From a mother’s mouth: time-saving lunch boxes

Rita McLuckie, mother of Ethan – a Type 1 diabetes patient, shares her tips for time-saving lunch boxes.


As moms, we are ruled by routines. This may sound familiar to all mothers of all backgrounds, in all countries and of all cultures. Starting early in the morning, after getting ourselves presentable for the day and before heading off, for most of us, to a full day at work, there are many little things that need to be done. My biggest annoyance in the morning has always been “What do I pack in the kids lunch boxes today?”

Son is a fussy eater

I will be the first to admit that I am terrible at planning, I am indecisive and always running late. To top that, I have a extremely fussy eater in Ethan, my 10-year-old son. He has been living with Type 1 diabetes since he was 16 months old. Ethan also has epilepsy and is being treated for attention deficit disorder (ADD).

Some can say that fortunately the hunger-robbing Concerta is counteracted by the hunger-inducer Epilim. Though this is true to a certain degree, Ethan is naturally a person who does not enjoy eating. The only exception is when his blood sugar is dropping sharply, then he becomes a hungry little PacMan.

Thumbs down to an old-school sandwich

Neither of my sons (I have a teenage son Aiden) were ever particularly fond of the old-school favourite – the sandwich. This is a good thing though, since this traditional lunch box filler, coupled with fruit and the occasional treat, is high in carbohydrates.

Nonetheless, Ethan has to eat and because he is reluctant to eat bread, this presented a huge challenge for me. Ethan must eat to maintain good health. If I know he is eating I don’t worry about him at work. Also, Ethan is rather small for his age. With a BMI of 16, he cannot afford to lose any weight at all.

Adapt and plan ahead

As a result of my own tardiness and indecisiveness, and most of all ensuring Ethan has a good selection of snacks to choose from, I have had to adapt and plan ahead a little.

My way of coping is to pre-pack smallish snacks which I can then pop into both kids’ lunch boxes in the morning. The snacks that I tend to go for are: sliders or mini burgers, mini protein filled pancakes, mini pulled beef naanwiches, samosas etc. These are all readily available, with varying prices, from Checkers, Pick ‘n Pay or Woolworths.

I accompany the little convenient snacks with fruit, a dairy (usually different cheeses) and a protein, such as biltong, nuts, meatballs, sausages, fish fingers/cakes. I know that my inclusion of carbs will probably be frowned upon by many in the diabetic community. However, when you have a child who would rather do almost anything than eat, I have had to compromise.

Provide a choice

The whole purpose of the lunches I pack is so that Ethan can choose what he wants to eat. He is not expected to finish absolutely everything in his lunch box.

I write the carb value for each item in his lunch box on a Post-it or similar sized note paper. Once he has decided what he wants to eat, he boluses himself for the carbs for each of the items he has chosen to eat. This way, I don’t have to worry about his blood sugar dropping too low as a result of him not eating enough for the insulin he is injected.

When Ethan’s blood sugar has gone low, the quickest way to fix it, usually involves high-sugar foods or juices, provided by a panicked teacher or school staff member, which then inevitably causes a high blood glucose reading later.

Aftercare lunch

We are fortunate in that the school aftercare lunches Ethan receives are relatively healthy cooked meals with a fruit in the afternoon. If Ethan does not want to eat the aftercare lunch on a particular day, he usually still has some snacks in his lunch box to choose from.

Lunch in pictures

Below are images of my box of snacks, usually pre-packed by me on a Sunday evening, and the resulting lunch boxes from Monday to Friday.

Lunchbox planning

Wednesday

lunch box

Monday

lunch box

Thursday

lunch box

Tuesday

lunch box

Friday

lunch box

MEET OUR EXPERT


Rita McLuckie lives in Benoni, Gauteng.


Cataract formation due to certain medications

Do certain medications induce cataract formation? Dr Niemandt answers this question.


Cataract formation is a common occurrence; the human lens opacifies due to protein build up in the lens. The link between diabetes as a risk factor for cataract formation has been established. There is, however, also a risk for early cataract formation due to the use of certain medications.

Types of cataracts

  • Nuclear cataract: this is an age-related cataract which forms in the central zone of the lens, also known as the nucleus1.
  • Cortical cataract: opacities that develop on the outside edge (cortex) of the lens2.
  • Subcapsular cataract: this opacity forms on the back surface (posterior) of the lens2.

Corticosteroids

The medication that is most renowned for its risk of cataract development is corticosteroids, particularly in the development of subcapsular cataracts3. This is a drug that is known for its anti-inflammatory effects4. It is used to treat conditions, such as arthritis, colitis, asthma, bronchitis, certain skin rashes and allergic reactions pertaining to the nose and eyes4.

Examples of medication that contains corticosteroids4:
  • Cortef
  • Cortisone
  • Celestone
  • Prednisone
  • Prelone
  • Kenalog
  • Dexamethasone Intenso

The link

Many studies have confirmed the link between steroids and subcapsular cataract formation. There are, however, different opinions regarding the link between dosage and incident or severity of these cataracts5. Researchers have suggested that not only the amount of steroid usage, but also the patient’s susceptibility or genetic effects play a role in subcapsular cataract development5.

The Blue Mountains Eye Study also showed that the use of phenothiazines (found in drugs, such as Promapar and Procomp7) showed association with nuclear cataract development. While patients that were taking aspirin chronically had a higher risk of subcapsular cataract formation8. This study also suggested that the use of chloroquine for a period longer than a year could lead to posterior subcapsular cataract development8.

Symptoms

As subcapsular cataracts forms faster than other types of cataracts (sometimes developing within a couple of months), symptoms to look out for if you are on any of the above mentioned drugs are6:

  • Cloudy (blurred) vision
  • Difficulty with night vision
  • Glare sensitivity
  • Frequent change in spectacle and/or contact lens prescription
  • Fading of colours
  • Double vision

Regular check-ups

It is important to talk to your doctor about your risk of cataract development if you are on any of the medications mentioned above, or any other drug containing corticosteroids. This is, especially, important if you have diabetes, as that in itself is also a great risk factor for cataracts. It goes without saying that regular check-ups with your ophthalmologist is also a must if you are taking any of these drugs.


References:

  1. https://www.allaboutvision.com/conditions/cataracts.htm
  2. http://www.visionaware.org/info/your-eye-condition/cataracts/different-types-of-cataracts/125
  3. Corticosteroid-induced cataracts – Robert C.UrbanJr.B.S.D.
  4. https://www.medicinenet.com/corticosteroids-oral/article.htm#for_what_conditions_are_systemic_corticosteroids_used?
  5. What causes steroid cataracts? A review of steroid-induced posterior subcapsular cataracts Clin Exp Optom 2002; 85: 2: 61-75 Andrew I Jobling BScHons PhD Robert C Augusteyn BScHons PhD DipEd FVCO. National Vision Research Institute of Australia.
  6. https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790
  7. https://www.medicinenet.com/phenothiazines-oral/article.htm#what_are_the_side_effects_of_phenothiazine_antipsychotics?
  8. https://www.ncbi.nlm.nih.gov/pubmed/9754187

MEET OUR EXPERT


Dr Marcel Niemandt is an eye surgeon specialising in cataract and laser refractive surgery. He has qualifications through the Universities of Pretoria and KZN and is a member of the CMSA and OSSA. Refer to www.drmcniemandt.co.za for further info or call the rooms at 012 809 6027.


Are nitrates and nitrites nasty?

Registered dietitian, Abby Courtenay, helps us better understand food processing additives – nitrates and nitrites.


I am sure you have heard the headlines about how processed meats are dangerous and that we should avoid them at all costs. Not only have they been linked to the recent listeriosis outbreak, but processed meats also contain food processing additives, called nitrates and nitrites, which many people are concerned about.

What are nitrates and nitrites and why are they used in food manufacturing?

Food is processed in different ways; one of these ways is curing. Curing is the process of adding sugar, salt, nitrates or nitrites to food with the aim of drawing out moisture through the process of osmosis.

Commonly used nitrates and nitrites include sodium nitrite, potassium nitrite, sodium nitrate and potassium nitrate. These can be added as a singular ingredient or in any combination with or without salt (NaCl or sodium chloride).

Nitrates, nitrites and other curing aids are added to meat and meat products to help improve their colour, texture and flavour (with the characteristic pink colour and saltiness of preserved meat being due to the nitrates/nitrites). They also prevent or delay unwanted bacterial growth, thus prevents the food from spoiling quickly. The maximum recommended levels of sodium nitrite salts allowed in cured meat is 200mg/kg, or in the case of side bacon 120mg/kg.1

Is there a difference between nitrates and nitrites?

Nitrates and nitrites are compounds that are found naturally in some foods (mainly vegetables), but they are also added to other foods as a preservative. The difference between a nitrate and a nitrite is the amount of oxygen atoms they possess with a nitrate containing three atoms (NO3) and nitrite containing two (NO2). Nitrates are converted into nitrites through bacterial or enzymatic activity (in the body or in food processing). Nitrites are the active curing/preserving compound.1,2

Why should I limit my consumption of nitrates/nitrites?

Nitrites are converted into nitric oxide and nitrosamines. Nitrosamines can also be formed inside your body from haem (in the low pH of your stomach). Nitrosamine compounds are known carcinogens (which means they are cancer causing)3.

It is vital to note that the amount of nitrates/nitrites found in processed foods is very little in comparison to the amount found naturally in some foods. However, processed foods are filled with other ingredients that are not healthful and this together with the cancer risk has led to the recommendation that you consume very little, if any, processed meats.3

Practical solutions to eat less nitrates/nitrites

Great alternatives to processed meats include fresh red meat (remember to limit this to no more than 350-500g cooked red meat per week, which equates to approximately 700-750g raw meat),4 poultry, fish, eggs, dairy and legumes. These options provide a good amount of protein and micronutrients at a lower risk. Some great ideas include:

  • So, instead of lunch meats (like ham or polony), try roast chicken, egg mayo or cottage cheese on a sandwich.
  • Replace your breakfast side of bacon or sausage with grilled minute steaks or slices of poached salmon. It will still taste great with your egg.
  • Try a Sloppy Joe, which is a roll filled with savoury mince instead of choosing hot dog viennas.

References:

  1. [Internet]. Wcrf.org. 2018 [cited 20 June 2018]. Available from: https://www.wcrf.org/sites/default/files/Cancer-Prevention-Recommendations-2018.pdf
  2. Honikel K. The use and control of nitrate and nitrite for the processing of meat products. Meat Science. 2008;78(1-2):68-76.
  3. Preventive control recommendations on the use of nitrites in the curing of meat products – Canadian Food Inspection Agency [Internet]. Inspection.gc.ca. 2018 [cited 20 June 2018]. Available from: http://www.inspection.gc.ca/food/sfcr/general-food-requirements-and-guidance/preventive-controls-food-businesses/meat/nitrites/eng/1522949763138/1522949763434
  4. Limit red and processed meat [Internet]. World Cancer Research Fund. 2018 [cited 20 June 2018]. Available from: https://www.wcrf.org/dietandcancer/recommendations/limit-red-processed-meat

MEET OUR EXPERT


Abby Courtenay RD (SA) is an associate dietitian at Nutritional Solutions Grayston and Melrose. She graduated with a Bachelor of Dietetics at University of Pretoria and also holds a Masters’ degree in Nutrition from the University of Stellenbosch. Abby has a special interest in: women’s health, infant feeding and oncology.


My sister’s keeper

Simone Quibell shares the ins and outs and the ups and downs of having a sister with diabetes.


Simone Quibell (28) lives in Somerset West. Her younger sister, Genevieve (16) has Type 1 diabetes.

Part of the diagnosis

My sister is a Type 1 diabetic. We, as a family, have been living a diabetic lifestyle for the past eight years. Which also happens to be how old Genevieve was when she was diagnosed.

We were fortunate that Gen was diagnosed before she could go into a coma. Friends of our parents were in Cape Town which means that we were being tourists with them. It was here that my parents thought Gen had a bladder infection. She went to the bathroom far too many times to be normal.

The very next day Gen and I spent about an hour, possibly even longer, at the pharmacy between seeing the Sister and Gen trying to urinate in a cup. All I knew when we left there was that the Sister had insisted on calling our mom and that the reading on the blood glucose tester said HI.

I remember telling Gen in the car, based on the information I had, she might very well have diabetes. She burst out crying. Not that she had any idea what that was at eight years old, but it sounded petrifying. I managed to calm her down, quickly explaining that we didn’t know for sure. But if it were true, we would handle it together.

By 8pm that evening we were all sitting in a hospital room, Gen being the one to calm us down.

Chosen treatment regime

Genevieve is an amazing child who not only has diabetes, but wears glasses, was the tallest kid for many years, and has a form of dyslexia. None of this stops her from being one of the kindest and strongest people that I know.

She now tests and takes insulin around five times a day. This includes the long- and short-acting insulins. Although there are insulin pumps and other options available, we, as a family, decided that the regular testing and injections were the best suited option. An insulin pump would just be an added reason for people to stare.

The injections and testers, although a nuisance, can be kept in a bag – helping to make life as normal as possible, without any additional eyes watching and judging along the way. We all deal with our own fair share of unnecessary judgement.

I do encourage Gen to test her blood sugar when we are out in public, as this is life. Though, I do understand that sometimes she’d rather just appear normal. So, I do not force it.

Diabetes is a lifestyle

I think the most important thing that we have learnt is that diabetes is a lifestyle, so our family lifestyle adapted accordingly. We all spent time learning the technicalities of diabetes. What it is? How the body is supposed to work? How insulin interacts with cells? Everything – to be at least one step ahead of the blood sugar readings, and to try and exist between 4 and 8. This is like an impossible magic trick.

Then the weather changes, Gen gets a cold, hormones start to fluctuate and you’re 10 steps behind the blood glucose again. Diabetes isn’t easy, not for the family, not for the person who is diagnosed, or for close family members and friends.

There are days that we laugh and come out on top, and there are days where it feels like the world is on our shoulders and we get nothing right. It is okay to take a break from the brave, to take a moment and break down. It is also okay to eat a slice of cake, that you later regret as it is so sweet that you want to puke. Because none of us are perfect.

It is important that even in the low moments we are supportive. All of this within reason of course, we can’t be eating cake when blood sugar readings are high. Cake becomes a special occasion treat, and a healthy diet the norm which helps Gen maintain a decent blood glucose reading. At least until the weather changes or hormones fluctuate.

Steady blood glucose readings are an art. I salute every diabetic patient that manages to keep this as close to great.

sister

Building blocks of life – Ethan McLuckie

We hear the extraordinary story of 10-year-old Ethan McLuckie, a Type 1 diabetes patient.


Ethan McLuckie (10) stays in Benoni, Gauteng with his parents, Craig and Rita, and his older brother, Aiden.

Little scientist

When you meet Ethan, you instantly recognise just how intelligent he is. He loves building things, especially from Lego pieces and proudly shows off his latest creation. In fact, he was the youngest person to have taken part in the Lego Expo 2017. His parents call him their little scientist. “He has such unique interests, he loves robots and is always watching documentaries on space. He can tell you about the speed of light and black holes. A few years back, he called himself a cyborg because of his continuous glucose monitoring system,” Rita explains. Not only is he smart but for a 10-year-old boy, he handles his Type 1 diabetes with utmost ease and acceptance.

Sickly baby

Ethan was born with a cleft of the soft palate. As a result, he had many ear infections and was put on plentiful cortisone and antibiotics. He had his first grommets at three months and at the age of five months, his palate was repaired. Rita believes the trauma of this could maybe explain why Ethan developed Type 1 diabetes as there are studies that say childhood trauma may increase the risk of Type 1 diabetes.

Then when Ethan was 16 months old, in April 2009, the McLuckie family went on holiday. Ethan had transformed from a puffy marshmallow (from the cortisone) into a skinny baby with no baby fat. At that time, Ethan was still in nappies and the urine seeped through them. Rita assumed the nappies were just a poor-make brand that she had bought, reasoning why she had to change his bed linen three times a night. Ethan also had an insatiable thirst.

Once the family got back from holiday, they went straight to a paediatrician. Luckily, due to Craig having studied medical biochemistry (he had written a paper on diabetes), he immediately linked the symptoms to diabetes. Ethan was listless and had dark rings under his eyes. By this time, they could smell the ketones in his breath (a fruity acetone smell).

The paediatrician, after seeing the sky-high results of the urine dipstick, instantly referred Ethan to a paediatric endocrinologist. Insulin was administered in the paediatric endocrinologist’s rooms and within an hour Ethan was up and running around. “He didn’t have to be kept overnight. The change due to the insulin was remarkable,” Craig says.

Epilepsy

Then at age 4, Ethan was diagnosed with epilepsy. Rita says epilepsy is quite common in children with Type 1 diabetes. It took a while for doctors to get to the diagnosis as at first they suspected Ethan had a heart problem. Fortunately, for the past two years Ethan hasn’t had a seizure and he continues taking his medication – Epilim. Interestingly, when Ethan had fits, his sugars levels were always normal.

Hope from a friend

A family friend, who also has Type 1 diabetes, gave Craig and Rita hope. He showed them that life can be lived to the fullest with diabetes. He was diagnosed as a kid and is still doing well. The friend also proved the warning of not using the same spot to inject insulin true, as he had fatty deposits on the side he favoured (as it wasn’t that painful) to inject.

Injection woes

When Ethan was diagnosed, his treatment regime was long-acting insulin (Lantus) during the day and at night he was on fast-acting insulin (Humalog), and Humulin N insulin. An injection was used, which was quite traumatic for him, as an insulin pen couldn’t administer such small doses (less than half a unit). Even using an injection proved arduous to get the exact dose that was needed.

However, after a few years of using an injection, Ethan experienced numerous lows and the paediatric endocrinologist suggested he use the insulin pump. Ethan was six years old when he started using a Medtronic MiniMed insulin pump.

Changing to a pump

The pump was welcomed by his nursery school teachers as they were quite nervous injecting him. Nonetheless, all the teachers were willing to assist. Though, once when Ethan was having hyperglycaemia, one teacher panicked and rummaged through his bag and instead of using the insulin, she injected him with Glucagon. Craig noticed this when he picked Ethan up and corrected it. “We can look back at it now and see it as an anecdote but back then it was scary,” Craig says.

For the first two years of using the pump, Ethan’s teachers would help him with it. A book was kept where they recorded what he ate and monitored his sugar levels. But now, Ethan manages the pump himself. The added-bonus is that his current teacher is also a Type 1 diabetic. Rita says, “The great thing with her is that she doesn’t baby him but rather encourages him to do it himself.”

About two years ago, Ethan was put on the Dexcom continous glucose monitoring system.  The Dexcom has given Craig and Rita better sleep at night. “If he has a high or a low, it sounds an alarm so we are not having interrupted sleep like we used to when we had to check his levels,” Craig says. Rita adds, “We still check the monitor readings every two hours, but it is just opening one eye and then seeing white lines and saying ‘Yay!’ and going back to sleep.”

Taking responsibility

Ethan is not a good eater so Rita packs him a variety of food items to choose from. She then writes all the grams of carbohydrates of the items on a Post-it and leaves it in his lunch box. Then once he chooses the items he wants to eat, he adds the carbs together and adjusts the pump dose accordingly. “It helps with his maths too,” Rita says.

Craig explains that Ethan is at the stage now where he can recognise if he is having a hypo or hyper and alerts them. They have also found an advantage to Ethan having diabetes – they can pick up when Ethan is coming down with something, like a cold or the flu. “Literally, 24 hours before he starts to show the symptoms, his blood sugar levels will go up and we can’t get them down. Then we start giving double-doses of insulin, taking up the basal rates up to 150%+. So, the advantage is that you can almost pre-empt when the body is going under extra stress,” Craig says.

Food is foe

Craig and Rita find it very hard to go out to eat as a family. Not many restaurants have the nutritional content of their food items so Ethan can’t ever try something new. “The only restaurant that gave us a booklet on the nutritional content was Wimpy,” Rita says.

Then also because Ethan is not a good eater, and has low muscle tone so he doesn’t like to chew a lot, they find that his sugar levels are low as he doesn’t always eat dinner. “We will open the fridge and low and behold there is his full dinner plate,” Rita says. “Then during the night, his sugar will go low…try feeding a sleeping child! We normally give him milk with a bit of sugar in it, as the fat in the milk rises the sugar levels slowly.”

Luckily Ethan loves nuts, biltong sticks and yoghurt. Rita gives him the full cream yoghurt as it absorbs slower. She admits breakfast is tricky as Ethan eats slowly; they solved this by giving him smoothies to drink. But now, Ethan seems to like French toast.

The family did try the whole carb-free diet. However, Aiden, their  teenage son has a huge appetite. So, this had to change.

Trial and error

On average, Ethan has insulin four to six times a day at mealtimes. Though on weekends, it can differ due to not being in his normal routine.

Craig and Rita have also discovered that Ethan’s body reacts differently to insulin at different times of the day. In the morning, from time to time, Ethan’s body isn’t that sensitive to insulin so they will have to inject him almost 45 minutes before he eats, where the normal time is about 10 to 15 minutes.

“If we inject the usual time, then he has a spike at school and they try to correct it, then he has a drop. It is a nightmare! These are the things that no one teaches you and you must learn for yourself. And just when you think you are on top of it and you have worked it all out, sugar levels go crazy, or he has a growth spurt or the sniffles, or his port gets blocked,” Craig and Rita say.

“In the afternoon, every so often, Ethan’s sugar levels can go a bit low. It is partly due to him being active as he is at aftercare and running around. His sensitivity to insulin also increases so less insulin can give the same result.”

Concerns as parents

To date, Ethan has never slept out, not even at his grandparents. Next year will be the first year that Ethan will go on a school camp. Rita is besides herself as she doesn’t know if he can go unless the school allows her to go with. Plus, she is worried that he will be upset if he can’t go. But her biggest concern is she doesn’t want him to miss out. “At the end of the day, he is just a normal little boy,” she says.

“If he is invited to children’s’ parties, you can’t expect parents to put out broccoli or carrot sticks. It’s hard. Recently, a child celebrated his birthday and the parents bought the whole class McDonalds. But we are proud to say Ethan came home with it, he had two tiny small bites and then his brother got hold of it,” Craig says.

Though once Ethan is a bit older, they would like to send him on camps for children with diabetes.

Hard on the family

Due to Ethan being diagnosed so young, he never knew what sweets were. With that said, Rita knows it was harder for her older son as he was told, “No, you can’t have that or else your brother will also want it.”

She also says that it is hard for family members, especially Ethan’s grandparents, as they just want to spoil him with treats. “There is the thinking that if you have a pump, you can still eat whatever you want, but it isn’t like that,” Craig says. “For example, peanuts or sugar-free sweets. These might be safe but all in small amounts. To much sugar-free sweets can lead to diarrhoea due to the aspartame in them.”

Pros and cons

When asked what he dislikes and likes about his diabetes, the 10-year-old responds, “I like that is it easy to control but what I don’t like is getting ports.”

The ports for the pump need to be changed every three to four days. Ethan doesn’t like the ports on his tummy, so it is put on his buttocks. The sensor for the Dexcom is inserted on Ethan’s arm and Rita does this when he is sleeping.

“Last year, for two months, Ethan asked for the injection. He was just fed up with the port and pump. We also like to give him a break from the pump, especially if we are at the beach,” Rita explains.

Tough kid

Ethan is very small for his age and Rita says because of this and the fact that his teachers initially had to give him extra time nd attention to test his sugar levels and inject him, the other children might have resented him a little. As small as Ethan is, he gives as good as he gets and is a tough kid. We concur especially due to the way he has faced all his health challenges.

MEET OUR 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


FUTURELIFE® ZERO Smart food™ with berries and nuts

Ingredients

  • 4 Tbsp. (40g) FUTURELIFE® ZERO Smart food™
  • 100 ml cup warm water
  • ¼ cup warm milk (optional)
  • 1 Tbsp. dried berries e.g. goji berries
  • 1 Tbsp. chopped nuts e.g. almond

Method

  1. Cover the FUTURELIFE® ZERO Smart food™ with warm water, mix until combined.
  2. Sprinkle over raisins and nuts.
  3. Add milk (optional).

For more information on the product used in this recipe visit: http://futurelife.co.za/product/futurelife-zero-smart-food/


Warm FUTURELIFE® HIGH PROTEIN Smart food™ Chocolate Drink

Ingredients

  • 25g (1/4 cup) FUTURELIFE® HIGH PROTEIN Smart food™ chocolate flavour
  • ¾ cup warm low fat milk
  • ½ cup boiled water
  • 1 teaspoon cocoa

Method

  1. Blend together until smooth and enjoy immediately with your feet up under a blanket.

For more information on the product used in this recipe visit: http://futurelife.co.za/product/futurelife-high-protein-smart-food/


FUTURELIFE® Smart Bread™ pudding with spinach and mushrooms

Ingredients

  • 4 slices FUTURELIFE® Smart Bread
  • 1 cup mushrooms, sliced
  • 2 cups low-fat milk
  • ½ cup gruyère cheese, grated
  • ¼ cup parmesan cheese, grated
  • 1 bunch spinach, stemmed and washed thoroughly in two changes of water (more if necessary)
  • 1 tablespoon extra-virgin olive oil
  • 1 teaspoon fresh thyme leaves, coarsely chopped
  • 1 – 2 garlic cloves (optional)
  • Salt and freshly ground pepper
  • 4 eggs
  • Spray’n Cook

Method

  1. Bring a medium or large pot of water to boil, salt generously and add the spinach.
  2. Cook 2 to 3 minutes, until tender but still colourful.
  3. Transfer to a bowl of cold water, then drain and squeeze out excess water. Chop coarsely and set aside.
  4. If using garlic, cut one of the garlic cloves in half and rub the slices of FUTURELIFE®Smart Breadwith the cut side. Then mince all the garlic. Cut the FUTURELIFE®Smart Bread into 2cm squares.
  5. Heat the oil over medium-high heat in a heavy, wide skillet and add the mushrooms. Cook, stirring often, until they begin to soften, and add the thyme, garlic and salt and pepper to taste. Continue to cook for another minute or two, until the mushrooms are tender and fragrant. Stir in the spinach, toss together and remove from the heat.
  6. Preheat the oven to 180°C. Spray’n Cook a large oven-proof dish, soufflé dish or gratin. In a large bowl, combine the FUTURELIFE®Smart Bread cubes, the mushrooms and spinach, and the two cheeses and toss together. Transfer to the prepared baking dish.
  7. Beat together the eggs and milk. Add salt to taste and a few twists of the pepper mill, and pour over the FUTURELIFE®Smart Bread Let sit for 5 to 10 minutes before baking so that the FUTURELIFE® Smart Bread can absorb some of the liquid.
  8. Place in the oven and bake 40 to 50 minutes, until puffed and browned. Remove from the oven and serve hot or warm.

For more information on the product used in this recipe visit: http://futurelife.co.za/product-type/bread/


Young and thriving – Shaun Tobela

We speak to 20-year-old Shaun Tobela and hear how he has dealt with Type 1 diabetes during his youth.


Shaun Tobela (20) lives in Midrand, Gauteng with his parents. He is currently studying logistics – supply chain management. 

When were you diagnosed?

I was diagnosed in 2007 at the age of eight (about to turn nine) and was doing third grade. I got extremely sick before the whole symptom phase. No one knew what was wrong with me. I was raised by my grandmother; she thought it was just a bug or infection that could be dealt with. But as time went on, the diabetes symptoms stepped in: I urinated a lot and was always thirsty. My mouth was dry and, at times, I would feel drowsy. I was always hungry and my immune system was weak. My bed was my best friend until I was taken to the doctor where I was declared diabetic.

What medication are you currently on?

I am currently on Biosulin (long-acting insulin) and Humalog (short-acting insulin) and inject three times a day using an insulin pen: morning, afternoon and night. I take the long-acting for morning and night. Then I take the short-acting midday.

How did you handle managing your diabetes at school?

It was embarrassing to have my peers know that I was diabetic and having to take insulin at school. I was looked at in a different way – I was known as ‘that sick kid’, which was not nice.

For a long time, I would go to a private place to inject myself. Thankfully, I finally found the courage and started injecting myself in front of the whole class. They did all stare at me and it would humiliate me – which made me resent the condition. But as time passed, I gained confidence and became proud of my diabetes.

I think more than anything, it has been this experience that has helped me grow – having to accept myself for who I am. Nowadays, I am the one to tell people I am diabetic before they even ask.

In Grade 11, when I gained my self-assurance, I was bold enough to teach my Life Science class about diabetes with no shame.

How did you overcome the embarrassment?

I eventually got over the shame because I accepted the fact that I will always be diabetic and it was something I have to live with for the rest of my life. That changed my attitude. I had to accept diabetes myself before I could expect people to accept me.

What does your diet consist of?

I eat almost everything, but in small portions of course. Nowadays, most food items come sugar-free. As a diabetic, you’re able to eat and live like a normal person, it is just your diet will be slightly different with more sugar-free products.

For breakfast, I have cereal. My mid-morning snack is usually fruits. Then for lunch I have a sandwich and my 330ml can of Coke Zero. At night, I eat meat and vegetables. I try to avoid carbs, but I do eat them now and then and in small portions. Throughout the day, I try to eat protein as snacks: peanuts, meat, fish, biltong. That’s how most of my days go.

Are your friends aware of your diabetes?

Yes, my friends are. I’ve involved everyone close to me – they know the different types of insulin I use and are aware of the times I must take them.

When you go out with friends, do you drink alcohol? 

No, I don’t. Well, I’ve tried and it makes me sick, so I avoid it. Plus, you can still have fun without alcohol. I have my sugar-free energy drink (Red Bull) while my friends consume alcohol and we get the night going.

How have your family supported you?

My family have always been supportive. They help me eat healthy and stay on a good healthy diet. My father had been the most supportive. He made sure I always took my insulin and that my sugars levels were where they are supposed to be. Though, he is harsh at times. I only understand now why he is like that – for my own health.

What bugs you the most about having Type 1 diabetes?

Nothing really bugs me. Though, my biggest fear is missing my insulin shots. I just hate missing them, I feel a bit off.

What is the best thing about having diabetes?

The best thing about having diabetes is the fact that you’re different. You’re unique. You’re not normal and not being normal is a specialty. That’s my personal take on it.

How do you want to help youth who have diabetes?

I want to help the youth by raising awareness. I want to help diabetic kids that are going through what I went through. Especially those that think life is not worth living simply because they have diabetes. I am living proof that it’s possible to live with diabetes and live normally like everyone else. I want to change lives. Someday, I want to start a foundation to teach people about diabetes, even people without it. We need to spread the word.

When you got tattoos did your doctor inform you that your blood sugar needs to be well managed and if not it can slow down healing?

Honestly, I didn’t consult with my doctor before I got my tattoos. But I knew my healing process would take time compared to a normal person if I didn’t manage my sugar levels well.

What are your hobbies?

Playing soccer and lots of video games. I enjoy motivational speaking, bike riding, exercising, cycling and reading.

Do you have any side effects from diabetes?

No, I don’t and I’m grateful to God for that. I’m healthy and still in good shape.

MEET OUR 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


Winter tips for diabetics

Novo Nordisk South Africa shares five winter tips for diabetics.


Beanies, gloves, boots and jackets. These are the clothing items that help us keep warm during the cold winter months we find ourselves in currently. Coupled with heaters and hot beverages, many of us feel ready to brave the cold and chilly days ahead.

For people living with diabetes, winter is a time of adjustments. This is because during colder months diabetes patients have higher HbA1c levels than over the warmer months.[1]This increase can be attributed to changes in their diet and exercise, and the prevalence of colds and flu[2]. Therefore, people living with diabetes need to be extra vigilant and adjust their management plans during the colder months. Here are some tips and tricks to help you get through winter:

  1. Keep testing your blood sugar levels

Did you know that cold hands can make testing your blood glucose levels difficult? The trick is to try and warm your hands before you do the blood glucose test. Testing regularly will assist with catching any highs, or lows, and keep your sugar levels under control[3].

  1. Keep active even in the cold

Keeping active is important. Even though all you may want to do is stay indoors, under warm blankets and heaps of clothing. Even if the amount of physical exercise decreases, that is okay. As long as you do some form of exercise. It will help keep your blood glucose levels under control and keeps you warm in the process.

You can even start an indoor workout routine if bracing the cold doesn’t sound very appealing. A little activity each day will help with insulin sensitivity (in all types of diabetes) which can help the body to better regulate sugar levels[4].

  1. Watch what you eat

Winter food can be thought of as ‘comfort food’ because our bodies may require extra intakes to defend itself against the cold. So, where possible, stick to your meal plans.

You can also take advantage of diabetes-friendly seasonal fruits and vegetables in moderation, such as citrus fruits, nuts, root vegetables, and varieties of squash. Be careful of the easy and quick meals which only raise blood glucose[5].

  1. Boost your immunity

We know winter is when colds and flu take over and living with a chronic disease means taking even more precautions. Speak to your doctor about whether you should be taking medication in the event that you do get a cold or even about getting the flu vaccination. Bear in mind that when you do catch a cold or the flu, your energy levels decrease and your blood glucose levels could rise in response to the illness[6].

  1. Avoid the winter blues

Cold, unpleasant weather, lack of sunlight and stress in itself can cause blood sugar to rise. This is due to the body tapping into its stored glucose supplies and releasing sugar into the bloodstream – ‘preparing for battle’, i.e. making more sugar available to have the energy to fight whatever is causing you to feel stressed.  This is an example of how emotional and physical health are finely balanced in diabetes. So, it’s crucial to take care of both during winter[7]. It is therefore important to speak to friends and family if you are feeling overwhelmed, anxious or if you think you may be suffering from depression.

All it takes is a bit of extra effort to get through the shorter days and lack of sunlight. Making the necessary adjustments will ensure you are well equipped to make it through this winter.

Article supplied by Novo Nordisk South Africa.


Image credit – Coffee Geek


References:

  1. 7 Tips to Keep Blood Sugar Under Control in Winter: https://diabeteshealthpage.com/tips-blood-sugar-control-winter/ Last accessed 08 June 2018
  2. 7 Tips to Keep Blood Sugar Under Control in Winter: https://diabeteshealthpage.com/tips-blood-sugar-control-winter/ Last accessed 08 June 2018
  3. Diabetes and Cold Weather: https://www.diabetes.co.uk/diabetes-and-cold-weather.html Last accessed 11 June 2018
  4. Diabetes and Cold Weather:https://www.diabetes.co.uk/diabetes-and-cold-weather.html Last accessed 11 June 2018
  5. 7 Tips to Keep Blood Sugar Under Control in Winter: https://diabeteshealthpage.com/tips-blood-sugar-control-winter/ Last accessed 11 June 2018
  6. [1]Diabetes and Cold Weather: https://www.diabetes.co.uk/diabetes-and-cold-weather.html Last accessed 11 June 2018
  7. Taking care of your emotional health: https://www.novonordisk.com/patients/diabetes-care/type-2/Living-type-2-diabetes/Emotional-health.html Last accessed 12 June 2018