eyes to widen the pupils and inspect the interior of the eye.
8
Some symptoms to be on the alert for are: bad vision in dim lighting, blind spots, double vision or floating spots, blurry vision, pain in the eyes or headaches, and poor peripheral vision.
If you experience any changes in your vision, contact your doctor immediately.
Leaking or irregular blood vessels and swelling of the retina are early symptoms of diabetic retinopathy. A thorough eye exam at least once a year with an eye specialist will identify any warning signs early.
7
Have your blood pressure checked at least twice a year – a blood pressure of under 130/80 is safest for people with diabetes.
Eye disease can often progress without any symptoms, so be sure to keep appointments with your eye care specialist and prevent complications by managing your blood sugar and blood pressure levels carefully.
Ask the expert: Dr Dale Harrison, Ophthalmologist “Every diabetic needs to ask themselves each year: ‘Do I have retinopathy - yes or no?’ “
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C
M
Y
CM
MY
CY
CMY
K
Outdoor family fun
Want to enjoy the warmer days in new ways? Claire Barnardo has some great ideas. Summer is finally here, so be sure to make the most of it! It’s time to cut your jeans into shorts, pack your beach bag and celebrate the longer days. Get into the swing of summer by trying something new with friends and family. Here are a couple of great ideas:
Unwind in nature
Welcome in the heat by heading outdoors. Whether it’s to the beach, climbing a mountain, walking through a forest or playing in a park, there’s no better way to enjoy the summer weather than by being in nature.
Magical markets
Lifestyle
Looking for a new way to do breakfast or lunch? Meet your friends at a market and indulge in something fresh, organic and delicious. While you’re there, you can shop for arts and crafts and stock up on your holiday gifts too.
“A life without love is like a year without summer.” Swedish Proverb
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Fruit picking
Picnic perfection
Raise your glass
The great weather makes picnics the best way to meet up with friends and family. Shake things up by changing the time of day – have a breakfast picnic or meet for sundowners somewhere with a beautiful view. Keep the kids busy with games while you put your feet up and enjoy a holiday read. Don’t forget to pack healthy snacks!
Want to spend the day on a farm? Plan a self-picking adventure and pick your own cherries, strawberries, figs, or peaches. This is a fantastic way to enjoy fresh air and summer fruit. Just be sure to check the weather beforehand! Why not make your own diabeticfriendly iced tea, lemonade, or ginger beer this summer? You could also arrange a tea-tasting for friends in your garden, with a selection of flavoured teas in pretty cups. Or toast to holiday freedom with sugar-free champagne... The options are endless for diabeticfriendly celebrations!
Lifestyle
Open air concerts
Another way to celebrate the summer is by heading to an outdoor concert. Whether it’s musicians in the botanical gardens, a weekend festival, or a play in an amphitheatre, there are all kinds of musical treats to choose from.
Hot finds Summer concerts • Kirstenbosch Summer Concerts (Cape Town) - 021 761 2866 • Carols by candlelight in the Botanic Gardens (Durban) - 031 322 4021 • Johannesburg Zoo (Joburg) - 011 646 2000
Fruit picking • Tangaroa Strawberry Farm (Hartebeespoort) - 012 207 1116 • Camdeboo Peach Farm (Johannesburg) - 082 495 1151 • Klondyke Cherry Farm (Ceres) - 023 312 1521 • Hoogwater Fig Farm (Ceres) - 083 762 2803
Ask the expert: Ciska Thurman, Lifestyle Manager “Start your day earlier, and I mean from 5:30am! Set your alarm, rise with the sun and enjoy that pre-dawn calm. Go for a walk, soak up the morning sounds, meditate, or even just drink your coffee on the lawn outside. Appreciate the gift of summer by having an extra hour or two to spend on yourself.” Get more great tips: www.mylifeorganised.co.za
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Have a ball this summer This is the season to be outdoors socialising in the sunshine, not running on a treadmill in the gym. Nicole McCreedy tells us how to get started.
T
Work It Out
he beauty of ball sports is that they’re easy to learn. Simply find an open space to play, organize some equipment, teams, and learn a few basic rules. You’ll soon be laughing your way to better health.
Rounders
Touch rugby
You need a tennis ball, bat and six players per team. A match has two innings so each team can bat and bowl. An innings ends when the last batter is caught out. Each person gets a chance to bat. When bowling, the ball must not bounce, must be above the batter’s knee, below the batter’s head, and not at the batter’s body. The batter hits the ball and runs in a circle of markers. A ‘rounder’ is when the batter makes the entire circuit in one hit of the ball. The team with the most rounders wins. A batter is out if the ball is caught before it hits the ground or if the ball is fielded before the batter reaches a marker. A batter who has missed the ball can run to the first marker and then continue to the next three when the next batsman strikes the ball. Only one person can stand at a base at a time.
It is like rugby – the ball is passed backwards during play. But in touch rugby you don’t tackle your opponent, you touch the person running with the ball on any part of their body, clothing or the ball. Once touched, the player in possession of the ball returns to the mark where the touch occurred and performs a ‘rollball’. Facing the defending try-line, the player rolls the ball between their legs. After six touches the ball is handed over from the attacking to the defending team and the game starts again from the halfway line in the centre of the field. The aim is to score a touchdown over the defending team’s try-line. Five to six players are on one team at a time, and a game lasts forty minutes a side.
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It’s as simple as kicking the ball around with mates. Players dribble the ball on the ground, kicking it to pass to each other. There are usually 11 players per team. The goalkeeper is the only player allowed to use his/ her hands. Teams are made up of defenders, midfielders and forwards. Two defenders patrol the left and right area while the two central defenders
play in the middle. The midfielders play both defence and attack. Forward positions score the goals. The centre forwards play in the middle flanked on each side by a wing. Be aware of the offside rule! If you are behind the other team’s defenders without the ball, you are offside. But if the ball is kicked past the defenders, you can pass them. Laduuuuuuma!
Ask the expert:
Ask the expert:
Anette Thompson, Podiatrist
Sarah Hall, Biokineticist
Shoes or barefoot?
Keep these tips in mind when playing outdoor sports:
A person living with diabetes should not walk or run barefoot. Even well • A sport-specific warm up is essential. controlled, highly active people who Try and focus on the muscle groups don’t have any complications can you’re about to use and make sure experience a delay in healing if their that you pay particular attention skin punctures or cracks. This is a poto those during your warm up. If tential entry point for infection. Wear you’re about to play soccer, try to footwear that most closely resembles loosen up the ankle joints, stretch barefoot benefits. ‘Barefoot-like’ the groin muscles and do a short sports shoes allow maximum flexibilrunning warm up. ity and give the feet the most natural • Wear supportive footwear that workout. The benefits are improved cushions the rest of your body as blood flow to the feet and lower limbs, you run. which feeds nerves and muscles • Make sure you have enough water during exercise. Ensure shoes are for the whole game. Keep fast actwide enough and the correct size, and ing snacks handy as you may use invest in good quality socks. up more energy than you think.
Work It Out
Soccer
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Easy summer solutions Take all the stress out of entertaining friends and family this holiday with these delicious, healthy recipes for breakfast, lunch and dinner.
Choose from our budget-friendly or fabulously foodie options and whip up a meal to remember - that just so happens to be good for you. Celebrations all round! FOOD EDITOR: CAROLINE GARDNER PHOTOS: MARK PEDDLE
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Breakfast
Budget
Cinnamon bircher muesli
serves: 4 average cost:
453kJ
4g
fat
carb
2.6g 15g
½ cup rolled oats ¼ cup low-fat plain yoghurt ¾ cup low-fat milk 1 ½ Granny Smith apples, grated ½ t ground cinnamon 1T desiccated coconut
GI
GL
44 7.5
per portion
energy protein
R8
Mix all the ingredients in a medium mixing bowl. Cover and chill overnight. Serve with a few slices of strawberries.
Foodie serves: 4 average cost:
Baked Mediterranean eggs 979kJ
13g
fat
carb
10g 15g
GI
GL
44
8
1 packet cherry tomatoes 4 spring onions, finely chopped 1 chilli, finely chopped 1/3 cup basil, torn Salt and milled pepper 4 large eggs 4 t low-fat milk 4 slices low GI toast, to serve
per portion
energy protein
R15
Preheat oven to 180°C. Halve the cherry tomatoes and mix with onions, chilli, basil and seasoning. Divide the mixture into 4 greased ovenproof ramekins (grease with a dash of canola oil). Crack an egg over the tomato tumble in each ramekin and add 1 t milk to each. Place the ramekins in a shallow basin of water, covered by tin foil. Bake for 12 to 15 mins, until the whites have set and the yolk is to your liking. Serve with toasted low GI toast.
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Lunch
Budget
Minute prego rolls
serves: 4 average cost:
1762kJ
41g
fat
carb
16g 23g
GI
GL
58* 14
per portion
energy protein
R43
1 T olive oil Juice of 1 lemon 1 bay leaf 2 garlic cloves, crushed 1 red chilli, chopped 4T red wine Salt and milled pepper 4 minute steaks 1 red pepper, sliced 1 carrot, grated 1 packet cherry tomatoes, halved 1T chopped fresh thyme 4 wholewheat bread rolls, toasted
Mix first six ingredients and season. Pour over steaks and marinate for 30 mins. Heat a dash of oil. Fry steaks for 1 to 2 mins on each side. Remove steaks from pan and boil marinade vigorously for 2 mins. Toss in vegetables and thyme, and cook until soft. Season. Top toasted rolls with steak and tomatoes. Spoon over extra sauce and serve with a large leafy green salad.
*(Calculations done on "regular bread" with GI of 70+)
Chicken summer salad 39g
fat
carb
12g 6g
GI
GL
42
5
per portion
energy protein 1306kJ
Juice of 1 lemon 3 garlic cloves, crushed Foodie 1 chilli, finely chopped serves: 4 average cost: 2T origanum, finely chopped 2T white balsamic vinegar 2T olive oil Salt and milled pepper Preheat oven to 180째C. 3 cups broccoli florets Toss lemon, garlic, 3 chicken breasts, thinly sliced chilli, origanum, 1 packet sugar snap peas, finely sliced vinegar and oil in a bowl. Season and whisk 1 packet mixed sprouts to form a marinade. 1 packet baby spinach Mix broccoli and 2 carrots, shaved in ribbons chicken through 1 cup cucumber, diced marinade. Roast Milled pepper broccoli for 10 mins,
R65
then add chicken and roast until cooked through (10 to 15 mins). Toss broccoli and chicken with sugar snap peas, sprouts, spinach, carrots and cucumber. Season with pepper and serve.
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Dinner
Tasty meatballs and mash 1789kJ
35g
fat
carb
13g 40g
GI
GL
50 20
1 sweet potato, peeled and diced 4-5 baby potatoes, chopped in half 2 onions, 1 diced and 1 grated 2 cups low sodium chicken stock 1 pinch salt and milled pepper 3T chopped thyme 2 t ground cumin 2 garlic cloves, crushed Juice and peel of ½ a lemon ½ Granny Smith apple, grated 200g pork mince 200g chicken mince 1/2 cup low GI breadcrumbs Flour to dust 2T oil
per portion
energy protein
Place potatoes, diced onion and stock in a saucepan and simmer until cooked through. Drain, season and mash until smooth. Mix grated onion,herbs, lemon, apple, mince and
breadcrumbs together. Shape into meatballs and dust in flour. Heat oil in a non-stick pan and fry meatballs in batches. Serve with mash, steamed broccoli and carrots.
Budget serves: 4 average cost:
R58 Fresh fish and spicy chips 24g
fat
carb
12g 29g
GI
GL
52 15
per portion
energy protein
Foodie
1348kJ
serves: 4 average cost:
4 pieces hake Salt and milled pepper ¼ cup self-raising flour 1 dash olive oil 1 small knob butter 1 onion, chopped 2 t fresh rosemary, finely chopped 2 t dried chilli flakes 2 cloves garlic, finely sliced Juice of ½ an orange Juice of 1 lemon 1 packet courgettes and patty pans, halved 1 sweet potato, washed and dried, skin on 2T olive oil A pinch of cayenne pepper A pinch of salt A pinch of freshly ground black pepper
R69
Preheat the oven to 220°C. Cut the potatoes in ½ cm thick slices. Mix the oil and seasonings, and add sliced potatoes. Toss to coat. Place in a single layer on a lined baking tray. Bake until lightly browned and crisp, about 30 mins. Fry onion, chilli and rosemary until soft. Add garlic, lemon and orange and simmer for 10 mins to form a sauce.
Rinse fish fillets, pat dry with paper towel, and season. Cover and refrigerate for 1 hour. Dust fish in seasoned flour and shake off excess. Heat oil and butter, add fish and cook for about 3 mins on each side until golden. Pour sauce over fish and serve with grilled courgettes and sweet potato crisps.
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Dessert Holiday fruit tarts 510kJ
3g
fat
carb
7g 11g
GI
GL
52
6
½ roll defrosted puff pastry 1 small knob melted butter 1 ½ nectarines (or peaches), sliced 2 granadillas 4 spoons plain low-fat yoghurt
per portion
energy protein
Using a cookie cutter, cut out puff pastry rounds. Using a slightly smaller cutter, make a dent in the round to form a border. Bake at 220°C until crisp, golden and puffed.
Slice nectarines and toss with granadilla pulp. Arrange fruit in the puffed rounds and serve topped with a spoonful of natural yoghurt. Yum!
Treat serves: 4 average cost:
R20
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Kids
Get creative!
The end of the year means it’s time to give gifts. We’ve found an easyto-make craft that kids will love. Claire Barnardo shows us how... Fun Frames What you need: • 1 sheet of craft foam / pair of scissors / magnets / photo sleeve / craft glue • Decorative odds and ends: foam cut-outs, beads, buttons, jewels or shells
1
Choose the shape for your frame. A rectangular snapshot size is a simple option to start with.
2
Use a photo sleeve from an old album and cut it out. Insert your photo into the sleeve.
4
Apply glue on to the white side of the magnet and stick it to the back of your frame. Let glue dry.
3
Stencil your shape on the craft foam and cut it out. Stick the sleeve on to it with craft glue.
5
Decorate the outer foam to suit the person you are making the gift for. Ta da! Instant gift!
Wrap it up This year, get creative and make your own wrapping paper. It’s more affordable, and eco-friendly too! Simply scout around your home for any paper or brown bags that can be re-used. You could even use old magazines, or simply buy some cheap, recycled brown paper. Decorate the paper with different potato stamps, hand prints, or words - then wrap your gifts. Beautiful!
Ask the expert: Esme Paulsen, Diabetes Nurse Educater “There are more challenges for children with diabetes during the festive season. Parents should try and get children involved with all aspects of planning for the celebrations. Try to take the focus off food and on to the entertainment - like treasure hunts or egg-and-spoon races.”
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GET IT TOGETHER
ZESTY CANNELLINI BEAN AND BACON SALAD The perfect workday lunch. 1072kJ ENERGY
9g PROTEIN
16g FAT
22g CARBS
PER SERVING
PER SERVING
PER SERVING
PER SERVING
Juice (60ml) and grated peel of 1 lemon 1 tbsp (30ml) olive oil 1 tsp (5ml) PnP white sugar 3 tbsp (45ml) parsley 1/ cup (80ml) PnP basil ³ 1 chilli, chopped 1 tbsp (15ml) white balsamic vinegar Salt and milled pepper 1 packet bacon, fat removed and diced 1 red onion, sliced, blanched in hot water and squeezed dry 1 can (410g) cannellini beans 251g drained and rinsed 1 packet (80g) salad leaves 2 cups (500ml) diced cucumber 70g PnP fat free Danish feta cheese, crumbled
Serves 4
+
+
Blitz together lemon juice and peel, olive oil, sugar, parsley, basil, chilli and vinegar. Season. Fry bacon until crispy, drain on kitchen paper and set aside. Toss bacon, dressing and onion together and mix with beans, salad leaves and cucumber. Serve topped with feta cheese.
Great idea:Stir through shredded, cooked chicken.
5 steps to manage your diabetes 1. Consume wholegrain cereals and legumes regularly, limit your intake of animal fats and moderately increase monounsaturated fats such as olive oil and avocado. Exercise regularly. 2. Eat a variety of vegetables as they have a low glycaemic load – fill half your plate at each meal with vegetables.
GARLICKY HUMMUS Great for low GI snacking. 932kJ ENERGY
19g PROTEIN
8g FAT
20g CARB
PER SERVING
PER SERVING
PER SERVING
PER SERVING
1 tbsp (30ml) olive oil 1 onion, finely chopped 3-4 PnP garlic cloves, unpeeled 1 tsp (5ml) PnP paprika 2 tsp (10ml) ground cumin 1 can (410g) chickpeas, 224g drained and rinsed Juice (30ml) of ½ lemon Salt and milled pepper 1/ cup (80ml) tahini paste ³ ½ cup (125ml) PnP plain fat free yoghurt ½ tbsp (7ml) sesame seeds Cayenne pepper, to taste
Contact Pick n Pay's dietitian at the Health Hotline with your nutrition-related queries. Also go to www.pnp.co.za/healthcorner and chat to Terry Health Guru on the Pick n Pay Facebook page.
Serves 4
+
+
Heat oil in a saucepan and sauté onion, garlic, paprika and cumin over a low heat until tender. Blend with chickpeas (setting a few aside), lemon juice, seasoning, tahini paste and yoghurt until smooth. Transfer into a serving bowl and scatter with reserved chickpeas and sesame seeds. Top with a dash of cayenne pepper and a drizzle of olive oil. Serve with vegetable crudités and toasted pita breads or wholewheat crackers. Recipes and images courtesy of Fresh Living magazine
3. Remember that sweetcorn, potatoes and sweet potatoes count as starch – it is critical to control their portion sizes. 4. ALL fruits can be eaten and should be included in the diet. Aim for 3-5 portions a day but have no more than 1 serving at a time. 5. All diabetics should see a registered dietitian and follow an individualised eating plan – visit www.adsa.org.za for a registered dietitian in your area.
Last Word SLM05_Last_Word.indd 1
“Smile, breathe, go slowly.” Thich Nhat Hanh
2012/10/11 3:02 PM
The biggest threat to your health comes from within - take a stand Diabetes is defined as having blood glucose levels above a predefined normal range. Exposure to higher than normal blood glucose levels over years causes damage. High blood pressure, High cholesterol and smoking accelerate the process.
Type 2 diabetes in its early stages and pre-diabetes in particular are curable and reversible with weight loss and exercise. Typically in type 2 diabetes the pancreas fails over time and insulin is required. Insulin is the elixir of life but with it comes weight gain. Increased weight leads to greater degrees of insulin resistance and inflammation in the body. To keep blood sugars controlled the dose of insulin is increased further and the vicious cycle continues.
What can you do to avoid this cycle or to escape it if you are already in it. Overweight and obesity are the precursors of type 2 diabetes in the majority of people. Intervening at this stage with a daily exercise program alone can prevent or delay the onset of diabetes even if you have a family history. Exercise is best performed on a daily basis. One needs to be realistic about your ability to establish and maintain an exercise program that fits your life and your schedule. “1 actual home exercise day under the belt is worth 2 in the gym�. Even more beneficial than exercise is weight loss. Weight loss of just 5% has marked benefits in reducing the risk of progression from pre-diabetes to diabetes. The secret to weight loss is to stick to a low calorie eating plan. For people with insulin resistance or diabetes, a low carbohydrate based calorie restricted plan is most beneficial. High-fat high-carbohydrate foods are packed full of calories and also stimulate inflammation in the hours after they are consumed adding to the inflammation generated by the fat cells. These foods also spike the
blood glucose level which promotes inflammation, strains the pancreas, and may lead to carbohydrate cravings as the blood glucose levels drop back to normal.
What else can you do? In recent years it has become clear that inflammation may form the foundation for the majority of the common lifestyle diseases. The root causes of this inflammation include our modern westernized diet, aggravated by overweight and obesity and a possible imbalance in our gut bacteria. Fat cells do far more than store energy and insulate us. These highly metabolically active cells also produce pro-inflammatory chemicals that are linked to the development of insulin resistance, a precursor of diabetes. Storage of extra calories creates larger and more metabolically active and damaging fat cells. The chemicals produced aggravate high blood pressure and also increase your risk of clot formation and heart attacks as well as certain cancers. Research has shown that our changing environment is responsible for the epidemic rise in lifestyle diseases and our intestinal system forms our largest interface with this toxic environment. An unbalanced gut flora adds fuel to the metabolic fire by increasing energy harvesting from the food we eat, directing incoming calories to be stored as fat and promoting inflammation.
The modern diet is deficient in beneficial anti-inflammatory Omega-3’s and overloaded with pro-inflammatory Omega-6 fatty acids. Clinical evidence suggests that EPA and DHA (eicosapentaenoic acid and docosahexaenoic acid, the two omega-3 fatty acids found in fish oil) help reduce risk factors for heart disease, including high cholesterol and high blood pressure. Micronutrients, vitamins and trace elements have been shown to improve insulin sensitivity, reduce inflammation or protect against cancer and heart disease. These include chromium picolinate, folic acid, vitamin D and E.
Symbio-D is a unique dietary supplement combination of Vitamins, Omega-3 and Pro-biotics. Symbio-D was designed, developed and clinically tested in South Africa. Each of the components was selected to target the root causes of inflammation and reduce the collateral damage caused by the excesses and deficiencies of a modern diet and lifestyle and aggravated by overweight and obesity. 50-100% of people developing type 2 diabetes have a first degree relative who has diabetes. Look around at your family members and friends- who are at risk. Who needs a gentle push or a pull towards a healthier future?
Lead by example, choose Symbio-D. By Dr David Segal
MB ChB (University of the Witwatersrand), FAAP (USA), FACE(USA)
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