What is diabetic amyotrophy?

Christine Manga, a diabetes nurse educator, clarifies what diabetic amyotrophy is and the necessary information you need to know.


Listen to this article below or wherever you get your podcasts or visit our playlist.

Diabetic amyotrophy is also known as proximal diabetic neuropathy, ischaemic mononeuropathy, diabetic lumbosacral plexopathy, Bruns-Garland syndrome, to name but a few.

In 1890, neurologist Ludwig Bruns first described the condition in people with diabetes, usually poorly controlled. In 1955, another neurologist, Hugh Garland coined the term amyotrophy. For this article I will refer to it as diabetic amyotrophy.

What is diabetic amyotrophy?

Diabetic amyotrophy is a rare episodic and progressive form of diabetic neuropathy. It’s characterised by loss of unilateral (sometimes bilateral) proximal motor function, atrophy (wasting, shrinking) of muscles in the front upper legs, sensation of severe burning, weakness, and pain.

An extreme aching pain in the hips, thighs and buttocks are almost always present. This is often followed by weakness. Anywhere between 35 – 50% of affected people will report unintended weight loss. Getting up from a sitting position becomes difficult. This condition can be disabling with some people requiring wheelchair assistance for a time. Progression of diabetic amyotrophy is quick, taking a few months.

Causes

The causes are not fully understood. Possible causes include but are not limited to:

  • A sudden reduction in blood glucose levels of a person with chronically raised blood glucose levels
  • Initiation of anti-hyperglycaemic treatment
  • An immune mediated vasculitis causing ischaemic (insufficient blood supply) damage to the nerves, and it has also been referred to as idiopathic.

Who is at risk?

Almost 50% of people with diabetes will experience diabetic neuropathy. However, diabetic amyotrophy only affects approximately 0.8 – 1% of people with diabetes. It affects more people with Type 2 diabetes compared to Type 1.

Onset is usually during middle age but can be seen in younger individuals. Males over the age of 50 with Type 2 diabetes are the most frequently affected. Duration and severity of diabetes are not predisposing factors. People with good glucose control can also experience diabetic amyotrophy.

How is diabetic amyotrophy diagnosed?

Diagnosis usually consists of a thorough history taking and physical examination especially of the lower limbs as well as reflex testing. To exclude other conditions with similar symptoms, such as nerve compression, a process of elimination is used.

A lumbar puncture, nerve conduction studies, and MRI scans may be performed. A blood workup will be done to assess diabetes control, vitamin deficiencies and inflammation markers.

Treatment

Treatment is pain management. However, it does not respond to conventional pain medication, rather anti-epileptic, antidepressants, such as amitriptyline, and nerve pain treatments. Recently steroidal medication has been used. It appears to increase recovery time but also causes an increase in blood glucose levels. There is still not enough evidence for its use. Good glucose control is to be strived for.

An improvement in diet, physical exercise, such as physio, and stopping smoking and alcohol aid in recovery. The physiotherapy can aid in nerve restoration.

Diabetic amyotrophy can lead to anxiety and depression. Education is of utmost importance, hence explaining the progression to possible severe disability, paraplegia, and extreme pain. Although, it will not reverse diabetic amyotrophy, regular foot examinations for injury, wounds and infection will prevent further complications. The goal of treatment is to improve quality of life.

Prognosis

Diabetic amyotrophy is self-limiting and the likelihood of full recovery is probable. The entire process takes a few months up to about two years. Sometimes, but not often up to three years. Reassurance and encouragement that it will resolve is vital.

Prevention

There is no precise way to prevent diabetic amyotrophy. The principles used to prevent general diabetes complications should be adhered to, including smoking cessation, good glucose control, limit alcohol intake, maintain a healthy BMI and regular check-ups with your doctor, dietitian, and educator.

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 supplied

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

Roasted Spiced Butternut Soup

Who doesn’t love a roasted spiced butternut soup in winter?

The added plus is this recipe is approved by the GI Foundation of SA and Diabetes SA.


Serving: 6 | Cooking time: 3 hours | Difficulty level: Easy


INGREDIENTS

Soup

  • 1 ½ kg butternut, peeled, seeded, and cut into ½cm cubes (2 large butternuts)
  • 1 large carrot, peeled and cut into ½cm chunks
  • 30ml (2 Tbsp.) olive oil
  • 3 sachets Huletts EquiSweet
  • 5ml (1 tsp.) ground cinnamon
  • 5ml butter, cut into cubes
  • 1 large onion, thinly sliced
  • 4 cloves garlic, chopped
  • 20ml (4 tsp.) vegetable or chicken stock powder prepared with
    • 1 litre (4 cups) boiling water
    • 2 sprigs thyme
    • 1 bay leaf
    • Freshly ground black pepper

Topping

  • 250ml (1 cup) low-fat yoghurt
  • 1ml (pinch) ground cinnamon
  • 1ml (pinch) nutmeg
  • 1ml (pinch) salt
  • 1ml (pinch) garlic/onion powder
  • Chives, chopped to garnish

METHOD

  1. Preheat oven to 230°C.
  2. Toss the butternut and carrot together with 25ml of olive oil (keeping 5ml aside). Sprinkle with Huletts Equisweet and cinnamon and divide and spread onto two baking trays.
  3. Roast until the butternut and carrot have browned (about 40 minutes). Turn two- or three-times during cooking. Set aside.
  4. Place 5ml butter and remaining 5ml of olive oil, onion and garlic into a large saucepan over medium heat and sauté until soft and lightly brown.
  5. Add the roasted butternut and carrot to the saucepan and add the prepared stock, thyme sprigs, and bay leaf. Bring to a boil, lower heat and simmer until vegetables are soft (about 10 minutes). Remove the thyme sprigs and bay leaf.
  6. Blend soup with a blender until completely smooth. Season with black pepper.
  7. Return soup to saucepan and keep warm.

Topping

  1. Mix the low-fat yoghurt, cinnamon, nutmeg, garlic powder and salt. Set aside.
  2. Serve soup with a dollop of the spiced yoghurt, chopped chives and a slice of low-GI bread, if desired.

Tip: Freezes well for up to three months.

NUTRITIONAL INFO (per serving)

Nutrients per serving: One serving is equivalent to three portions vegetables and one portion low-fat protein.

GI (calculated) = 44 (low-GI). GL per serving = 17.

Energy Protein Carbohydrates Fat Fibre
Per serving   1046 kJ  6.8 g 38 g 5.5 g 5.5 g

DSA News Winter 2024

– DSA National Office News –

Chery Middelburg Diabetes Awareness Event

Eastvaal Chery Middelburg hosted a Diabetes Awareness Event at Eastdene Pharmacy last year in honour of World Diabetes Day. The event was spearheaded by Eastvaal Chery Brand Manager Derick Truter, who has Type 1 diabetes.  DSA National Office supported the event with literature and contacts.

The public also had the opportunity to test drive one of the Chery vehicles on display and win prizes throughout the day.

Chery Middelburg and Eastdene Pharmacy, alongside the Witbank Diabetes Centre, HomeMed, Pharmoco, Contour, Rubicon Medical Centre and more made this day possible.

 It was a great privilege to be able to host the event in Middelburg and see so many smiling faces. It was fantastic to bring a positive vibe and energy to the community.

The following tests were administered to anyone wanting to evaluate their health: (FREE)

  • Haemoglobin A1C test
  • Lipogram blood test
  • Glucose test
  • PSA test

– DSA Western Cape News –

Parents’ Breakfast

DSA Western Cape held a breakfast for moms and dads with children with Type 1 diabetes in April at the beautiful Chart Rose Farm in Wynberg, Cape Town. One family drove all the way from Kleinmond to attend the breakfast.

Speakers that presented to the parents were: Dr Adnaan Mia who has a daughter with Type 1 and Sr Lyn Starke who was in charge of the Diabetic Paediatric Clinic at Red Cross Hospital for 45 years.

It was a beautiful sunny day with the smell of roses wafting over the meeting.

Milnerton Diabetes Support Group

Nurse Onyinye Nwaulu of DSA Milnerton Support Group presented a talk for pastors in the Western Cape and also the Cameroon Community in March and May 2023.

She educated women on the importance of taking good care of their health, most importantly covering diabetes, hypertension, kidney health and general well-being of women.

She extends her thanks to DSA for always supporting the Milnerton Diabetes Support Group.”

– DSA Pretoria News –

March Wellness Meeting

On 2 March 2024, DSA Pretoria hosted an interesting discussion on proper planning of meals and the importance of moderation. The speaker was Bernadine Blom, a dietitian. The meeting was well-attended.

May Wellness Meeting

On 4th May 2024, DSA Pretoria held their monthly diabetes meeting in Pierre Van Ryneveld Park. The speaker was Welma Geldenhuys from The Association for Dementia and Alzheimer’s of South Africa (ADASA). She spoke in general on dementia and how the different types of Alzheimer’s fit under the dementia umbrella.

She also mentioned that dementia is a brain disease and not a mental disorder, and made the connection of dementia with other chronic conditions like diabetes.

It was so great finding out about the signs and symptoms that family members can look out for in their ailing loved ones. The talk was very interesting, interactive and everyone learned such a great deal about a disease that is so debilitating for the person that has it. DSA thanks Welma for giving up her valuable family time to be with the group. So appreciated.

Medical Personnel Wellness Event

DSA Pretoria was invited to participate in a wellness event run by medical personnel in Centurion. There were seven stations altogether. It was aimed mainly at people who need services but do not have medical aid. The medical personnel want to make it a monthly event. Bravo to this health outreach to the community.

– DSA Port Elizabeth News –

DSA Young Guns

The DSA Young Guns enjoyed a fun day outing that included a 5km walk through the forest. The cherry on the top was that there was no entrance fee. 

Health Awareness Morning

On 17 May, Pamela Molefe, Elizabeth and Martin Prinsloo attended a Health Awareness Morning for the employees of PnP Hypermarket, Moffet Retail Park, which was held in their board room. We had a PowerPoint presentation on diabetes that they could watch while waiting to have their blood glucose tested.

– DSA Pietermaritzburg News

Diabetes Symposium

In March, DSA PMB branch hosted a diabetes symposium with 70 attendees. There were several talks given:

  • The importance of taking their medication on time by pharmacist, Mr Moodley.
  • The diabetic journey by Dr Naidoo
  • Diabetes in the Pead by Dr Naidu
  • Understanding food labels by dietitian, Pranisha Deonarain
  • Diabetes in your pet by veterinarian, Dr Singh
  • The role of herbs and spices in your diabetic diet by Dr Mohan
  • Diabetes and menopause by gynaecologist Dr Pephra
  • The vegan way of eating by Mrs Lubbe

Fig and Olive, a local company focusing on healthy homemade juices and shots, also presented products at the symposium. Sensors from Libra and Medtronic were on display. Attendees could also purchase nuts and healthy snacks from Chrissy’s table. B.braun also displayed supplements. There were plenty of lucky draw prizes up for grabs. Attendees also revived goodie bags.

The role of the podiatrist

Lynette Lacock, an occupational health sister, highlights the role of the podiatrist in the healthcare team for those living with diabetes.


Listen to this article below or wherever you get your podcasts or visit our playlist.

You may not be aware of how important it is as a person with diabetes to take care of your feet. Since diabetes can cause poor circulation and neuropathy, it’s essential to have your feet and lower extremities examined by a podiatrist regularly.

Podiatrists are doctors who treat conditions of the lower limbs, including feet and ankles. Therefore, they are the best healthcare professional to see routinely to prevent any future problems relating to feet and diabetes.

The saying prevention is better than cure rings true in this case.  Wounds are often difficult to treat when you have diabetes due to poor blood flow. You need to be vigilant when it comes to preventing sores and infections and you also need to be on the lookout for blisters or sores caused by ill-fitting shoes. If you have even a mild neuropathy in your feet, your shoes may not feel tight even though they are damaging your skin.

What can podiatrists assist you with?

  • Routine foot exams

It’s crucial for all people with diabetes to have a professional exam of their feet and lower extremities on an annual basis. A trained podiatrist will be able to see things that you may have not noticed.

  • Early detection and prevention

Detecting a blister or treating an open wound when it first happens is the key to preventing the problem from getting worse. Most people with diabetes have problems with poor circulation and neuropathy. Neuropathy is caused by nerve damage due to uncontrolled blood glucose. It causes you to have less feeling or sensation in an extremity. If you can’t feel that your shoe is too tight or rubbing in an area, then you can develop a blister or wound without even knowing about it.

  • Mechanical assessment

A podiatrist can watch your gait or the way you walk to see if there is anything out of the ordinary. If there is, they can recommend a specialised shoe or orthotic to help prevent any damage from happening.  

  • Foot wound and ulcer care

If you do get a wound or ulcer, the podiatrist is the best person to treat it. You may also need a course of antibiotics which they can also prescribe. Don’t ignore a blister, wound or open ulcer.  These are difficult to treat in people with diabetes and you want to take care of it immediately to prevent it from getting any worse. 

  • Surgical procedures

Podiatrist can also perform any surgical procedures necessary to treat lower extremity deformities or to debride dead tissue to allow an existing wound to heal.

Multi-disciplinary care

Although podiatrists are the foot specialists, they are part of a team that works together treating diabetic foot and lower extremity problems. They collaborate with vascular surgeons if they feel you need to be referred because of poor circulation. And if they are aware that you are having problems controlling your blood glucose, they may refer you to an endocrinologist. They all form a team that play a part in keeping you healthy.

Now that you understand the role of the podiatrist, make an appointment to see one. Don’t put it off until something is seriously wrong. Rather try to prevent complications before they happen by having routine check-ups and keeping your blood glucose under control.


References

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

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

Chimichurri Pork Meatballs

These delicious Chimichurri Pork Meatballs are an easy, high-protein midweek hit that will satisfy even the hungriest family members. The lean pork mince and almond flour are more nutritious alternatives.

Servings: 12 | Prep time: 20 minutes | Cooking time: 15 minutes | Cut: pork leg


Ingredients

Meatballs

  • 500g lean pork mince
  • 1/2 cup almond flour
  • 1/2 cup fine bread crumbs
  • 1 egg
  • Salt and pepper
  • Olive oil to fry

Chimichurri sauce

  • 1 small shallot, cut into wedges
  • 3/4 cup flat-leaf parsley leaves
  • 1 fresh oregano leaves
  • 2 garlic cloves
  • 1 1/2 tsp. kosher salt
  • 1 tsp. freshly cracked black pepper
  • 1/2 tsp. red pepper flakes
  • 3/4 cup extra virgin olive oil
  • 1/4 cup red wine vinegar, plus more to taste

Method

Meatballs

  1. Combine the lean pork mince, almond flour, bread crumbs, egg, salt and pepper in a bowl.
  2. Mix well and roll into balls.
  3. Fry in olive oil until crispy.
  4. Serve with Chimichurri sauce.

Chimichurri sauce

  1. In the base of a food processor, combine the shallot, parsley, oregano, garlic cloves, salt, and pepper. Pulse until well combined but still slightly chunky.
  2. Transfer the mixture to a small bowl. Add the olive oil, vinegar, and red pepper flakes. Stir to combine. Store refrigerated in an airtight container for up to two weeks.

Note: makes 1 1/4 cup 


Visit sapork.co.za for more info on pork.


Don’t let the cold win: exercise

Retha Harmse explores safe outdoor exercise activities to keep you active in the colder months.


Listen to this article below or wherever you get your podcasts or visit our playlist.

Physical activity plays a critical role in maintaining optimal health, particularly during the winter season.

For those managing diabetes, staying active isn’t merely a suggestion, it’s a fundamental aspect of effective diabetes care. However, the colder weather brings its own set of challenges, impacting blood glucose levels and overall well-being.

During winter, the shorter daylight hours and cooler temperatures can deter even the most dedicated individuals from engaging in regular physical activity. Additionally, fluctuations in blood glucose levels due to the cold weather pose additional hurdles for those with diabetes. Therefore, it’s essential to explore a variety of indoor and outdoor exercise options tailored to various preferences and fitness levels.

Whether you prefer indoor workouts or outdoor adventures, there’s something for everyone to stay active and healthy throughout the winter season. Let’s delve into these options to help you maintain your physical fitness and blood glucose control during the colder months.

Outdoor exercise ideas

Benefits of outdoor exercise in winter

While South Africa’s winter may not have the concern of snow-covered landscapes, it may still be really hard to continue the exercise habit, but exercise remains crucial for people managing diabetes.

Venturing outdoors during winter allows you to benefit from exposure to natural light, which can regulate your sleep-wake cycle and improve mood. Breathing in fresh air can also boost your energy levels and overall sense of well-being, making outdoor exercise an excellent choice for maintaining physical and mental health during the cooler months.

Walking

Walking outdoors in winter offers numerous health benefits. It provides an opportunity for physical activity while allowing you to enjoy the beauty of nature. To ensure a safe and enjoyable walking experience in cooler weather, dress warmly in layers, wear appropriate footwear and consider walking during daylight hours for maximum exposure to sunlight.

Hiking

Winter hiking allows you to explore scenic trails and connect with nature while reaping the health benefits of physical activity. Choose trails suitable for your fitness level and take precautions, such as wearing sturdy hiking boots, packing adequate water and snacks, and checking weather conditions beforehand.

Sports

Consider activities such as trail running, mountain biking, or beach volleyball, depending on your location and preferences. These outdoor sports provide opportunities for cardiovascular exercise, muscle strengthening, and co-ordination improvement while enjoying the beauty of the South African landscape.

Tips for safe and effective winter exercise

Blood glucose management

Maintaining stable blood glucose levels is crucial during winter exercise. Before physical activity, check your blood glucose levels to ensure they are within a safe range. Monitor regularly during exercise, as cold weather can affect insulin sensitivity and glucose utilisation. Have fast-acting carbohydrates on hand for hypoglycaemia and be ready to adjust insulin dosage as needed. After exercise, monitor again for post-exercise fluctuations and take appropriate action.

Dress appropriately

Proper attire is essential for comfort and safety during outdoor exercise in winter. Dress in layers to trap heat and regulate temperature effectively. Start with moisture-wicking base layers, insulating layers for warmth, and finish with a waterproof and wind-resistant outer layer. Wear thermal socks, gloves, and a hat to keep extremities warm and choose breathable fabrics to prevent overheating.

Hydration and nutrition

Stay hydrated by drinking water regularly before, during, and after exercise, even in cooler temperatures. Fuel your body with healthy snacks containing carbohydrates and protein before and after winter exercise sessions to replenish energy stores and support muscle recovery. Choose nutrient-dense options, such as fruit and nut butter, yoghurt with granola, or a small handful of biltong and cheese sandwich.

Safety precautions

Exercise safely by checking weather forecasts and avoiding extreme conditions. Dress appropriately, use reflective gear and lights in low-light conditions, and inform someone of your exercise plans. Consider exercising with a buddy or group for safety and motivation and be prepared to modify or postpone your workout if conditions become unsafe.

Insulin storage

During the winter months, proper insulin storage becomes even more crucial for people managing diabetes. Fluctuating temperatures can affect the efficacy of insulin, potentially leading to inadequate blood glucose control. It’s essential to store insulin at the recommended temperature range of 2°C to 8°C (36°F to 46°F) to maintain its potency.

However, extreme cold temperatures, such as those experienced during winter, can cause insulin to freeze, rendering it ineffective. To prevent this, store insulin in a cool but not freezing environment, away from direct sunlight and sources of heat. Insulated bags or containers can help protect insulin when travelling outdoors in colder weather.

Additionally, be cautious when storing insulin in vehicles or other unheated spaces during winter, as temperatures can drop significantly, compromising insulin quality. By following these guidelines, people with diabetes can ensure that their insulin remains effective, enabling them to manage their condition successfully throughout the winter season.

Support, share and care

In conclusion, prioritising physical activity during the winter months is essential for people managing diabetes. Through a variety of indoor and outdoor exercise options, you can maintain physical fitness and blood glucose control during the colder months. Remember to prioritise safety, monitor blood glucose levels, dress appropriately, stay hydrated, and take necessary precautions when exercising outdoors.

As you embark on your winter exercise journey, share your favourite activities and tips. Your insights may inspire others in your community to discover new ways to stay active and thrive with diabetes during the winter season. Let’s support each other through our wellness journeys and enjoy the benefits of a healthy, active lifestyle year-round.

Retha Harmse is a Registered Dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping the in the field of nutrition. She is currently in private practice in Saxonwold, Houghton and believes that everyone deserves happiness and health and to achieve this she gives practical and individual-specific advice, guidelines and diets.

MEET THE EXPERT


Retha Harmse is a Registered Dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping the in the field of nutrition. She is currently in private practice in Saxonwold, Houghton and believes that everyone deserves happiness and health and to achieve this she gives practical and individual-specific advice, guidelines and diets.


Header image by FreePik

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

Marilyn Nicolaisen – If you still breathe, there is hope

After a series of major health complications, Marilyn Nicolaisen chooses to focus on the positive with her life motto of: if you still breathe, there is hope.


Listen to this article below or wherever you get your podcasts or visit our playlist.

Marilyn Nicolaisen (48) lives in Pretoria, Gauteng with her husband and two children, aged 14 and nine.

Diabetes diagnosis

Twenty-four years ago, in 2000, Marilyn was diagnosed with Type 2 diabetes after having the symptom of drinking an extreme amount of water but still staying thirsty. After being admitted to hospital, the diagnosis was made.

She was immediately put on insulin and was given guidance on how to change her diet. Currently, she uses insulin glargine and insulin glulisine.

Multiple sclerosis diagnosis

In 2017, Marilyn was diagnosed with multiple sclerosis (MS), a chronic disease of the central nervous system which is thought to be an autoimmune disorder.

This came about after her pen constantly fell out of her hand as well as her coffee mug, like she had no control over her hands. Her right leg also became weak.

After consulting a neurologist, a lumbar puncture and MRI of the brain and spine were ordered. “A few lesions were seen on the MRI and I can’t remember the results of lumbar puncture but I was diagnosed with MS.

After her diagnosis, several medications were used as management (as there is no cure). Currently, she undergoes an IV infusion of ocrelizumab every sixth months. The cost per infusion is expensive but thankfully her medical aid covers it in full.

Marilyn says this diagnosis was much harder to accept than the diabetes diagnosis as there is no cure. “It was a huge shock for me and my family; I was extremely disappointed and very emotional,” she says.

Recent health scares

In April 2021, Marilyn’s whole life changed. “First I had a heart attack then two weeks later a stroke. My right side was mostly affected but with three months of rehab and a lot of exercise I have improved. While in rehab I had a MS relapse and then got COVID. My husband was out of country and no one was allowed to visit me. Thankfully, my mom took care of our children. It was the most difficult three months of my life. I tried to be positive for my husband and children but cried silently every night. We were obligated to get rails in the house, shower, etc. and a caretaker to help me. My new mode of transport, a wheelchair, was delivered to my house and a whole new life was awaiting the whole family,” Marliyn says.

She goes on to say that the heart attack and stroke were due to uncontrolled diabetes and high blood pressure. Since having the stroke and heart attack, she has tried to change her diet but says it isn’t easy; she eats mostly from the green list and low-carb foods.

Adapting to life in a wheelchair

Marliyn admits that accepting she needs a wheelchair has been beyond difficult. “I don’t think anyone will easily accept the fact that they are in a wheelchair. It’s three years now and every day is a challenge. However, my eight-year-old son makes it fun and drifts me,” she explains.

Grateful to be alive

Despite a life filled with health challenges, Marilyn is grateful to still be alive. “Every day is a challenge but I say thank you to the Lord for another day with my hubby and kids. When I think of them, I know the reason why I’m still here. I insist on making the lunchboxes myself in the morning; this makes me feel useful and needed. I sell online goods to keep me busy and motivated during the day as I was a busy bee before the wheelchair. Every evening I help prepare dinner with my caretaker and ensure I do my fair share. To help me mentally and emotionally, I consult a psychiatrist (via Zoom) and have to take medication,” Marilyn says.

Seeing the bright side

Marilyn’s children are the sole source of her motivation and positivity. “My 14-year-old daughter takes over the personal tasks from my caretaker in the evenings and over the weekends; she is my diamond. My husband and son help with other tasks, like getting me into bed or whatever I need help with. Without them I would surely not manage. My motto now in life is: if you still breathe, there is hope.

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 [email protected]


Header image supplied

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

Unlocking the hidden healing potential of the human body

Veronica Tift enlightens us on the hidden healing potential of the human body and how you can tap into it.


Listen to this article below or wherever you get your podcasts or visit our playlist.

Have you ever stopped and actually thought about the marvel that is your body? What it is capable of and the amount of regeneration and healing potential that occurs every day without you even being aware of it happening?

Your body is constantly trying to find balance, its working hard to fight off infection, maybe as you read this it’s digesting lunch or eliminating the waste from breakfast. Your heart is pumping blood around your body as your lung’s breathe in the air, all while cells regenerate and repair. There is function of the human body that science is still discovering, and the full capabilities of the body is underestimated and unexplored.

For me, this is the most apparent when thinking of the placebo effect and the nocebo effect. Never heard of the nocebo effect? Well, it’s the phenomenon were when you are told you might have a symptom from a treatment or intervention and you actually manifest those symptoms, even if that treatment was harmless. It’s kind of the opposite to the placebo effect, instead of having a positive effect from a belief you have a negative one.

In the book Mind Over Medicine, author Lissa Rankin writes about patients who were mistakenly informed that they had only a few months to live and died within that time frame, even when an autopsy found no physiological explanation for their death.

If the mind has been proven time and time again to have such a vital role in the ability to heal and even in how humans experience illness, then why are we not practicing more in-depth body-mind connection?

The power of regeneration of the body

One of the most powerful healings is the body’s ability to regenerate tissues and organs. You don’t need to ask the minor cut or bruises to heal, your body knows what to do and gets to it. More complex regeneration processes in the liver and stem cells are crucial without us even being aware of it.

The immune system became a hot topic during lock down. What I found fascinating is how little we actually understand what is considered the first-line of defence against harmful pathogens and foreign invaders. This protection function plays a key role in health and recovery from injury or infection.

We have hundreds of different immune cells at work within us. Making this system even more complex to study is the fact that every person’s immune system is unique. What is similar about the immune system in most people is that stress or exhaustion will have an effect on how we fight infection.

Nutrition and lifestyle, we know, has an important role to play in the body’s ability to heal. However, when looking at people who had experienced spontaneous remissions, Dr Joe Dispenza, a physician and scientist, found in years of interviews, that nutrition isn’t the major factor. He believes that while these can play a role in healing, changing the inner state of the mind will have a deeper impact on the body’s ability to heal.

While we can say “you are what you eat” and that proper nutrition, good quality sleep and physical exercise are the building blocks for healing and regeneration, it’s not the only factor. I would even argue that when humans have an inner state that is healing and processing emotions, rather than suppressing feelings and without anxiety taking over, humans are more capable of making better choices around nutrition and sleep habits, leading to better health overall.

The mind-body connection

The field of psychoneuroimmunology is a field of study that explores the complex connection between the brain, nervous system and immune system. Factors like stress, emotions and social structure all influence the immune function and healing. There are many factors that have been shown to help the body, like meditation, yoga and a variety of body work.

When stress is reduced, inflammation lowers, enhanced immune function is seen and these all help the healing processes. These all complement conventional medical treatment and support overall health and well-being. Please note: while I absolutely believe in the body’s ability to repair itself, I’m in no way suggesting that you should not seek medical advice of modern medicine.

Reflexology

Reflexology is an ancient healing practice which can help unlock the hidden healing potential of the human body. This gentle art of applying pressure to the reflex points on the feet can stimulate the body’s natural healing mechanism, aid in relaxation and help to restore balance to the body.

Part of my education as a coach, we learn the importance that self-care has on our mental well-being and while things like body work, coaching, or even time to journal might seem like luxuries, its actually self-love and caring for your body and mind, and in turn give yourself the space and time to heal.

Harnessing the healing potential

There is little doubt that the body is able of remarkable healing and I’m sure we can all think of an instance when someone was given little chance of healing and made a miraculous recovery.

Unlocking the body’s full potential while still not fully understood, we know where to start. A holistic approach to physical, emotional and environmental factors is needed. Conventional medicine with complementary approaches, optimising nutrition, managing stress, positive relationships and emotional support can all help the body heal and thrive.

The body really is resilient and has a range of sophisticated mechanism for healing and regeneration that we are still trying to understand. We can tap into this healing potential of our bodies and support it with the right tools, tools that you can discover for yourself through exploration of supportive modalities, like reflexology.


References

The Four Pillars of Healing (drjoedispenza.com)

Adding Nutrition to Balance the Body (drjoedispenza.com)

Rankin, Lissa. Mind Over Medicine. Hay House. Kindle Edition.

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

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

The tell-tale signs of the skin

Dr Rakesh Newaj shares the tell-tale signs of the skin that can be indicative of underlying diabetes.


Listen to this article below or wherever you get your podcasts or visit our playlist.

Diabetes, a multi-faceted condition marked by the body’s inability to regulate blood glucose levels effectively, can exert profound effects on various organs.

Most of the time, it’s discovered fairly late, when other organ complications, prompts the medical practitioner to do a blood glucose test. At this stage, some of the damage caused by unregulated blood glucose is usually irreversible. Fortunately, the skin, serving as a visible interface with the external environment, often reflects internal metabolic disturbances, offering valuable insights for diagnosis and management.

Acanthosis nigricans

One prominent cutaneous manifestation indicative of insulin resistance and impending diabetes is acanthosis nigricans. This condition manifests as velvety, hyperpigmented patches of skin, typically observed in areas such as the neck, axillae, and facial regions.

Despite rigorous hygiene practices, the distinct texture persists, prompting individuals to seek evaluation for underlying insulin resistance and diabetes. Treatment strategies encompass a holistic approach, including meticulous blood glucose control, regular physical activity, weight management interventions, and, in some cases, adjunctive therapies like chemical peels to address cosmetic concerns.

Dry skin

Individuals grappling with poorly-controlled diabetes often contend with troublesome dermatological issues, such as dry skin, particularly prevalent on the shins, accompanied by intense itching. This tends to be very persistent with bouts of scratching that leads to injuries on the skin.

Effective management entails meticulous blood glucose regulation alongside targeted interventions, such as the application of specialised moisturising creams, to alleviate discomfort and prevent complications. Sometimes the use of antihistamines and steroid creams can be very helpful in easing symptoms.

Skin tags

Moreover, the presence of multiple skin tags in regions like the neck, face, axillae, or groin may signal an underlying association with diabetes, often also linked to obesity. These tags can appear over a short period of time and can be very unsightly.

Treatment modalities typically involve the removal of these skin tags through cautery procedures, aiming to alleviate discomfort or improve the cosmetic look.

Skin infections

Diabetic individuals, owing to compromised immunity and metabolic dysregulation, frequently encounter recurrent skin infections. Bacterial infections commonly present as multiple sores scattered across the body, necessitating prompt medical attention and targeted antimicrobial therapy.

Conversely, rashes in skin folds should raise suspicion of fungal infections, such as candida. Another very common fungus infection in people with diabetes is called pityriasis versicolor. It appears as hypo or hyperpigmented patches mainly on the back and chest regions.

Addressing these infections may involve antifungal medications and meticulous hygiene practices to prevent recurrence. Additionally, diabetic individuals may contend with recurring vaginal yeast infections and oral thrush, warranting comprehensive management strategies tailored to individual needs.

Delayed wound healing

Prolonged hyperglycaemia can culminate in systemic complications, including impaired circulation and nerve damage, precipitating delayed wound healing and the development of diabetic ulcers.

In severe cases, chronic poor glycaemic control may precipitate toe gangrene, necessitating aggressive interventions, including amputations, to forestall further complications.

Diabetic dermopathy

Diabetic dermopathy is characterised by brownish skin discoloration on the shin. This type of skin lesion is fairly common and starts as pale macules which become darker in colour with time.

Many patients are unaware of its implications and try to ignore it at first till it becomes a cosmetic disturbance. The brown patches pose a therapeutic challenge to doctors due to their stubborn nature.

Diabetic blister

Sometimes patients present with a single blister on the lower leg, without a history of trauma. The blister appears overnight and can be fairly big. This is called a diabetic blister and warrants a full investigation to exclude the disease.

Necrobiosis lipoidica

Necrobiosis lipoidica can be considered as one of the cutaneous markers of diabetes. It presents as yellow atrophic patches, most often on the shins. Sometimes a red-brown rim may indicate activity at the border. Ulceration may also occur and is very slow to heal. There can be reduced sensation to fine touch in the affected area. The affected person needs to see a dermatologist to confirm the diagnosis and treat this condition.

Comprehensive management

While various other rare cutaneous signs may serve as harbingers of underlying diabetes, consultation with healthcare professionals is paramount for accurate diagnosis and comprehensive management. By adopting a multi-disciplinary approach encompassing lifestyle modifications, pharmacotherapy, and preventive measures, individuals can mitigate the impact of diabetes on skin health and overall well-being.

Dry skin and fungal infection in a diabetic
Dry skin and fungal infection in a diabetic
Acanthosis nigricans and skin tags
Acanthosis nigricans and skin tags
Diabetic dermopathy
Diabetic dermopathy
Dr Rakesh Newaj is a specialist dermatologist with special interest in skin surgeries. Since qualifying in 2010, he practices in Waterkloof, Benoni, Kempton Park as well as Mauritius. His special interests lie in skin cancers, hidradenitis suppurativa and stem cell and fat grafting.

MEET THE EXPERT


Dr Rakesh Newaj is a specialist dermatologist with special interest in skin surgeries. Since qualifying in 2010, he practices in Waterkloof, Benoni, Kempton Park as well as Mauritius. His special interests lie in skin cancers, hidradenitis suppurativa and stem cell and fat grafting.

Visit dermsa.co.za


Header image by FreePik

JOIN THE DSA FAMILY!

Become a member and receive a range of benefits.

Five ways to track your food using the mySugr app

Do you want to know how to make the most out of food tracking using the mySugr app? We have got you sorted.


Listen to this article below or wherever you get your podcasts or visit our playlist.

The mySugr app is full of handy features to help you track your food, learn from your data and identify patterns. Tools like the Photo Function and Notes allow you to add valuable details about what you’re eating. Plus, Tags and the Smart Search Function means you can easily find what you’re looking for in just a few taps.

1. Photo Function

A picture speaks a thousand words, and photos of your food provide you with valuable information and details, so you can look back and learn from your data. Plus, you’ll become a carb-calculating connoisseur as the Photo Function trains your eye to judge a food’s carb content.

To make the most out of the Photo Function:

  • Make sure you photograph your entire meal. This will help you more in the long run and allow you to judge whether your carb estimation was correct.
  • Add contextual information to each photo, including location, estimated exchange quantity, and a precise description of the meal. This way, the next time you visit your favourite restaurant, you can find it in your past entries, see exactly what you ate, how much you dosed, and whether your estimations were on target. Check your blood glucose trends in the graph to see if you hit the bullseye.
  • Use the same photos so you don’t need to take a new photo every time (as long as the portions remain about the same). Just make sure you turn on the Save photos to Photos app setting, so you can quickly select pictures from your library without having to take new ones each time.
  • Add the picture after eating. Log entries can be backdated, meaning you can snap a quick photo of your food and then dig right in. Add the photo from your photo library and describe your meal afterwards.

2. Tags

The mySugr diabetes tracker app lets you create a new food log entry with handy Tags. You can select between almost 50 small icons that describe different situations and emotions. These Tags are there to help you understand the context of each entry better. Using the Tags regularly can help you to discover patterns when using the Smart Search Function.

3. Food type 

Vegetable, fruit, dairy. If you want to keep an eye on what type of food you eat, you can easily track it with the Food Type Function. Just tap on the little icon with the plate on it in the mySugr App and you get a selection of different food types to choose from.

These food labels can help you understand the context of each entry better. You can easily search for food type tags and identify patterns using the Smart Search Function.

4. Meal descriptions notes

Add contextual information to your data by entering descriptions of meals in the text field. So, you can easily find out what, where, when and why? Every log entry tells a story, and when it comes to your diabetes, the more detail, the better. Find out all you need to know about each log entry by adding descriptions of meals and referring back to them in the future.

5. Save meals

Save meals and find out how your blood glucose is affected. It’s super handy to have your favourite meals on file so you know exactly how they affect your blood glucose. Log your meals in the mySugr app and refer back to them anytime to easily learn from your data.

Top tip: The Smart Search Function 

The Smart Search Function in the mySugr app helps you find important data faster. Remember those handy Tags we discussed above? You can find food you have previously tagged using the Search Function. Easily locate things like food types and specific meals by searching for specific tags.

So, there you have it. Logging your food in the mySugr app means that you can say goodbye to confusion at meal times and a big hello to deliciousness.

Download the mySugr app now!

You can download the mySugr app in the Google Play store or the App Store.

 

 

Please contact our customer support team to check if your mobile device is compatible with the mySugr app.

For more information, contact your healthcare professional.


For any questions related to your diabetes management, kindly reach out to your healthcare provider.

Should you have any queries about our products, please get in touch with our customer support centre at [email protected]. Country-specific contact numbers can also be found in the information below.


facebook-icon-preview-1-400x400

Join the conversation @RocheDiabetesCareSSA



Visit the website www.rochediabetescaremea.com for more information on our products and diabetes management tips.


Email: [email protected] | Toll Free: 080-34-22-38-37 (South Africa only) | +254 20 523 0560 (Kenya only) | +234-1227-8889 (Nigeria only) | +27 (11) 504 4677 (Other countries)

ACCU-CHEK, ACCU-CHEK INSTANT and MYSUGR are trademarks of Roche. All other product names and trademarks are property of their respective owners. | © 2024 Roche Diabetes Care | Roche Diabetes Care South Africa (Pty) Ltd. | Hertford Office Park, Building E | No 90 Bekker Road | Midrand, 1686, South Africa. ZA-504


Information provided is void of any representation and warranty as to the reliability, accuracy, usefulness, adequacy, or suitability of the information provided and is not a substitute for professional medical expertise or treatment for medical conditions, applications of medication. For personalised medical advice, consult an appropriate medical professional for queries regarding any medical conditions.