Category: 2017 Spring – Diabetes Focus

six steps boost health

Six steps to boost health and ban dread disease

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John Hamlett, a fitness expert, shares six steps to boost health and ban dread disease.

According to the most recent South African Demographic and Health Survey, almost 70% of South African women are either overweight or obese, as are 13% of our children. More than double the global average of 5%.

While heart disease and diabetes are directly linked to being overweight or obese. There is evidence that a causal link exists between excess weight and cancers of the oesophagus, colon, rectum, liver, gall bladder, pancreas, breast, ovary, kidneys, thyroid gland, and even leukaemia.

It’s clear that South Africans need to take stock of their health, and their approach to regaining control of their weight – and what’s more, they need to take more action than signing up for a gym membership in January, then never using it.

“The slide to being overweight or being obese does not happen overnight. It’s the culmination of months and years of unhealthy eating, inactivity, and avoiding the right food and exercise choices for a variety of reasons,” says John Hamlett, a fitness expert and TomTom Athletics Club founder. “Losing the weight won’t happen overnight either – but doing so is vital if you are to reduce your risk of contracting a life-threatening disease, such as cancer or heart failure.”

Six tips and tricks to boost health and ban dread disease:

  • Limit your calorie intake. This doesn’t mean you need to stop eating. It means you need to make healthier food choices. Consult with your doctor or dietitian to find out what your daily calorie intake should be, and base your food choices on achieving that with the help of this handy online calorie counter.
  • Get out and about. One of the best ways to feel better about yourself is to get active – and you don’t have to go from zero to cardio hero to see the benefits. Track your movement with a TomTom Touch Cardioentry-level fitness tracker, which helps you monitor your daily step count, number of calories burned, as well as sleep and active time. Set yourself daily or weekly challenges, and decide on rewards before you start each challenge, to give yourself time to plan something healthy.
  • Ditch the diet drinks and choose water instead. Water hydrates the body, giving you a healthy glow, reducing wrinkles, and boosting weight loss. Drinking coffee or tea doesn’t count towards your daily recommended intake of eight glasses – you want to choose pure, unflavoured water for the best results.
  • Love the food you eat. It’s true that you’ll have to give up some types of food, but if you balance your food choices within your targeted calorie range, you can still enjoy tasty, filling meals. Veggies are low-calorie and include fibre (which makes you feel full) – but you can do so much more than just boiling them as part of a healthy eating plan. Steam them, roast them, bake them, spice them up with chilli or other fragrant spices. Healthy food certainly doesn’t have to be boring.
  • Up your game. Getting active by taking a walk around the office park at lunchtime is a great start – but you’ll see better results in your weight loss and health programme if you push yourself a little more each week. Take a jog at lunchtime instead of a walk, or use your newfound fitness as a foundation to make that gym membership worthwhile. If you’ve been tracking your progress on your TomTom fitness device, you can set yourself new goals (and rewards) to boost your activity even further.
  • Be prepared. Plan your meals in advance. Make sure you have all the required ingredients to prepare lunches for work in advance and have a good breakfast. A good breakfast will help you avoid those mid-morning nibbles, and a packed healthy lunch will reduce the temptation to eat unhealthy convenience foods during the day.

MEET OUR EXPERT - John E. Hamlett

John E. Hamlett is the Founder and Designer of John's New Lifestyle and is the coach of the TomTom Athletics Club Elite Athletes. He has been a professional athlete, teacher, electronic engineer and intelligence colonel; qualified as a specialist in nutrition and fitness (studied in Russia and the USA); was a physical training instructor in the military, qualified aerobics and swimming coach instructor, tri-athlete coach, gym instructor.
diabetes apps

Diabetes apps: helpful or technology fad?

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Jessica Pieterse, a dietitian, helps us understand diabetes apps. She explains how to use them and shares the top five.

Carbohydrate counting may provide more freedom to a person with diabetes. One can adjust a meal depending on the blood sugar levels measured before a meal or adjust the insulin dosage according to the amount of carbohydrates eaten. However, keeping track of all this information may be challenging. Diabetes apps are the new kids on the block. Technology can aid you to count carbohydrates, monitor your intake, and track information that is important to a person living with diabetes.

What is an app?

An app is a software application designed for smartphones or tablets. It is different to programmes that are used on a computer or laptop as it runs directly on the mobile device and not on an internet browser.

How can diabetes apps help you?

Diabetes apps can help you monitor your glucose levels, food intake, medication doses, symptoms, kilojoule intake, carbohydrate intake, weight and exercise as well as supply meal recipe ideas and interesting articles. Most people always carry phones or tablets with them, which makes diabetes apps an easy and convenient method to store info.

What diabetes apps should you download?

CDE Club App

Free – available on Android and iOS.

  • The Centre for Diabetes and Endocrinology (CDE) provides scientific-based articles, videos, recipes and health-risk assessments.
  • Promotes participation by setting Life Actions, which are daily goals. If you are a CDE Centre patient, then your weight, blood pressure, glucose and HbA1c values are also recorded.
  • Provides reputable info, however, tracking of carbohydrates is not provided.

Diabetes apps

Diabetes in Check

Free – available on iOS.

  • Allows you to track your glucose, medication, food intake, exercise and weight.
  • It is user-friendly with helpful settings to make the records individualised, such as choosing the brand of insulin.
  • Highlights carbohydrates eaten at meals, which can assist with carb counting. However, portions are not always clear when entering into the app.

diabetes apps

Diabetes Lite

Free – available on iOS.

  • Tracks blood glucose, medication, physical activity, weight, food and water intake.
  • An advantage is that its comprehensive and includes water intake, which not all diabetes apps do. However, it is less user-friendly than other diabetes apps.
  • The nutrition tracking is probably the most confusing section as it is challenging to search for and log food items.

diabetes apps

Carb Counter

Free – available on iOS.

  • Can be helpful for the experienced person with diabetes – a person who already understands food.
  • The carbohydrate content can simply add the grams of carbohydrates eaten and note what meal or snack it is.
  • Tallies up a total daily carbohydrate intake.
  • Requires knowledge of carbohydrate contents of foods as no database of food items are given.

diabetes apps

Diabetes:M

Free – available on Android and iOS.

  • It is useful for an experienced person with diabetes. You can develop a detailed logbook of medication, glucose levels, meal times and carbohydrate intake.
  • Knowledge of carbohydrate contents of foods is needed as no food database is given.

How do you download diabetes apps?

Mobile devices will have an app store, either Google Play (Android) or Apple iStore (iPhone), to download various apps. You can search for diabetes apps by typing in the direct name of the app, or search for a general function that you desire.

Some diabetes apps are free while others you’ll need to purchase. If you are interested in an app, click on the ‘Get’ button, and then ‘Install’ button. Once it is downloaded, you can click on the ‘Open’ button.

What must you look out for when searching for diabetes apps?

There are plenty of diabetes apps to choose from, although not all of them should be used. Choosing the right one is a matter of understanding what function you want the diabetes app to have and where the diabetes app can support the health professional guidance.

Be cautious of prescriptive diabetes apps. Some diabetes apps prescribe goals, such as blood glucose levels or total kilojoule intake. This should be personalised and prescribed by your team of healthcare professionals, who have completed a comprehensive medical assessment and understand your unique requirements.

Should people with diabetes use diabetes apps?

Diabetes apps can provide useful information as well as an easy and convenient method of tracking important health data. These diabetes apps should be used as a complementary tool to your regular appointments with your health professional and not replace them.

Your health professional can use your tracked data on your chosen diabetes app to increase their understanding of your progress or difficulties. These diabetes apps can be used together with education on carbohydrate counting from your registered dietitian.

MEET OUR EXPERT - Jessica Pieterse

Jessica Pieterse is a registered dietitian at Nutritional Solutions in Bryanston, Gauteng. She has a special interest in nutrigenomics, weight loss, diabetes, hypercholesteromia, hypertension and gut disorders. She lecturers at the Health and Fitness Professional Academy.
mind

Mind over body

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Ilze Alberts explains how her excellent management of Type 1 diabetes came about – through mind over body.

Ilze Alberts (58) lives in Johannesburg with her husband. She has two adult children.

Type 1 diabetes fell out of heaven and hit my body; unexpected, uninvited, and bringing only promises of devastation. It felt like the end, but in retrospect, it was really just the start of a new beginning. One that proved infinitely better than the original plan that I had in mind.

If you’re reading this, you might have Type 1, Type 2, or you might be pre-diabetic. I know how scary that can be. Our afflictions, though different, are much the same – especially in the way we need to handle them. Perhaps you’re feeling angry, confused, even depressed. Maybe you blame yourself. “Why has this happened to me? What now?” It is within this context that I share my story with you.

Unexpected change in direction

I was a blooming 21-year-old with big dreams ahead of me; healthy and filled with a zest for life. I was in my final year of studies at university, working towards becoming a teacher, but I had wanderlust. I decided to become a flight attendant, to explore the world.

When I went for the medical, they told me, “You have diabetes.” It was one of the most cataclysmic events of my life. I was terrified, but I knew the first step was education. This is what I learnt:

  • Type 1 diabetes is an autoimmune condition in which the immune system is activated to destroy the cells in the pancreas. The cause is unknown, and it cannot be cured or prevented.
  • It occurs when the pancreas does not produce insulin.
  • It is managed with insulin injections several times a day, or the use of an insulin pump.
  • It represents around 10% of all cases of diabetes and is one of the most common chronic childhood conditions.

Finding the terrific in the terrible

Our biggest defeats often turn into our biggest victories. I would like to encourage you to find the terrific in your terrible. This requires that you apply your mind. I am not saying that your mind alone can be a substitute for the medication that you might need to take, but with the power of your mind, you can change the emotional and health impact it has on you.

Once I had educated myself and got the hang of things like the injections, correct eating, and regular exercise, I turned my attention – and still do – to the power of the mind to overcome challenges. I became aware, with lots of help, that my insulin dependency might well respond to the healing powers of my own mind.

I was so inspired to see the power that my mind had over my body. I began realising that my diabetes was not solely genetic, but also resulted from my unconscious perception that the condition somehow gave me more benefits than drawbacks, more pleasure than pain, and more positives than negatives. I wanted to know, “What is my hidden strategy? Why have I pulled this into my life?”

Exceptional management

Over time, as I committed my mind to wisely take control of my diabetes, my body started to respond positively to my actions. It was a slow process; it didn’t happen overnight. But eventually, with sustained physical and mental commitments, conscious actions to take control of my diabetes, the impact of diabetes became less. My HB1Ac levels remained constantly under 6, and my body loved the healthy eating and regular physical exercise.

Even an integrative and healthy-ageing practitioner was impressed. He had this to say: “When I met Ilze as a patient four years ago, I was blown away. She mentioned she was a Type 1 diabetic. I stopped in disbelief and looked at the blood tests done prior to her consultation. There was no indication of any underlying diabetes. The level of glucose in the red blood cells over the last 90 days was normal. Even today, this remains the case. Her holistic approach to her being, her life and her health is astounding. It is a source of hope not only to others, but also motivates me as a medical doctor to focus more on all the preventative lifestyle factors, and not just the disease and the management of the symptoms, signs and complications.”

How diabetes saved my life

Ironically, diabetes is one of the best things that has happened to me, for the following reasons:

  • I had to let go of my flight attendant plan. Instead, I studied psychology to master’s degree level, and I have practiced for over 30 years now. Today, I am also a life strategist, helping other people to create beautiful lives of their own. It gives me joy as I fulfil my purpose and live a life of meaning in serving others.
  • I was blessed to have given birth to two wonderful children, Charne and Jacques, despite my illness. They are healthy and diabetes-free, with a lust for life. They watch what they eat and exercise regularly.
  • I was widowed in my forties, but then met an extraordinary man, who is younger than me. One of the reasons he was attracted to me is because I am focused on empowering my life in all areas. We are happily married.
  • I am healthy, and I am filled with energy and vitality.
  • My health issues forced me to deal with the onslaught of bad food that we are exposed to. I exercise daily, eat very well, and I have a good body (according to my hubby).
  • My friends and family have been inspired by my life and my example.

Mind over body

“Yes, but I have Type 2,” you might say. “So, what worked for you will not work for me.” Not so. Like me, what has happened is that your body has communicated to you, that you need to adjust your lifestyle to be healthier. Your body is doing all that it can to wake you up and show you how to live an inspired and magnificent life. That is actually a blessing:

  • Has your illness added years to your life because you are forced to eat better and exercise?
  • Has this saved you from a stroke or a heart attack?
  • Have you helped your family because you have inspired them to live healthier?
  • Do you find you want to make every moment count, because you see how precious and valuable your life is? If not, when will you start?
  • Have you empowered your life by taking control, educating yourself, and focusing more on your family and the people that love you?

What is your big why?

You see, you need to have a big WHY, like I do – why is it so important to manage diabetes? If we don’t have this big why, the how will not appear. That is the big motivation. I desire to live my life with fulfilment, to live my vision, to make an impact on the world, to serve my family, to serve my clients, and I can only do that if I have a body that’s filled with health and vitality.

It became ever more apparent that I really wanted to be there for my husband, my children, my clients. I still do, as much as I ever did. My body is the vehicle through which I take my unique gift to the world (we all have one). If I don’t look after my body and my mind, then I cannot do this. How will you use your body’s response of trying to become well (manifest in your diabetes), to serve the people that you love, and the world?

I hope, with all my heart, that you see your life through new eyes because of my story. Our biggest stresses can be our biggest blessings. This is so true for me, because of my empowering journey with diabetes. May you, too, be inspired and motivated to live a beautiful life, and to powerfully share that with the world.

For more info or to contact me please go to bellavida.co.za

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Sleep apnoea and diabetes – is there a link?

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Adele Duvenage, the Snore Sister, explains the link between sleep apnoea and diabetes.

Why do people snore?

During normal sleep, the muscles that control the tongue and soft palate hold the airway open. If these muscles relax, the airway becomes narrower. As one breathes in, the soft or floppy part of the throat vibrates; snoring being the result. In some cases, snoring can be very loud and unpleasant for the person sleeping next to the snorer. But usually, this is the only way snoring is recognised – by a friend or partner who observes the person sleeping.

Worryingly, more complex conditions, such as sleep apnoea, can be consistent with snoring. Snoring is recognised as a more serious symptom of obstructive sleep apnoea (OSA). Before relying on techniques that may mask symptoms but not treat the underlying condition, people who snore should seek professional medical advice.

Even the loudest snoring does not mean that an individual has sleep apnoea. The symptom that is most suggestive of sleep apnoea is when the snoring stops. A simple apnoea screen test, in the comfort of your own home, will confirm or exclude the presence of sleep apnoea.

What is OSA?

Obstructive sleep apnoea is a sleep disorder, characterised by abnormal pauses in breathing or instances of abnormally low breathing, during sleep. Your airway may: narrow – limiting airflow as you breathe; vibrate – commonly heard as snoring; or collapse – you stop breathing.

Each pause in breathing, called an apnoea, can last from ten seconds to minutes, and may occur five times or more an hour, or several hundred times during the night. Similarly, each abnormally low-breathing event is called a hypopnea.

In OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, making snoring common. A person with sleep apnoea is rarely aware of having difficulty breathing, even upon awakening. Symptoms may be present for years (or even decades) without identification, during which the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

There are several factors that can cause or worsen throat narrowing during sleep, such as being overweight, drinking alcohol, abnormalities of the nose and throat, smoking, and the use of sleeping pills.

Mild occasional sleep apnoea, which people experience if they have an upper respiratory infection, may not be worrying, but chronic severe obstructive sleep apnoea requires treatment to prevent low blood oxygen (hypoxemia), sleep deprivation, and other complications.

Is OSA life-threatening?

OSA has been linked to be the possible cause of several serious life-threatening conditions, including Type 2 diabetes, high blood pressure, high cholesterol, hypothyroidism (underactive thyroid), heart disease, heart attack, stroke, and depression.

Because of severely disrupted sleep, many people suffering OSA are excessively tired during the day. Studies have linked this tiredness to increased occurrence of traffic accidents.

The link between sleep apnoea and diabetes

It’s common for people with Type 2 diabetes to have sleep apnoea. Sleep apnoea and Type 2 diabetes often co-exist because of shared risk factors like obesity. The more severe the untreated sleep apnoea in a person with Type 2 diabetes is, the more difficult it is to control glucose levels.

The cause of sleep apnoea and how it connects to Type 2 diabetes has a lot to do with weight. People with Type 2 diabetes may be obese, insulin resistant, and have large amounts of visceral fat (the fat deep inside the body that surrounds the organs). The extra weight causes the tissues in the neck and throat to narrow the airway.

Sleep apnoea can also increase blood sugar levels because of the stress associated with chronic sleep deprivation and abrupt awakenings in the night. When you get stressed, your body releases stress hormones that can release stored glucose into the liver. Over time, the increase in blood sugar levels can contribute to insulin resistance.

Treatments and benefits

Getting a good night’s sleep, often for the first time in years, can lead to significant improvements in other aspects of a person’s life, including psychological health and happiness.

Treatment of OSA can lead to a reduction in snoring, which benefits the person with OSA as well as his/her bed partner. Improved sleep leads to an improved quality of life, as treatment reduces OSA- related symptoms.

Effective treatment of OSA reduces cardiovascular risk, which also results in better control or resolution of hypertension, and may have positive effects on diabetes control. In some people, lifestyle changes are enough to manage snoring and possible OSA. Some recommendations include losing excess weight, quitting smoking, and avoiding alcohol or sedatives in the evening.

Other methods used to treat OSA include oral appliances. For moderate to severe sleep apnoea, the most common treatment is the use of a continuous positive airway pressure (CPAP) or automatic positive airway pressure (APAP) device. These devices ‘splints’ the patient’s airway open, during sleep, by means of a flow of pressurised air into the throat.

The patient typically wears a facial mask, which is connected by a flexible tube to a small bedside CPAP machine. The CPAP machine generates the required air pressure to keep the patient’s airways open during sleep.

Advanced models may warm or humidify the air and monitor the patient’s breathing to ensure proper treatment. There are many different types of masks, and finding the most comfortable one is detrimental to effective CPAP treatment. It can be compared with buying a shoe that is comfortable – will you be able to wear that shoe every day? Will you be able to sleep with that mask every night?

Who is more likely to get sleep apnoea?

  • Males more than females
  • Obesity BMI>40
  • Age 40 – 64
  • Smoker>40/day
  • Family history of snoring
  • Neck circumference male ≄ 43 cm female ≄ 40 cm
  • Degenerative medical conditions
  • Nasal obstruction neuromuscular diseases

Symptoms of sleep apnoea

  • Feeling excessively sleepy or tired during the day in spite of a full night’s sleep.
  • Gasping, choking or snorting during sleep.
  • Waking up tired or with a headache.
  • Falling asleep in inappropriate situations (movies, church, sitting quietly) or without meaning to sleep.
  • Problems with memory and concentration.
  • Being ill-tempered or irritable.
  • Personality changes.
  • Aggressiveness, anxiety or irritability.
  • Depression.
  • Recurrent awakening at night.
  • Night sweats.
  • Weight increase.
  • Impotence.
  • Decreased libido (1/3).
  • Dry mouth/drooling.

MEET OUR EXPERT - Adele Duvenage

Adele Duvenage is a registered nursed. She is known for her expertise in OSA, its diagnosis and treatment and was responsible for successful negotiation for the performance of home-based sleep studies and tests to treat OSA by most major medical aids.