Category: 2023

The water element and winter

The water element and winter

Posted on by
Share

Veronica Tift enlightens us on how the water element plays a role in the winter season and how to achieve balance with this element.

Let me take you on a little journey, you’re sitting nestled by a warm, glowing fire, crackling away. The blankets wrapped around you are comforting and make you feel held. You have in your hand a warm soothing drink and your beloved pet is comfortably nuzzled in a little ball near your feet. Why does this sound so completely ideal, as the cold weather starts to settle around us?

Because deep down we know that winter is the time for this kind of rest and restoration. Winters are like that, a more inward and sensitive time; its natures resting season, quieten down, deep in the earth and the roots preparing for spring. This is also a great time for you to go deeper within yourself, resting, reflecting and looking for replenishment.

The water element and winter

Are you feeling a little more emotional these days, craving salty foods or maybe everything tastes a little too salty, possibly feeling more fearful, especially in the evenings you can feel the anxiety creeping in?

According to the Chinese Five Elements, winter is related to the water element. Winter is the season in which the water element is most dominant. The kidneys, adrenal glands and bladder are the organs associated with the water element and the winter season.

From a Traditional Chinese Medicine (TCM) point of view, people with deficient water energy may struggle to slow down, rest or relax. A balanced water element allows fluidity and flow, there is the ability to nourish and rest, not only for themselves but others. Both water and emotions are unpredictable, when flowing, all is well, but when blocked or stagnant, great pressure can develop, or disease can set in.

Water is amazing; of all the qualities that are needed for life on earth, water is in all living things, whether they live at the bottom of the ocean or the dry desert. Water has made life possible on earth. It is adaptable, taking shapes of its container, changing form with cold and heat.

Having a water element out of balance doesn’t mean drinking large quantities of water. While you need to look at the quality of your water, the intention in which you drink it and being mindful of how much you drink or don’t drink, there is more to this season and the water element.

The kidneys

In TCM, the kidneys house our jing or in the Western world this would equate to your DNA and longevity. The building blocks for physical vitality are responsible for our aging. Jing is also responsible for fertility and reproduction, growth and development. So, when you move against the flow of life, you are exhausting out your own precious life force.

Use your Jing wisely. Step into flow rather than against it, this does not mean being complacent, but rather spending time and energy on things that align with your true desire and authentic expression. Warm yourself emotionally with family and friends, doing things that bring you joy.

Overworking, stressful or traumatic events, overexertion, emotional stress, spending energy on things that drain you, poor diet and lack of sleep will all make it harder to handle the cold and feel balanced during the winter season.

The emotion fear relates to the water element. The kidneys and urinary bladder organs can reflect as we see when anxiety and chronic stress correlate in scientific literature to frequent urination or painful urination as well as pelvic pain. In Chinese Medicine, the stress is specific to the emotion of fear and urgency to release pressure.

The kidneys can be thought of as your batteries, they can give you horsepower that is needed to move towards your ambitions, but only when they are in alignment. The changing of each season can bring stress to the body and illness itself can give you the opportunity to re-evaluate your life.

Questions to ask yourself  

  • Am I over-reacting in situations and do these situations really require this much stress from me?
  • Do these actions align with my natural gifts, talents and interests? Does it feel like my authentic truth?
  • Is this the right time for me to act? Is this the season of my life for this intention to flourish?
  • Am I forcing anything, pushing past signs that this is not right and acting outside my authentic self.

Ways to balance the water element

These include resting, walking in nature, moving your body, journaling, meditation, prayer, eating whole foods that are in season, reducing alcohol and drug use, and prioritising sleep.

Be with feelings of grounding, breathe and feel your body. Bring love to your fear, have compassion for how hard it has been and send yourself some kindness. Listen to your authentic self and wisdom of your body, feel what feels right for you.

Winter diet

As you move into winter, it’s a good idea to shift your diet to create more heat internally. Fruits should be eaten less. Vegetables should be steamed or baked. Eat hearty vegetable soups with root vegetables like carrots, turnups and onions. Not forgetting warming spices like ginger root and garlic while cayenne pepper adds heat to your meals and warmth to your toes.

Cooked whole grains can also be an excellent staple in winter and roasted nuts can be a good snack. The most important thing is to listen to what your body is really telling you to consume. Brewing an herbal tea with ginseng roots or ginger are also traditional energisers.

Exercise in winter

Winter is the season of storage and preparation, take care of your activity level during the winter month and don’t run your batteries down. Move every day with stretching and dance, deep breathing and keeping that circulation moving. It’s a good time for indoor exercise like yoga, even a short practice can be beneficial.

The KD-1 point

The Yong Quan or KD-1 is the first point along the kidney meridian. It’s found between the second and third metatarsal bones on the sole of the foot. This point connects you directly with the vitality of the earth/yin energy and can aid in grounding and elevating energy, depending on what the body needs. It can bring up a deep well of energy or calm energy down, just like a fresh water spring emerges from the darkness of earth.

The KD-1 point gives access to the energy that is balanced and harmonious, and can be useful for fertility, easing anxiety and panic, restlessness, memory and insomnia. This is just one reflex point on the feet and regular treatments are key during the winter months.

Massaging this point, especially before bed, making contact with the earth when walking barefoot if possible and gripping your toes slightly in the earth while imagining energy flowing up into your body and reflexology are all great ways to keep your water element in balance.

References

www.noscoyoga.com/instagram

Inge Dougans Reflexology the 5 elements and their 12 meridian’s a unique approach; Thorsons

Haas. Dr Elson M. 1981, Staying healthy with the seasons

Axe, Dr Josh. 2021, Ancient Remedies for modern Life

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

MEET THE EXPERT

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

Header image by FreePik
Visit the A-Z of Diabetes - Your Journey
noy

Farewell Noy, farewell A4C

Posted on by
Share

Sadly Noy Pullen passed away in February 2023, we look at all she achieved with the DSA project: Agents For Change.

When did Agents for Change start?

Agents for Change (A4C) began in 2007. The World Diabetes Foundation (WDF) began financially supporting Agents for Change in 2008.

In June 2015, Martin Wolf Andersen and Susanne Olejas from WDF Denmark, attended Agents for Change seminars in Western Cape and North West Province during a field visit.

Aim and the mission of A4C

Diabetes is a huge problem in South Africa (SA) and worldwide. There are over four million people diagnosed with diabetes in SA. The International Diabetes Federation reports that 50% of people with diabetes are undiagnosed worldwide.

Lack of trained healthcare providers in diabetes in SA is the most critical issue impeding the delivery of high-quality diabetes care. The aim of A4C is to train healthcare providers and other healthcare practitioners in diabetes in all provinces, including rural areas.

The programme creates awareness about the importance of lifestyle change when living with diabetes and reducing the risk of getting it.  Participants attend intensive two-day workshops, six months apart, where they learn about diabetes, how to manage it and prevent complications. They are also taught communication skills so that they can empower people living with diabetes for self-management. To do this, they are encouraged to change their own behaviour for better health.

In 2006, Noy Pullen relocated to Cape Town from Johannesburg where she met Buyelwa Majikela-Dlangamandla who was then a diabetes educator at Groote Schuur Hospital. They worked together on this project (A4C) through DSA since 2007 until January 2022.

Noy was also the editor of Diabetes Focus for many years. She had interest in diabetes and helping people as she had a family member with diabetes.

What are the greatest achievements for A4C?

The greatest achievements of A4C were training more than 2 000 healthcare providers. The majority of participants managed to change their own lifestyle, such as eating healthily, losing weight and doing physical activity.

Some of them started vegetable gardens. A4C supported them by providing them with tools, such as seeds, skipping ropes, measuring tapes, information booklets, etc.

During all trainings, A4C did practical food demonstrations, and everybody helped. Many said they thought that healthy eating was boring, but said they enjoyed the food during training and changed the way they prepared food at their homes.

A4C was recognised by the South African Department of Health and the trained healthcare workers reached more than 100 thousand people in the country.

What was Noy Pullen known best for?

Noy loved colour. Although she had a teaching qualification, she stopped teaching many years ago. She was also a make-up artist. Noy was an excellent article writer, interviewing people and writing their stories. She was a spiritual person who loved her family and was good at uniting them. She was a coach and teacher and encouraged people to be themselves and do their best.

How did she impact A4C?

A4C would never be the same without Noy. Her guidance helped and encouraged Buyelwa to use the guiding style of teaching rather than the old way of directive teaching. Noy had great influence and encouraged Buyelwa to write a diabetes book. She was accurate with bookkeeping and writing up of reports including financial reports to the sponsors.

A4C project stopped

Unfortunately, due to the sponsor stopping their financial support of A4C, the last A4C training was in January 2022.

Farewell Noy and farewell A4C; may your soul rest in eternal peace.

References

Agents for change WDF08-378 (project description)

Agents for change WDF11-590 (project description)

Agents for change WDF14-876 (project description)

Agents for Change: champions in the fight against diabetes in South Africa (Diabetes Voice, June 2009 | Volume 54 | Issue 2) http://www.idf.org/sites/default/files/attachments/2009_2_Pullen.pdf

HRH Strategy for the Health Sector: 2012 to 2017 (pdf) (http://www.ahp.org.za/files/1896/HRH%20Strategy%202012%20to%202017.pdf)

Gut health

Gut health and diabetes

Posted on by
Share

Mel Fourie explains the mechanisms of gut health in relation to Type 2 diabetes and what happens in your body when you eat nutrient-dense foods compared to empty calories.

Did you know that sugar consumption has gone from twenty teaspoons a year to twenty two teaspoons a day? When we primarily eat foods containing high sugar, dangerous trans fats, and low fibre, your body doesn’t know how to utilise these anti-biological nutrients which cause metabolic dysfunction and weight gain due to the proliferation of inflammatory gut bacteria. Your gut health (flora) becomes toxic spiralling your microbiome into dysbiosis, a term meaning imbalance.

Blood glucose imbalances, mood swings, weight gain, and sleep disturbances are just some of the many side effects that can happen when your dietary choices contain harmful ingredients.

At its very core, Type 2 diabetes can be understood as a disease caused by too much insulin, which your body secretes when you eat too much sugar.

Solving the problem – the quality of the food

Knowledge is power and presenting the problem this way is incredibly profound because the solution becomes immediately obvious. You can lower your insulin levels by reducing your dietary intake of sugar and refined carbohydrates thus improving your gut health.

This leads me to sharing a rather bold statement, that obesity and diabetes can’t be cured in a doctor’s office alone. The journey to healing diabetes begins on the farm, in the supermarkets, in the restaurants, in your kitchens, on your plates, and in your gut.

Depending on the quality of the food, it will have profoundly different effects. If you have, for example, broccoli or your favourite soda, they’re both carbohydrates, but they have very different effects in your gut and microbiome, as well as your biological responses.

Broccoli vs soda

To illustrate how this works, let’s follow a sequence of biological responses that occur as broccoli and soda enters your body.

Soda

Let’s begin with a few gulps of soda. Your gut quickly absorbs the fructose and glucose. The glucose spikes your blood glucose, starting a domino effect of high insulin and a cascade of hormonal responses that kicks bad biochemistry into gear. The high insulin increases storage of belly fat, increases inflammation, raises triglycerides, lowers HDL, raises blood pressure, lowers testosterone in men, and may contribute to infertility in women. Your appetite is increased because of insulin’s effect on your brain chemistry. The insulin blocks your appetite-control hormone leptin. You become more leptin resistant, so the brain never gets the I’m full signal. Instead, it thinks you are starving.

Your pleasure-based reward centre is triggered, driving you to consume more sugar fuelling a sugar addiction. The fructose makes things worse. It goes right to your liver, where it starts manufacturing fat, which triggers more insulin resistance and causes chronically elevated blood insulin levels, driving your body to store everything you eat as dangerous belly fat.

You may also get a fatty liver, which generates more inflammation. Chronic inflammation causes more weight gain leading to obesity. Anything that causes inflammation will worsen insulin resistance. Another problem with fructose is that it doesn’t send informational feedback to the brain, signalling that a load of calories just hit the body. Nor does it reduce ghrelin, the appetite hormone that is usually reduced when you eat real food. Now you can see just how easily your favourite soda can create biochemical chaos.

Broccoli

Let’s look at the digestive pathway of broccoli. As with your favourite soda, broccoli is made up primarily (although not entirely) of carbohydrates.

To clarify what that means, because the varying characteristics of carbohydrates will factor significantly into the contrast, carbohydrates are plant-based compounds comprised of carbon, hydrogen, and oxygen. They come in many varieties, but they are all technically sugars or starches, which convert to sugar in the body.

The important difference is in how they affect your blood glucose. High-fibre, low-sugar carbohydrates such as broccoli are slowly digested and don’t lead to blood glucose and insulin spikes, while table sugar is a quickly digested carbohydrate that spikes your blood glucose. Therein lies the difference.

Slow carbohydrates like broccoli heal rather than harm. When you eat broccoli there is no blood glucose or insulin spike, no risk of fatty liver, and no hormonal chaos. Your stomach distends sending signals to your brain that you are full. There is no triggering of the addiction reward centre in the brain. You also get many extra benefits that optimise metabolism, lower cholesterol, reduce inflammation, and boost detoxification.

The phytonutrients in broccoli boost your liver’s ability to detoxify environmental chemicals, and the flavonoid kaempferol is a powerful anti-inflammatory. Broccoli also contains high levels of vitamin C and folate, which protect against cancer. The glucosinolates and sulphorophanes in broccoli change the expression of your genes to help balance your sex hormones, reducing the risk of breast and other cancers.

This rather simple illustration clearly demonstrates that good nutrition is a fundamental cornerstone of well-being and gut health. When you shift your diet, you change your biology, so choose to eat well.

But what does it mean to eat well for good gut health?

Basically to eat whole foods in their most natural form, including all the colours of the rainbow every single day to ensure you are getting plenty of beneficial phytochemicals and antioxidants to support whole-body health.

  • You can start by adding more veggies to every meal. Try incorporating high-fibre vegetables like broccoli, cauliflower, kale, peppers, and spinach.
  • Substitute sugar-laden treats with low-glycaemic fruits like blueberries, cherries, kiwi, and raspberries.
  • Add healthy fats like avocados, olives, extra virgin olive oil, organic coconut oil and cold pressed hemp seed oil.
  • For those who choose to eat animal products, move away from industrially-raised meat products and start sourcing grass-finished or free-range meats and eggs as well as wild caught fish and seafood.
  • Add a few anti-inflammatory nuts and seeds and incorporate a diversity of healing herbs and spices.

Exercise – the most powerful medicine

Did you know that exercise might be the most powerful medicine to manage blood glucose levels and make your cells more insulin sensitive? Walking, yoga, Tai Chi, or similar more gentle forms of exercise are great ways to start.

Final thought

Obesity and Type 2 diabetes are closely related, and generally, increased weight increases the risk of disease. The correlation is not perfect but, nevertheless, maintaining an ideal weight, eating nutrient dense foods, and taking care of your gut flora are the first steps to prevention.

  • Broccoli vs Soda illustration adapted from The Blood Sugar Solution.
Mel Fourie is an AADP Board Certified Holistic Health Practitioner. She joined the International Quantum University of Integrative Medicine and holds a bachelor’s degree in Holistic Health Science, a Bachelor of Science in Holistic Nutrition, and a Bachelor of Science in Botanical Medicine. She later continued her studies to incorporate a Master of Natural Medicine, a Doctorate in Alternative Medicine, and now continues her research venture towards a PhD in Natural Medicine.

MEET THE EXPERT

Mel Fourie is an AADP Board Certified Holistic Health Practitioner. She joined the International Quantum University of Integrative Medicine and holds a bachelor’s degree in Holistic Health Science, a Bachelor of Science in Holistic Nutrition, and a Bachelor of Science in Botanical Medicine. She later continued her studies to incorporate a Master of Natural Medicine, a Doctorate in Alternative Medicine, and now continues her research venture towards a PhD in Natural Medicine. 
Header image by FreePik
Visit the A-Z of Diabetes - Your Journey
sports drinks

The impact of sports drinks on blood glucose

Posted on by
Share

Lynette Lacock looks at the impact of sports drinks on blood glucose levels in people with diabetes and offers healthier alternatives.

The origin of sports drinks

Sports drinks have been around since the early 1900s. One of the first commercially successful drink was Lucozade which was launched in the UK in 1927. Originally it was sold by a pharmaceutical company and primarily marketed to sick people. Today we have a large variety of sports drinks marketed to healthy active people. In fact, globally it is a (USD) $26 billion industry.

These drinks are designed to replace fluids and electrolytes that are lost while exercising. They mostly contain water, sugar (carbohydrate), minerals, electrolytes, vitamins and some also include caffeine.

What do they do for you?

During periods of intense exercise, you lose water and electrolytes.  Both of these are essential for your muscles to work properly. When you exercise for long periods of time, your body turns carbohydrates into glucose that your body uses as fuel. If your glycogen (glucose) storage gets low, you will become tired and not be able to perform optimally.

Using energy drinks can help hydrate you and provide your body with an energy source. However, these drinks contain an average of nine teaspoons of sugar per helping. So, if you have diabetes, this high amount of sugar can cause your blood glucose to spike.

Do you need the added caffeine?

Many energy drinks on the market contain caffeine as well as carbohydrates and electrolytes. The reason behind this is that caffeine has been shown to stimulate your brain by increasing focus, concentration and reaction time. The goal being to enhance your sporting performance.

The amount of added caffeine may be well-tolerated by a healthy adult but can spike blood glucose levels in someone with diabetes. The caffeine causes your blood glucose to rise followed by a spike in blood insulin levels. Caffeine can stay in your system for up to six hours prolonging this response in the body and causing havoc with your glucose metabolism.

Consuming sugary drinks with caffeine on a regular basis can put you at an increased metabolic risk and excessive caffeine should be avoided altogether in children, adolescents and people living with diabetes.

Do people with diabetes need sports drinks when they exercise?

As you exercise, your body becomes more dehydrated and blood glucose rises as your bloodstream becomes more concentrated. Adding carbohydrates will elevate your blood glucose even more.

If your drink also contains caffeine, it will make your blood glucose level rise even higher, requiring more insulin to bring your blood glucose levels back to normal. Overall, consuming these drinks when you have diabetes makes regulating your blood glucose very difficult.

So, to answer the question: no, people living with diabetes don’t need to consume sports drinks when they exercise. You need to look for a healthier alternative that hydrates and replaces electrolytes.

First and foremost, you must stay hydrated by drinking enough water. If you are exercising in the heat and sweating for more than one hour, you may want to replace lost electrolytes as well.

Everyone’s blood glucose reacts differently to various types of exercise and to monitor yourself effectively you need to be drinking sugar-free and caffeine-free drinks. Always check with your doctor before starting a new exercise regime and follow the tips below to see how your body reacts to the increased activity.

Monitoring tips when exercising

  • Check your blood glucose before, during and after exercising.
  • The first couple times you start a new exercise, check your blood glucose two, four and six hours after exercising because it can cause your blood glucose to drop, requiring you to eat more or lower your evening insulin dose.
  • Keep a carbohydrate snack on hand in case you experience a hypoglycaemia attack while you are exercising.
  • Drink plenty of water to remain hydrated while you exercise.

Healthy alternative drinks for people with diabetes

Sports drinks companies have already come out with sugar-free and low sugar alternatives. For example, Energade Light and Powerade Zero contain little or no extra sugar or caffeine but still contain electrolytes.

Unfortunately, most contain artificial sweeteners which don’t raise your blood glucose but do have other risk factors.  If you want to avoid artificial sweeteners, there are healthier alternatives. You could drink some of the following:

  • Unsweetened coconut milk (contains electrolytes).
  • Unsweetened fruit juices diluted with water (contains electrolytes).
  • Vegetable juice (contains electrolytes).
  • Kombucha (contains electrolytes).
  • Unsweetened tea.

You could also eat something that contains electrolytes and drink water. For example, a banana has electrolytes and you stay hydrated by drinking water.

There are other healthy sugar-free alternatives on the market. Ask your doctor or pharmacist which one is best for you.

References

https://diabetes.org/healthy-living/fitness/sports-drinks-impact-on-glucose-blood-sugar#:~:text=Caffeine%20(sometimes)%3A%20Many%20of,spike%20your%20blood%20sugar%20significantly.

https://www.nhs.uk/conditions/type-1-diabetes/living-with-type-1-diabetes/exercise-and-sport/

https://endocrinenews.endocrine.org/energy-drinks-cause-blood-glucose-insulin-levels-to-spike-and-hinder-blood-sugar-control-in-teens/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995988/

https://www.eatingwell.com/article/8009374/best-and-worst-hydration-drinks-for-people-with-diabetes/

Sr Lynette Lacock

MEET THE EXPERT

Sr Lynette Lacock received her Bachelor’s Degree in Nursing and Biofeedback Certification in Neurofeedback in the US. She has over 30 years’ experience in healthcare which has enabled her to work in the US, UK and South Africa. Initially specialising in Cardiothoracic and Neurological ICU, she now works as an Occupational Health Sister. She is passionate about teaching people how to obtain optimum health while living with chronic conditions.

Header image by Adobe Stock
Visit the A-Z of Diabetes - Your Journey
Siyabonga Kwanele Zuma

Siyabonga Kwanele Zuma – Tired of living a double life

Posted on by
Share

Siyabonga Kwanele Zuma shares how he got tired of living a double life and now that he has shared that he has Type 1 diabetes, he is at peace and his glucose management has improved.

Siyabonga Kwanele Zuma (27) lives in Howick, KwaZulu-Natal with his family, including his fiancée and their six-year-old son.

Diagnosis

At age 11, I was diagnosed with Type 1 diabetes in April 2008. It was a random school day where I fell sick. My teacher took me to the school office and asked for my parents to be called to fetch me. My eldest sister fetched me and took me to the doctor. 

According to her, they could not pinpoint what was wrong with me. I was disoriented, so I don’t remember much of the doctor’s visit. My sister said as I was about to be diagnosed with the common flu, another doctor walked in. He asked what my symptoms were and once he knew, he suggested that they check my blood glucose levels. The results confirmed the second doctor’s suspicions.

The doctor then wrote a letter for me to be admitted at the hospital. I wasn’t on medical aid, so my parents took me to a public hospital. I was later transferred to another public hospitals where I stayed for three weeks.

Interestingly, my older sister also has Type 1 diabetes. She was diagnosed seven months before my diagnosis, in September 2007 aged 16. I call her my chronic twin.

Treatment

If my memory serves me correctly, I was put on Actraphane, which I believe is insulin given for free at government hospitals. I was on Actraphane for over a year, and I would get sick often.

One day in 2009, I was at my uncle’s house for the holidays. My glucose levels were uncontrollable; I think the change of climate also influenced that. One day I would experience hyperglycaemia and the next hypoglycaemia. I ended up being admitted to another public hospital in Durban.

My uncle was traumatised by the whole experience, as the hospital service was very poor. When I got discharged, he decided to put me on his medical aid, so I could get adequate help in managing my diabetes.

After that I consulted with diabetes specialists, who decided to put me on insulin aspart (NovoRapid), which is taken three times a day before meals, and insulin detemir (Levemir) which is taken at bedtime.

Since I’m not on my uncle’s medical aid anymore, I’m now on Isophane insulin (Protaphane) as it’s more affordable than Levemir but still take insulin aspart (NovoRapid).

Keeping my diabetes a secret

When I was diagnosed, those I went to primary school with knew that I had diabetes. However, when I went to high school, I decided to not share it with anyone. So, I would say I kept it a secret for 12 years.

The reason was I felt ashamed. I felt like it was my fault that I had it, and it made me different from my peers and all I ever wanted was to fit in. I didn’t feel cool which is what teenagers like being and I didn’t want to be judged when I did things my peers did, like drinking alcohol and smoking weed. Like I said, I wanted to fit in, and I did just that. Pushed by fear of missing out (FOMO) and peer pressure.

Tired of living a double life

Before my son was born, I felt like I had nothing to live for. Back in 2010, my doctor told me that if I don’t live a healthy life, I won’t reach the age of 21 with functioning kidneys, or even worse, alive. Hearing those words made me vulnerable to peer pressure and pushed me to live my life like there was no tomorrow, subconsciously. FOMO and peer pressure pushed me to rebel.

When my son was born, my perspective started to change gradually. I no longer felt like I had nothing to live for. I wanted to be a father that he would be proud to point out and say, “That’s my dad.’’

What also helped was my favourite artist, Kendrick Lamar, dropping his Pulitzer Prize winning album, DAMN. which made me develop a love for writing poetry. As time went by, I started writing poems about my life experiences and my ups and downs.

My writings made me grow tired of living a double life. As someone who loved and was inspired by Kendrick Lamar’s music, which is honest and authentic, I was doing the exact opposite. I was writing about my life hoping to inspire someone out there, but I wasn’t honest at all. I was omitting the most important factor that affected my life which is living with Type 1 diabetes. How can I claim to be a writer when my work lacks authenticity?

I wrestled with these emotions for over a year. Keeping my diabetes a secret proved to be detrimental in my life, and I couldn’t handle the pressure anymore. So, in April 2020, I courageously posted on social media that I have diabetes.

At peace with myself

I feel at peace with myself as I’m no longer in denial. Plus, I no longer have to worry about how I will take my insulin without somebody catching me do it. I feel so empowered because of that. My management has improved a lot. Before, I wouldn’t be able to say no to something I knew that I shouldn’t be doing because I would have to lie about the reason. But now with everyone aware of my situation, I can say no and give a valid reason.

Battling with flu every winter

Season changes are a nightmare for me. I struggle to control my glucose levels, as they are always up and down during these times. Getting flu doesn’t make it any better because it also affects my glucose levels.

Watching what I eat

I would be lying if I said I follow a particular diet. Even though I’ve had diabetes for 15 years, it’s only been three years since I’ve accepted it so I’m now gradually changing my lifestyle as I’ve found it quite challenging in many aspects.

Added to that, at the moment I can’t afford to be on a specific diet because my household consists of 10+ people, and those who can, contribute to buying groceries. A diet is personal, and I can’t expect everyone to follow my diet because I can’t afford it. What I do for now is to watch what I eat.

Love for poetry

My poetry book is titled Millennial Thoughts and it will be published sometime this year. I wrote most of the poems when I still had not accepted diabetes (2017 – 2020), therefore it doesn’t really focus on me living with diabetes. It’s more of a social commentary book, from a millennial’s perspective.

However, I do have a few poems where I mention my diabetes that I wrote post-acceptance. I’m also working on a memoir, where I’ll be speaking about my struggle with the negative peer pressure in my adolescence while also living with diabetes. It will tell how I managed to break-free from it and gravitate towards positive peer pressure, which led to self-acceptance helping me to regain the self-control I had long forgone for the fast life.

YouTube channel

Recently, I started my own YouTube channel which forms part of my journey to self-acceptance. As I’m a writer, that’s where the Living With Diabetes series on my YouTube Channel comes in.

I want to share my story in every way possible as not everybody enjoys reading. Some may not read my work but may watch my work. I want to grow my audience as much as possible, so I can share my knowledge about diabetes, and also learn new things about diabetes in the process.

A poem Siyabonga dedicated to his sister who also has diabetes.

CHRONIC TWINS

Our diagnosis threatened to make us the weak ones

But instead, it made us the sweet ones.

On some days, we’d feel bleak together

At the end of the week, we’d prevail together.

In a world full of unreliable souls

To me, you’re one of the few dependable

You are far from being expendable

You made an undesirable journey more bearable.

I don’t think I would’ve made it this far

If you and I grew up apart.

I want to impart that you are my star

My chronic twin, I love you with all my heart.

Connect with Siyabonga

YouTube | Facebook | Instagram | TikTok | Twitter

My sister and I; we both have Type 1 diabetes. This was in 2010 when I was admitted at hospital for a hyper.
My sister and I; we both have Type 1 diabetes. This was in 2010 when I was admitted at hospital for a hyper.
My sister and I were wearing blue in honour of World Diabetes Day 2022.
My sister and I were wearing blue in honour of World Diabetes Day 2022.
Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

MEET THE EDITOR

Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

Images supplied
Visit the A-Z of Diabetes - Your Journey
menstrual cycle

Love your menstrual cycle

Posted on by
Share

Veronica Tift advocates for women to love their menstrual cycle and explains how reflexology can ease the moody blues.

The menstrual cycle temper tantrum of 2022 will go down in our house as the big one. It was a day, like any other, except this day my kids used my yoga matt in their fort and while they had cleaned up, they had neglected to put my mat away. My Rottweiler had the audacity to casually walk on the matt, her nail nicking a little hole into my beautiful matt.

Well, this set me off and it spiralled, it was no longer about the tiny tear in my matt, it was about the kids not packing away, my husband for not fixing that thing, the expired tin of baked beans. Nothing was off limits.

My husband stood by and watch this scene unfold; 18 years together has given him extra special PMS sensors and he slowly picked up his keys and headed out the door.

Later that day when I got home, a new yoga matt was waiting in our room, I immediately burst into tears. The next day I started my period and my melt down suddenly made sense, PMS had struck again.

What is premenstrual syndrome (PMS)?

PMS is a somatic (bodily or physical) and psychological (mental and emotional) collection of symptoms (hence my emotional meltdown) that occurs late in the post-ovulatory phase. This is usually a week or two before the start of menstruation, the luteal phase.

Signs and symptoms can include oedema, breast swelling or tenderness, abdominal distension, backache, joint pain, constipation, aggression, skin breakouts, food binges, fatigue, anxiety and irritability, mood swings, food cravings, headaches, sex drive changes and even clumsiness.

According to Christiane Northrup’s book Women’s Bodies, Women’s Wisdom, the high consumption of certain dairy products, excessive caffeine consumption, rapidly elevated insulin levels, changing hormone levels, hormonal imbalance and the associated cellular inflammation, excessive body weight, a deficiency in the diet, lack of exercise, emotional stressors and unresolved trauma are all contributing factors that she has seen in her practice.

The reason there isn’t a one-time magic solution for PMS is because the causes are so varied from person to person. We can dive into the science of PMS, looking at the biological changes that happen in the body. However, it doesn’t give us the whole picture. Looking back, the days before my PMS emotional explosion, I can see how I had been neglecting myself and what my body was trying to communicate with me. Plus, I hadn’t eaten breakfast yet.

Creating balance 

Medication that balances hormones can help some women with PMS. There are also solutions for managing the emotional roller coaster that for some women can become extreme. Never ignore these symptoms and find a doctor or healthcare provider you trust and can communicate openly with about how you are feeling.

A nutrient-rich whole food diet can add in the balancing of insulin and glucagon, why is that important? Dr Katharine Dalton’s work on PMS treatment showed that poor-eating habits can cause PMS symptoms and that when blood glucose levels were stabilised, it not only helped with PMS, but also with fertility. This is because when your blood glucose levels zoom up and down chaotically, it can have an effect on your hormones and spark off sugar cravings, creating a vicious circle of bingeing habits and weight gain.

Stress has an effect on your menstrual cycle and PMS symptoms. Deep relaxation like meditation and breathwork have been shown to help reduce PMS within three months of regular practice.

Learning your cycle and loving it

We all have cycles, ebbing and flowing in our bodies and in nature, night and day, breathing in and out, our heartbeats. Being conscious of these cycles can help you better adapt to the changes they bring, seasonal or hormonal.

If you can find a way to welcome and appreciate your menstrual cycle, then the transition into phases like menopause could be much easier. When you start to use encouraging language around your cycle, positivity can be injected into these changes and make this inner guidance system part of your life, you can then start to heal both emotionally and hormonally.

See each phase as a gift

If you break down your menstrual cycle, you can see each phase as a gift. The luteal phase happens in the second part of your menstrual cycle. It begins around day 15 of a 28-day cycle and ends when you get your period. The luteal phase prepares your uterus for pregnancy by thickening your uterine lining.

 This phase is when you can use the opportunity to be in tune with your inner knowing and use this time to witness what is working and isn’t working in your life.

Studies have shown that women even experience more frequent and vivid dreams during this phase. So, you have access to parts of your unconscious during this time of the month and this can then aid in your ability to recognise and transform the more painful and difficult areas.

While you might feel more emotional in this stage of your cycle, I think that what you feel more emotional about is usually something that has more meaning in your life and this increased sensitivity can be a gift of insight. Taking a look at what you might need for full personal development.

According to American author, Louise L. Hay, emotionally you can heal your life. PMS is a result of emotionally allowing confusion to reign and giving power to outside influences or the rejection of the feminine process. Part of her new thought pattern affirmation is I am a powerful, dynamic woman! Yes, you should be saying this all the time to yourself and loving how your body functions, falling in love with its wonderful cycle.

Respect your body

How you feel about your body matters and the level of respect you pay to your menstrual cycle; honour your body’s needs. Things like rest, nutrition and replenishing when feeling PMS taking hold.

In my case, slowing down, taking a deep breath and making a cup of tea would have been a much wiser choice in that moment, possibly a good breakfast.

PMS is not just medical and is related to other areas of a woman’s life. If you are able to learn how to tune into the languages of your body, you can make decisions that are informed, listening to the wisdom of your body.

Reflexology

According to author Frankie Avalon Wolfe, PMS is one of the most studied uses of reflexology and the results have been positive. How does reflexology help for such a host of symptoms?

One way is the promotion of endorphin production that can relieve pain and can help with relaxation. Reflexology can help the hormones, encouraging them back into balance, and the swelling and bloating symptoms can be helped when working on the lymph system reflex. The reflexes that a reflexologist would work to aid in PMS would be the ovaries, uterus and fallopian tubes working on relaxing the whole pelvic area. Not only the reproduction reflexes are worked and looking at the body as the beautiful connected being it is, the solar plexus reflexes, relaxation techniques and the brain reflex are worked to aid the whole nervous system. The process of addressing the emotional and psychological stresses can directly result in biochemical changes to the body.

A systematic review and meta-analysis on the effects of reflexology on premenstrual syndrome was conducted; in the results, 6 to 10 sessions of reflexology could decrease the severity of PMS. Reflexology had a significant impact on the severity of PMS.

Reflexology could also significantly affect somatic and psychological symptoms arising from PMS. The study also concluded that with each session the efficiency of the reflexology also increased.

No more temper tantrums

I can report that there has not been another PMS tantrum as fierce as the one of 2022. However, I can honestly say that I haven’t been free from all symptoms and this was clear when my husband hysterically laughed at my mentioning that I thought my PMS wasn’t that bad this month. It’s all about balance and some months are better than others in the busyness of life.

However, paying attention to these moments always brings me back to the importance of taking the time to ask; what are my emotional needs right now and do some inner work. I encourage you to do the same, you might be very surprised at the answer.

References

https://pubmed.ncbi.nlm.nih.gov/31673284/

Ruth Hull the complete guide to reflexology second edition Lotus publishing.

The complete idiots guide to Reflexology – Frankie Avalon Wolfe, Ph.D., Alpha books

Woman’s Bodies, Women’s Wisdom: Creating physical and emotional health and healing – Christine Northrup M.D 5th edition Hay House

Natural solutions to Infertility, how to increase your chances of conceiving and preventing miscarriages – Marilyn Glenville PhD published in the UK in 2000 by Judy Piakus (Publishers) limited

You can heal your life – Louise L. Hay – Hay House Inc

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

MEET THE EXPERT

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

Header image by Adobe Stock
Visit the A-Z of Diabetes - Your Journey
blood glucose meters

How accurate are blood glucose meters?

Posted on by
Share

Diabetes nurse educator, Christine Manga, answers the burning question: how accurate are blood glucose meters?

Blood glucose meters are an essential and convenient tool for people living with diabetes to manage their condition. These small devices allow you to measure your blood glucose levels quickly and accurately whilst on the go.

However, some people are concerned about the accuracy of these glucose meters. This is a valid concern as inaccurate readings can lead to incorrect treatment decisions, which can have serious consequences.

Trialled and tested

The accuracy of blood glucose meters has improved significantly in recent years. The accuracy of these devices is tested by regulatory bodies such as the Food and Drug Administration (FDA) in the United States before they are approved for use by the public.

Over and above this, manufacturers are also required to meet certain accuracy standards. The International Organisation for Standardisation (ISO) has established a standard for blood glucose meter accuracy which requires readings fall within 15% of a laboratory reference value. This explains why glucose readings can differ even when taken at the same time but on different fingers. Using two different meters will also yield different results due to the 15% allowance.

Blood glucose meters are generally considered to be accurate. Some meters come with a control solution that have a known glucose concentration, which you can use to test your meter’s accuracy. Newer meters don’t come with this.

Maintenance and use of the blood glucose meter

The accuracy of a blood glucose meter depends on several factors, most of which the user has control over. Included here are maintenance and use of the meter.

  • Check expiry date of strips, expired strips can give inaccurate results.
  • Use the meter according to the manufacturer’s instructions.
  • Close the strip container securely each time as moisture/humidity can damage the strips.
  • Avoid exposing strips and meters to extreme temperatures such as leaving them in a hot car or keeping them in a fridge.
  • Wash and dry hands properly before testing. Contamination from food and hand creams among other things can alter glucose readings.
  • Hands should be warm when testing, if they are cold, more pressure is applied to obtain the blood drop, getting some interstitial fluid (ISF) that can lead to unreliable readings.
  • Dehydration can affect readings, try to drink enough fluid every day.
  • Use a sufficient size blood drop, too little blood may give inaccurate results.
  • Do not share your meter.

Glucose sensor vs finger-prick readings

For people who wear glucose sensors, they may notice a substantial difference between their finger prick and sensor readings. This is not due to inaccuracy of either device.

Sensor glucose and capillary blood glucose are different because they measure glucose levels using different body fluids. Sensor glucose readings come from interstitial fluid (ISF), which is the fluid that surrounds the cells under the skin.

Finger-prick blood glucose readings come from the blood that flows in the small blood vessels near the surface of the skin. There is a delay between the glucose levels in the blood and the ISF because glucose first enters the bloodstream from the digestion of food, and then diffuses into the ISF. This delay can be up to five minutes.

Therefore, sensor glucose and finger-prick blood glucose readings may not always match, especially when glucose levels are changing rapidly, such as after eating, exercising, or taking insulin. This is normal and expected.

The difference in sensor and blood glucose doesn’t matter if you understand why they may not always match and how to use them correctly. Sensor glucose readings can give you a more complete picture of your glucose trends and patterns over time as they test your glucose every 60 seconds, while capillary blood glucose readings can give you a more precise measurement of your glucose level at a specific moment.

Ask for advice

If you are concerned about the accuracy of your readings, you should talk to your doctor or diabetes educator for advice. They can help you choose a meter and test strips and teach you how to use them correctly.

As another option, you can do a finger-prick test on your meter at the same time as you have blood drawn in a lab and compare the results. They should be within 15% of each other.

Blood glucose meters are fantastic devices that assist in day-to-day management of diabetes. They have without a doubt evolved over time.

Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

MEET THE EXPERT

Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

Header image by FreePik
Visit the A-Z of Diabetes - Your Journey
flu

Managing diabetes when you have flu

Posted on by
Share

Diabetes nurse educator, Kate Bristow, shares effective tips to manage diabetes when you have flu.

Winter season is here and with it an increase in the incidence of colds and flu. For someone with diabetes, flu can be more than just an irritation as it makes managing blood glucose levels more challenging.

What is the difference between a cold and flu?

A cold is an upper respiratory tract infection. Common symptoms include: starting with a sore throat, followed by a runny nose and some congestion and then a cough. Fever is uncommon in adults.

Colds and flu do share many symptoms, but an infection with influenza also manifests with higher temperatures, body aches, and cold sweats or shivers. This may be a good way to tell the two apart.

Flu symptoms are normally more severe and come on quickly. Both are caused by viruses and generally need to run their course. If they progress to a bacterial infection, then an antibiotic may be necessary. Stay in touch with your healthcare team when you are unwell.

SYMPTOMS COLD FLU
Fever Sometimes – mild Usual – lasts 3 – 4 days
Headache Occasionally Common
General aches and pains Slight Usual – often severe
Fatigue/weakness Sometimes Usual – can last 2-3weeks
Exhaustion Never Usual – especially at the beginning
Stuffy nose Common Sometimes
Sneezing Usual Sometimes
Sore throat Common Sometimes
Cough/chest discomfort Mild to moderate cough Common – can become severe
Complications Sinus congestion/middle ear infection Sinusitis, bronchitis, ear infection, pneumonia
Prevention Wash hands often and avoid contact with sufferers. Wash hands and avoid contact with sufferers,

annual flu vaccine,

possibly pneumococcal vaccine too.
Treatment Decongestants, pain relief medication. Decongestants,

pain relief medication.

Call your doctor – antiviral medication sometimes used.

How best can you manage your diabetes when you have a cold or flu?

When you are sick your body will make more glucose to give itself the energy to fight the infection, and to add to this you may make more of the stress hormone cortisol. Cortisol makes you more insulin resistant. This means that when you are sick you need more insulin and not less.

So, in effect what happens when you are sick is that your liver will produce more glucose and you will be more insulin resistant. It’s a double whammy for your body and your glucose levels. You will probably be thirstier and pass more urine in this case and the cells in the body will start looking for other ways to get energy.

The lack of fuel into the cells means that they will start looking for other energy sources and sometimes the body starts to break down fat to provide this. Fat is converted into ketones by the liver. Ketones are toxic to the body and can be very dangerous.

Look out for signs such as stomach aches, nausea and vomiting along with high blood glucose levels. This is called ketoacidosis and it’s important that you have an individualised sick day management plan that you have discussed with your healthcare team.

If you are not taking insulin

It’s still important to track your glucose levels even if you are not using insulin. Follow the guidance below:

  • Test your blood glucose more regularly; this includes during the night and 2 to 4 hourly during the day depending on your numbers.
  • Drink more water. You may be thirstier than normal. If you are feeling nauseous then sip steadily rather than gulping it down. It’s not necessary to eat if you are feeling nauseous. But do ensure you stay hydrated.
  • Take your medication as prescribed. Your doctor may ask you to stop certain oral diabetes medications when you are sick.

If you are taking insulin

  • Do not stop taking your insulin. You may need more rather than less due to the higher glucose levels.
  • If you are taking insulin to manage your diabetes and your glucose levels are high, check for ketones – see the symptoms of ketoacidosis below.

SIGNS AND SYMPTOMS OF KETOACIDOSIS (DKA)

High blood sugar levels – you will be thirsty and may urinate more often.  This leads to dehydration and further stress on your body.

Possible signs of ketone build-up:

  • Nausea and stomach-ache and eventually vomiting.
  • Be aware of vomiting without diarrhoea.
  • Rapid breathing with no cough or fever
  • Abdominal pain – can be severe.

Call for assistance if you have symptoms that worry you or that are not responding to your efforts to treat them. If you have abdominal pain or difficulty breathing, go straight to the hospital.

  • Have a sick day plan in place as discussed with your healthcare team.

 Take medication as suggested by your pharmacist, nurse, or doctor to relieve the symptoms of your cold or flu.  Be aware that some preparations may contain some sugar – discuss this with the pharmacist. If you are not getting better or start to feel worse call your doctor.

 What you should have on hand

  • Blood glucose meter.
  • Glucose test strips.
  • Other medication.
  • Quick-acting carbs, such as fruit juice, sugary drinks or sweets.
  • Water.
  • Insulin and ketone test strips.
  • Glucagon.
  • Contact details of your healthcare team in case of emergency.
Sister Kate Bristow is a qualified nursing sister and certified diabetes educator.

MEET THE EXPERT

Kate Bristow is a qualified nursing sister and certified diabetes educator.

Header image by Adobe Stock
Visit the A-Z of Diabetes - Your Journey
Foot disease

Foot disease and diabetes

Posted on by
Share

Dr Paula Diab stresses that every complication of foot disease relating to diabetes is preventable and gives guidelines to spot these complications in early stages.

Foot disease is probably one of the most feared aspects of diabetes. Almost everyone has a horror story about a friend or neighbour or sometimes tragically, a relative, who developed foot disease, gangrene or needed an amputation.

The statistics relating to foot disease are horrifying but what is worse, is that almost every single complication related to foot disease is entirely preventable. It’s not normal for people with diabetes to get foot ulcers and then need an amputation; it’s only through poor diabetes management that you lose sensation and circulation in the feet.

Educating yourself and knowing the signs and symptoms to look out for can radically improve your chances at retaining healthy feet despite having diabetes.

What causes diabetic foot disease?

You may have heard about macro- and microvascular complications related to diabetes. This refers to whether the large (macro) or small (micro) vessels in the body are affected. Foot disease can be caused by both macrovascular or microvascular disease which it is probably why is such a common complication.

Macrovascular disease occurs when blood circulation from the heart is diminished either through excessive glucose or cholesterol deposits in the vessels or narrowing due to high blood pressure. This reduces the blood flow into the distal peripheries and the feet are usually the first to show signs of this lack of circulation. Smoking and other cardiovascular risk factors will also enhance this risk and further slowdown blood flow.

Microvascular disease caused by persistently high glucose levels affects the nerves in the feet. When these become damaged, you may feel pain, tingling or even numbness in the feet.

These two mechanisms can also occur simultaneously when a loss of sensation in the feet can make it difficult to discern when you have a blister, minor cut or injury on the foot. As these minor injuries are left untreated, infection can set in causing bigger wounds or even ulceration. Due to blood flow being restricted, healing is further delayed, and the wound progresses even more.

Sometimes infections become so deeply invasive that intravenous antibiotics, surgical debridement or hospitalisation are required. High blood glucose levels can cause the arteries to become stiff and prevent blood flow to the feet.

What are the signs and symptoms of foot disease?

The most common symptoms of damage to the feet is increased swelling of the legs and feet or a change in skin colour on the feet. This usually manifests as a purple discolouration of the skin around the ankles or mottling of the skin. You may also notice a decrease in the hair growth on the top of your feet or lower leg.

All these symptoms are due to the decreased blood flow and poor circulation of blood from the heart. Nerve damage initially causes burning or tingling in the feet and then develops into a lack of sensation and numbness. This may happen intermittently at first but then begins to become more obvious and more difficult to treat.

Delayed healing of wounds, cracks and blisters on the feet are more advanced signs of foot damage.

Please also pay careful attention to ingrown toenails, warts, corns, calluses, bunions and hammertoes. These minor deformities often result in abnormal gait (the manner in which you walk) and as a result puts pressure on areas of the feet where you would not normally. This results in damage to the nerves and further enhances the risk of microvascular damage.

There are also nerves in the body over which you have no control. These are called autonomic nerves and control functions such as digestion, sweating and temperature regulation in the body. They too can be damaged by diabetes and may cause dryness, cracks, fissures, blisters and callus formation in the feet, all of which may lead to secondary infections and damage.

How should you take care of your feet?

As with all complications of diabetes, the basic control of glucose levels is of huge importance. Check your levels regularly and seek expert advice when they are not in target. Regular exercise can also prevent foot disease and promote good blood flow in the feet.

All that we require with regard to exercise is that you are simply more active today than you were yesterday. Aim to do 20-30 minutes of moderate intensity cardiovascular activity a day on most days of the week. Walking, jogging, swimming, cycling or even sustained household chores, such as mowing the lawn or vacuuming, may count towards this activity.

Other important footcare advice

  • Wash your feet every day with lukewarm (not hot) water and mild soap.
  • Dry your feet well, especially between the toes. Use a soft towel and pat gently but don’t rub the feet too vigorously.
  • Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
  • Keep your feet dry by dusting them with non-medicated powder before putting on shoes, socks or stockings.
  • Check your feet every day. You may need a mirror to look at the underside of your feet. Call your doctor if you have redness, swelling or pain that doesn’t go away, numbness or tingling in any part of your foot.
  • Don’t treat calluses, corns or bunions without talking to your doctor first.
  • Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them. File the edges of your toenails carefully.
  • Don’t let your feet get too hot or too cold.
  • Don’t walk barefoot. This is to prevent injuries to your feet.
  • Avoid putting your feet in front of a fire in winter to warm then, if they have lost sensation you could end up with burns or blisters which you do not feel.
  • Avoid using hot water bottles to warm your feet in winter as the bottle may be too hot and also cause blisters if your nerves are damaged.

Choosing footwear

You certainly don’t need high fashion or expensive footwear in diabetes. But you also don’t have to wear big bulky boots that look ugly. Here are important tips to consider when choosing your footwear:

  • Try not to wear shoes without socks as they protect the feet and prevent excessive sweating and pressure from the shoes.
  • Ensure that your socks are good quality and not worn or frayed that will cause damage to the feet.
  • Avoid open sandals or shoes where feet are not adequately protected from external injury.
  • Avoid high-heeled shoes and shoes with pointed toes that will change the architecture of the feet.
  • Wear well-padded socks or stockings in winter. Don’t wear stretch socks, nylon socks, socks with an elastic band or garter at the top, or socks with inside seams as these place undue stress on the skin and constrict blood flow.
  • Don’t wear uncomfortable or tight shoes that rub or cut into your feet. If you’ve had problems before because of shoes that didn’t fit, you may want to be fitted for a custom-moulded shoe.
  • Talk to your doctor or podiatrist before you buy special shoes or inserts.
  • Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they’ll probably be comfortable all day.
  • Break in new shoes slowly by wearing them for no more than an hour a day for several days.
  • Change socks and shoes every day. Have at least two pairs of regular shoes so you can switch pairs every other day.
  • Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores.

Seek help

If you do develop some type of wound on your feet, please get it seen to as soon as possible. Don’t wait until it’s too late before you seek help.

Your doctor, diabetic nurse educator or podiatrist can all examine the feet on a regular basis to test a variety of different functions and help prevent further injury and infection.

It’s also good practice to examine your own feet on a regular basis. Look for changes in skin colouration, hair growth and new sores or blisters that may have developed. Look at your feet at the end of the day when you remove your shoes and make sure that the shoes are not damaging your feet in any way. You should also make sure that a healthcare practitioner examines your feet at least once a year. If there are any concerns or changes, you should see a podiatrist immediately and treat the problem in its early stages.

The old adage prevention is better than cure is certainly true of foot disease. Regular exercise, monitoring your blood glucose levels and keeping them well-controlled and stopping smoking will go a long way to ensuring that you don’t land up under the surgeon’s knife or with complex infections.

Dr Paula Diab

MEET THE EXPERT

Dr Paula Diab is a diabetologist at Atrium Lifestyle Centre and is an extra-ordinary lecturer, Dept of Family Medicine, University of Pretoria.

Header image by FreePik
Visit the A-Z of Diabetes - Your Journey
steady glucose

Eating for steady glucose

Posted on by
Share

Dietitian, Felicity Black, offers guidance on how to get off the glucose rollercoaster by clothing your carbs for steady glucose.

Do you sometimes feel as if you are riding the rollercoaster of blood glucose spikes and crashes and not getting steading glucose readings? Unfortunately, this leaves you moody, exhausted and reaching for that next cup of coffee to get you through the day. Maybe you are struggling with cravings for sweet things or are finding you are constantly hungry. You have been riding the glucose rollercoaster.

How does the food you eat affect the ride?

Some foods lead to a steep ascent; they speed up the release of glucose into your bloodstream. Other foods put on the brakes; slowing down and stabilising the blood glucose levels. 

What goes up, must come down

Foods that cause glucose to climb then cause it to plummet leading to low moods, fatigue and cravings. Refined starches and sugar are the driving force behind these steep spikes. Think of a fluffy piece of white bread, minimal chewing and digestion is required while glucose is rapidly flowing into the bloodstream.

Breads, pasta, crackers, pastries, crisps, pizza bases, rolls, biscuits, rusks and cereals. How to tell if starches are refined? Well if it is made from mostly flour, has gone through many processes, has many ingredients listed, has no naturally occurring fibre or nutrients and won’t be found in nature; then yes it is most likely refined.

Synthetic vitamins and some bran fibre is often added in during manufacturing to make these products look more desirable by health-conscious shoppers.

Sugar speeds things up, especially in a liquid form. Smoothies, fruit juices, fizzy drinks, chocolate milk, flavoured drinking yoghurt, hot chocolate-type drinks can all cause glucose levels to rise quickly.

Which foods slow things down?

Protein, fat and fibre-rich foods all slow down your digestion which slows down the release of glucose into your bloodstream.

Protein-rich foods are mostly from animal sources. Think meat, chicken, fish, seafood and eggs.

Cheese and other dairy products don’t actually have all that much protein and are not a suitable substitute for the above foods. Whole unsweetened dairy has been shown to provide glucose stabilising effects even in small amounts.

Fats are wonderful at keeping glucose steady and help you stay fuller for longer.

Healthy fats to include are avocados, olive oil, olives, nuts and seeds.

Berries, green vegetables (such as broccoli) and legumes (beans and lentils) are great fibre-rich foods to include daily.

If you make sure to include either or all of these foods in your meals then you are sure to avoid post-meal glucose spikes.

Fibre – where should we get it from?

Many people assume high fibre means high starch. Fibre should be mainly be sourced from vegetables, not from breads and cereals. Fruit can also provide fibre but we need to manage how and when we eat it. If fruit was to be your main dietary fibre source then you would end up consuming far too much natural sugar.

As humans we are not made to eat starch without fibre. In nature we would find tubers, roots, nuts, fruits, whole grains – all of which have fibre alongside starch.

This fibre acts to slow down the release of sugars into your bloodstream, giving you a steady supply resulting in stable blood glucose levels.

In our modern world, we have breads, cereals, pastries, crisps, pasta – all without adequate fibre and consumed in large quantities.

There is a common misconception that brown refined starches are far superior than their white counterparts. Believe me, six slices of brown bread a day will not do you any favours. Clients need to be educated on lowering total refined starches regardless of the colour of said starch.

Most low-GI breads, cereals and pasta do not contain enough fibre to slow down the resultant spike. Therefore, reduce your overall carbohydrate and cut back on refined starches, they are not nutritious regardless of the colour.

Breakfast – setting a good foundation

Starting the day off right is very important for steady blood glucose levels. We are most sensitive to high sugar intake in the mornings than any other time of day. Therefore, if your blood glucose is not stabilised early on in the day, then you will struggle to manage it as the day goes on. Think of it as setting a solid foundation for the day.

A breakfast made up of only starch especially simple refined starches, such as bread and cereal, is sure to set you up for a rollercoaster of hunger, fatigue and cravings.

A good concept is the idea of clothing your carbs and this is also mentioned in the book The Glucose Revolution by Jessie Inchauspé. When you eat carbohydrates by themselves (without protein, fat or fibre) then your blood glucose spikes rather high and quite quickly.

Dessert vs sugary snack

If you are going to eat something with sugar, then have it as dessert after your meal and not between meals. Sugar that lands in a full stomach will lead to less severe glucose spikes. Rethink that afternoon coffee and cake. Bring out some fresh fruit to end off your meal.

Clothing for your carbs for steady glucose

Carbohydrate should be combined with either protein or fat or both. That includes fruit, do not eat fruit alone as a snack. The French have it right – cheese with fruit. The fat and protein in cheese (it’s mostly fat) helps reduce the spike from the fruit.

Other combinations are: biltong, nuts, full fat yoghurt, avocado, sugar-free nut butters and seeds. So, do yourself a favour and clothe your carbs.

Felicity Black is a registered dietitian at the Centre for Diabetes and Endocrinology and is based at the Port Elizabeth practice in Mill Park. Having completed the in-depth CDE Foundation Course in Diabetes Care, she has been able to treat her clients holistically and with a greater understanding of their individual needs.

MEET THE EXPERT

Felicity Black is a registered dietitian at the Centre for Diabetes and Endocrinology and is based at the Port Elizabeth practice in Mill Park. Having completed the in-depth CDE Foundation Course in Diabetes Care, she has been able to treat her clients holistically and with a greater understanding of their individual needs.

Header image supplied
Visit the A-Z of Diabetes - Your Journey