Denim for Diabetes

Cara Verster

Cara Verster, a Grade 6 learner, is thrilled that the Denim for Diabetes Day she organised at her school, Leeuwenhof Akademie, was such a success.

On 14th October, Leeuwenhof Akademie scholars swopped their school uniform for denims. They raised R3858 and donated the proceeds to Diabetes South Africa.

Cara Verster, a young diabetic, decided in the beginning of the year she wanted to get her school involved with the DSA Denim for Diabetes initiative. Leeuwenhof Akademie has been super supportive during Cara’s six years at the school.

The teachers and headmaster are always willing to help and very understanding when it comes to Cara’s diabetes management. Cara’s parents have peace of mind every single day sending Cara to school.

There isn’t a school activity or sport that Cara doesn’t try at school. She is an avid public speaker at the school, she is in the theatre group, she runs long distance, plays hockey and the drums. She is in the Top 10 academically and always full of beans. If you ask anybody at the school they will tell you Cara has never let diabetes stop her in any way. She always finds the strength to persevere and endure in spite of overwhelming circumstances.

Cara is looking forward to the Grade 7 trip to Cape Town next year.

Hannes Labuschagne

Hannes Labuschagne, a young boy with Type 1 diabetes, held a Denim for Diabetes Day at his primary school, Laerskool Mariepskop (Hoedspruit, Limpopo) in November. He raised R1500 for Diabetes South Africa from the proceeds of the day. His success was published in the local newspaper.

DSA News – Summer 2021

DSA Cape Town News

Timeless Care Team

Timeless Care Team hosted their monthly Soft Spot session in November 2021 at the Jolly Carp. To create awareness on World Diabetes Day, and with the kind assistance of Diabetes SA, they distributed reading material and Sister Kopolo of the Grassy Park Clinic delivered an informative talk on the ‘silent killer.’

It was a session filled with various activities from dry-haircuts to painting nails and health services provided various testing, such as glucose testing, blood pressure and Pap smears.

The chatter and laughter was evidence of a wonderful time had by all. The knitting club members proudly handed over their amazing love projects of baby beanies, booties, blankets to be distributed to those in need.

In the background the sounds of memorable music played and here and there a few sang along and some showed a dance move or two.


Margot McCumisky, National Manager of DSA, went to DeafSA on 26th November to do a talk on diabetes. An interpreter was present and the group had many questions and showed a great interest in diabetes. Two of the attendees had Type 2 diabetes and found the information very helpful.

DSA Port Elizabeth News

Diabetes Awareness in Kamvelihle, Motherwell

On 4 November 2021, Pamela Molefe, Martin and Elizabeth Prinsloo were privileged to be invited to address a group of elderly residents in Kamvelihle. They meet regularly in a large container and were so keen to learn more about diabetes. Pamela, our Xhosa speaking nursing advisor, spoke to them and answered their many questions. She also tested everyone’s blood glucose.

Pamela explaing about diabetes, while Martin and Elizabeth listen.
A few of the people present.
Lely Zweni (standing) is the co-ordinator of this group.

Diabetes Wellness meeting in Newton Park

The last meeting for this year was held on 10 November 2021. Our guest speaker was Felicity Black, a registered dietitian, who helped us all to understand more about how our bodies react to insulin and what we eat and drink. A time for questions and lively discussion followed her presentation.

Some of the people present.
Festive decor in Caritas Hall.
Felicity Black, registered dietitian.

DSA Young Guns World Diabetes Day – Boerie Braai

On World Diabetes Day, the DSA Young Guns held an event at The Willows, Three Pools. This was well-attended by not only the Young Guns but also by family members and friends who could chat while the youngsters had fun.

The day started at 10am and ended at 5pm. One of the DSA Young Gun leaders, Darren Badenhuizen, braai’d one hundred boeries in the pool lapa area. The kids enjoyed boeries with low-cal juice and a protein bar which was sponsored by Future Life.

Diabetes South Africa’s National Chairman Martin Prinsloo and his wife Elizabeth, who is the chairman of the Port Elizabeth Branch arrived with their grandson; Joshua, and his dog, Jessica. Joshua performed a lovely obedience show with Jessica and everyone was impressed with the dogs good behaviour and stylish outfit.

Martin did the raffle draw with the help of five Young Guns. Thereafter the kids took a break from swimming and did a potato and spoon race. The Young Guns played their own version of dodge ball which was most enjoyed by young and old. There was an exciting game of Tug of war where the rope snapped. This did not stop the kids as they tied a knot and carried on with the war in good spirits.

Families from Port Elizabeth and surrounding areas such as Jeffery’s Bay and Grahamstown joined the event. The youngest DSA Young Guns member in attendance was 4-years-old Type 1 diabetic.

Prizes were donated in the form of vouchers by The Valley Craig and Wacky Water World. These prizes were awarded to the winners of the many games played on the day.

DSA Pretoria News

A tribute to Rentia Kinchenton

The song is ended (but the melody lingers on). – Irving Berlin.

The Diabetes South Africa Pretoria Support Group members fondly remember Rentia who passed away in March 2021, especially on 27 September as she celebrates her birthday in heaven. She loved the Lord, had a compassionate heart, was a wonderful person, a born helper and a very courageous woman.

Rentia was a dedicated member of the DSA Pretoria Support Group. She volunteered her services on an ongoing basis with a heart-warming smile.

She was famously known as the sandwich lady as she was the maker of many tasty chicken, egg and mayo sandwiches for the Pretoria Diabetes Support Group meetings. Rentia was a loyal member always helping where she could. May her beautiful soul rest in eternal peace.

New Benoni support group

At the request of Nursing Sister Ferosa and in line with DSA’s objectives to empower all those affected by diabetes through support, education and information, the DSA Pretoria Branch encouraged and supported the establishment of a new support group in Benoni on 16 October 2021.

The meetings of this support group will be held monthly to provide support and information to the Benoni community and the surrounding areas.

It’s encouraging to note that as a build-up to World Diabetes Day on 14 November, an initiative pioneered by Sister Ferosa resulted in a number of people joining a Diabetes Support Group at the Northmead Clinic in Benoni.

The group benefitted from the awareness campaign which highlighted risk factors associated with diabetes as well as the promotion of a healthy lifestyle.

The turnout at this event is evidence that people are keen to know and understand what diabetes is all about. The more people know, the easier it will be for them to make better-informed choices and decisions. Furthermore, they will be able to manage diabetes effectively.

The more new support groups created, the better it’s for DSA to reach a wider audience. This has the capacity to increase DSA’s membership and to curb the scourge of diabetes which has a negative impact on health, families and society at large.

Benoni Lakes Lions Club Diabetes Awareness and Screening Day

Benoni Lakes Lions Club held a Diabetes Awareness and Screening Day at Elate Eatery in November. It was a great success despite some rainy weather which forced them to pack up early.

They managed to screen 47 people over a four hour period and are happy that all readings except two were within normal range. We had two men that had readings of 7,4 and 18,1 respectively. The gentleman with the 18,1 reading has already been diagnosed with diabetes.

DSA contributed literature which made a huge difference to the success of the day. Benoni Lakes Lions Club really appreciat the guidance and materials which DSA National Office provided. They are planning more Diabetes Awareness and Screening days in 2022 with the support and assistance from DSA.

Wound Care Wellness Workshop

The Diabetes South Africa Pretoria Support Group hosted a Wellness Workshop on wound care on 16 October 2021. We are thankful to Nursing Sisters Backeberg and van Zijl for an informative and detailed presentation on wound care. This insightful session was followed by a live demonstration on a willing volunteer on what to do when testing your feet at home. 

For a person living with diabetes, the reality is that short-term and long-term complications of the feet are potentially life-threatening. The diabetic foot in South Africa, as in all parts of the world is associated with a high risk of amputation. The daily individual foot checks and annual foot assessment by a professional are important consultations to mitigate against possible complications.

DSA Kwa-Zulu Natal News

Ulundi Diabetes and Hypertension Fighters

Ulundi Diabetes and Hypertension Fighters along with DSA planned a community outreach service to educate and do testing for free to disadvantaged people. Ulundi Diabetes and Hypertension Fighters works together with a multi-disciplinary team in conducting community services. They promote diabetes and hypertension awareness in different communities around Northern KZN.

We started this Diabetes and Hypertension Wellness Drives mid-year 2021. Our first drive was at Ulundi on 28th May. The day was all about educating the community about the signs, symptoms, treatment and management of hypertension and diabetes.

We also did screenings for all the attendees according to our specialisations and we have referred some of them for further investigations to their nearest doctors and clinics. We had the following practitioners on that day: biokineticist, dietitian, diabetes educator, optometrist, clinical nurse, coastal nephrology clinic, physiotherapist, and podiatrist.


On 18th June, we went to Nongoma to promote and install the same vision and goal of managing diabetes and hypertension. The community was so welcoming and they were eager to listen to the information we had to share with them. We managed to see 50% of patients of which was really good, hence it was the first thing to be done in the community.


On 29th June, we visited Hlabisa community to promote diabetes and hypertension awareness with an aim of educating the community and getting access to the health care resources they need to manage these conditions.

Due to COVID-19 restrictions, we did not do the presentations but we were able to do one-on-one patient education. Based on the information we received, we discovered that they need more of education mainly about medication, management and the importance of testing. We also referred a few for further investigations to their nearest doctors and clinics since we all stay far from their community. We planning to re-visit them again next year and we are hoping for better results.


On 5th July, we visited Melmoth with the same drive and vision of spreading the word of diabetes and hypertension management and treatment. Patients did come but there were few and most of them were rushing to work, we assume they also did not get the information plus we also had tight COVID -19 restrictions. We did all the testing and the patient education through one on one.


On 18th September, we visited Jozini (Sisizakele Special School), there was aerobics competition The Noah’s Ark presented by Intengu fitness centre.  We managed to conduct tests on few but most of them were focusing on the event. What we discovered with them is that yes they are into “fitness” but they lack guidance on proper exercise techniques and proper nutrition to avoid unnecessary complications.

Ulundi – WDD

On 14th November, we had a World Diabetes Day (100 years of insulin) in Ulundi. This was our end-year event. The purpose of the day was to mainly educate diabetic patients and the community of the disease and management. The plan is to make it an annual event.

On the day, we did testing (glucose, blood pressure, HbA1c and body composition), management exposure where they were oriented to different stations of different HCP. Participants had a Q&A session after the talk and prizes were given. All participants were given goodie bags for participating in the event.

We had a 30 minutes session of an exercise as part of the event. Exercise forms part of  diabetes management and treatment. It is highly recommended because it helps to lower HbA1c values by 0,7% (with medication and diet), lowers blood glucose, and boosts body sensitivity to insulin. It has been highlighted that people with diabetes who walked at least 2 hours/week were less likely to die of heart failure than sedentary individuals.

Angela Murphy: When diabetes became personal

Dr Angela Murphy tells us how she went from being a diabetes doctor to a mother of a child who has diabetes.

Angela Murphy (54) lives in Brakpan, Gauteng with her husband and three children.

I woke on the morning of 25 November 2005 to a new world. For the third morning in a row, my two-year-old daughter, Olivia, complained of being very thirsty at 5am. I had been trying to suppress a worry for the previous few days and decided to do a blood glucose test on her: 16, 6 – a number I will never forget.

By the end of the day, my husband, Olivia, and I were sitting in the offices of my medical school classmate and colleague, getting a prescription for insulin. In one day, I was unceremoniously pushed from being diabetic doctor to diabetic mother.

Our lives became consumed by numbers: fear of the low ones, annoyance with the high ones, relief if the numbers were good. Olivia had to learn that being injected several times a day with a sharp needle was her new normal. We were blessed to be able to put her on an insulin pump within six months of her diagnosis. It took the injection burden away but not the testing.

Support and special bonds

My first thought as I woke and my last at night was: What is her blood glucose? Handing her over to the care of her teachers was terrifying but we were so blessed that she was well looked after at St Dominic’s School, Boksburg. Special bonds were made with people that helped so much in those earlier years, especially the wonderful diabetes educator Jen Whittall. Through her we met other families and formed a support group on the East Rand that met once a month: Super Kids With Diabetes (SKWID). Our children always had friends with diabetes, so they never felt odd.

Coming to terms with the diagnosis

When Olivia was diagnosed with diabetes, I was almost eight months pregnant with her sister, Julia. Her brother, Lorenzo was just four years old. In that first year, I lived in a fog, battling an immense sense of loss. I clearly remember seeing billboards advertising fruit juice and being heartbroken that Olivia would not be able to just drink that without thinking and planning. I was angry that she would have restrictions and anxious to keep her safe.

Doctor vs mother

The comment I heard most often was how lucky Olivia was to have me as a mother. I understood what was meant, that all my knowledge about diabetes could be used to care for her. However, as a specialist physician my patients are adults; a toddler with diabetes was completely outside my clinical realm.

As a doctor I knew controlling the glucose levels to target was vital. As a mother, I was terrified of my child slipping into a hypoglycaemic coma. I was privileged to attend the International Society for Paediatric and Adolescent Diabetes conference in Durban 2008. I gained so much new knowledge and insight, not only medical but also on parenting a child with Type 1 diabetes. One statement was a light-bulb moment for me: “A child’s HbA1c is proportional to the mother’s fear of hypoglycaemia – the higher the fear, the higher the HbA1c”.

With the guidance of her endocrinologist, we adjusted insulin doses and gradually Olivia gained good control. I still woke to check her glucose every night for years to come but learnt not to accept higher glucose levels out of fear. This was a big step among many small steps in learning to manage the constant tight rope of highs and lows.

The realisation that there is no holiday or break from diabetes can be crippling in the days after diagnosis, something I have felt with my own patients. Having crossed the line from advising about diabetes to living with diabetes (a parent with a young child almost takes on the diagnosis), I do truly empathise with my patients. However, it’s still my job to guide, advise and help them aim to reach those diabetic goals. I never judge, as I know how tedious glucose testing, carb counting, and bolus timing can be. I have really had to try and practice what I preach. We all need to learn to ride the diabetes rollercoaster while we live our daily lives.

Proud mom

I would still wish Olivia’s diabetes away, but I know she can cope. However, I’m so grateful for the technological advances and the fact Oliva can use an insulin pump and glucose monitoring system. I remain hopeful that more breakthroughs will be made, and as radical a discovery as insulin was 100 years ago, something else may change the burden of diabetes in the future. In the meantime, I know Olivia will continue to live her best life.


Dr Angela Murphy is a specialist physician working in the field of Diabetes and Endocrinology in Boksburg. She runs a busy diabetes practice incorporating the CDE Programme, Discovery Diabetes Care Programme and an accredited insulin pump centre.

A closer look at Type 1 diabetes

Dr Angela Murphy shares informative insight on Type 1 diabetes, how it is managed and what the future holds.

What’s in a name?

The word diabetes originates from Greek, meaning increased or excess urination, a symptom common in the initial presentation of diabetes. However, an imbalance of hormones controlling water balance can also cause increased urination, but the quality of the urine is very different. Hence the terms mellitus, meaning sweet, and insipid which means clear. Diabetes mellitus describes the group of conditions where blood glucose is too high. Diabetes insipidus is an abnormality of water balance, either in the kidney or from the hormones in the pituitary.

What’s in a type?

Diabetes seemed to present in two different ways: more slowly and in older patients or very suddenly in younger patients. Some patients required insulin to survive, others could be managed with dietary changes and later, when they became available, oral medications.

Classification of diabetes has changed over the years and continues to be debated as there is likely an overlap of the different types. The current classification is based on the cause of the diabetes, not patient age or whether insulin is used.

Type 1 diabetes – autoimmune diabetes which will be discussed further.

Type 2 diabetes – insulin resistance (usually due to excess body fat) and decreasing insulin secretion from the pancreas cause high blood glucose levels. This is the most common type of diabetes accounting for more than 90% of cases.

Gestational diabetes – is diabetes occurring in the second or third trimester of pregnancy without a prior diagnosis of diabetes

Diabetes due to other causes – this includes monogenic diabetes, such as Mature Onset Diabetes of the Young (MODY); diseases of the pancreas, such as pancreatitis and drug-induced diabetes.

What went wrong?

Type 1 diabetes is a genetic, sometimes hereditary, autoimmune disorder present from birth. Our immune systems should activate to attack external dangers such as infections and allergens which could cause harm.

In autoimmune disease, the immune system is activated by an external trigger but then proceeds to attack the body’s own cells. In Type 1 diabetes, the target is the insulin secreting beta-cells which lies in the islets of the pancreas. There may be more than one attack on the pancreas before evidence of diabetes is seen. Insulin secretion is usually at 50% of normal before blood glucose rises significantly causing symptoms.

How does Type 1 diabetes feel?

Glucose is the primary fuel for the body and required for all cellular function. Almost all food is ultimately digested to glucose which is then transported around the body in the blood vessels. For glucose to enter each cell, insulin needs to unlock the cell door. If insulin is absent, as in Type 1 diabetes, the glucose gets trapped in the blood vessels. This causes:


Blood glucose is now trapped in the blood vessels causing hyperglycaemia (high blood glucose). When this blood is filtered in the kidneys, excess glucose spills into the urine drawing fluid with it.   This is what causes the excess urination as well as the ‘sweet’ urine. The glucose in the urine can be a breeding ground for bacteria and a urinary infection can further worsen the symptoms. This excess loss of fluid stimulates the thirst centre and so the person will develop another common symptom: incredible thirst and increased consumption of fluids.

Ketone formation

While the high glucose is causing problems by remaining in the blood stream, the lack of glucose entering the cells leaves them starving.  The cells must look for other sources of nutrition for energy production. Protein and fat stores are broken down to provide this source and as these are used up the person with Type 1 diabetes starts to lose weight, another common presenting symptom.

The energy produced may not be as great and so tiredness and fatigue become a complaint as well. As more fat is broken down, it creates a by-product – ketones. Ketones are acids which alter the pH of the body as they accumulate and can cause the dangerous condition of diabetic ketoacidosis (DKA). Sadly, an all-too-common presenting feature of Type 1 diabetes. The only way to rid the body of ketones is to give insulin which will then move glucose into the cells and switch off the use of fat as a source of energy.

Long-term complications

The circulating high blood glucose causes damage to the blood vessels, both small blood vessels (microvascular) and later large blood vessels (macrovascular).

Large clinical trials have conclusively shown that good glucose control reduces the risk of long-term complications. The most important trial, the Diabetes Control and Complications Trial (DCCT) showed intensive glucose control reduced the risk of all complications.

The Epidemiology of Diabetes Interventions and Complications (EDIC) trial followed the DCCT patients for up for a further 12 years and saw that the original intensively controlled group of patients continued to have a significant reduction in complication rates compared to those who had standard control. This proved the concept of ‘metabolic memory’ which means good control from diagnosis is vital for long-term protection.

How is Type 1 diabetes diagnosed?

The diagnosis of diabetes is the same for all types and accepted internationally as follows: if  fasting blood glucose level is ≥ 7,0mmol/L, or a two-hour post glucose challenge is ≥ 11,1mmol/L, or a HbA1c value is >6,5%.

In most instances, people presenting with Type 1 diabetes will have symptoms as described above so one test will confirm the diagnosis.  If there are no symptoms, a second confirmatory test has to be done.

How is Type 1 diabetes treated?

This is truly a one-word answer: insulin. This year we celebrate 100 years since the discovery of insulin and the fact that people diagnosed with Type 1 diabetes can live a long life. I have had several patients in my practice who have had Type 1 diabetes for more than 40 years and one remarkable lady for more than 60 years.

A healthy, balanced diet is important for people living with Type 1 diabetes and will contribute to overall better diabetes control.  However, the most important aspect of treatment is to ensure that there is enough insulin, at the right time, to move glucose from the blood stream into the cells.

Insulin fast facts

  • Basal insulin gives the necessary background insulin and specifically controls glucose released by the liver when a person has not eaten. It is longer-acting and is usually given as a daily dose; in some patients the dose can be split and given twice daily.

  • Bolus (short-acting) insulin is needed to absorb glucose derived from food eaten at mealtimes. The timing of bolus insulin is one of the biggest challenges for people living with Type 1 diabetes. It is essential that glucose and insulin ‘meet’ and do not miss each other. This means that the bolus injection must be given before meals and often up to 30 minutes before the meal. This holds true even for the new analogue insulins. No insulin is fast enough that it can be injected at the time of eating or even after a meal. For people with diabetes wearing sensors, it’s even easier to spot bolus insulin timing issues as we see a typical ‘witch’s hat’ picture in the glucose tracing (Fig.1). The sharp increase in the glucose is pathognomonic of a late bolus dose.

  • Pre-mix insulin has a fixed ratio of short-acting insulin and intermediate or long-acting insulin (ones that are usually used as basal insulins) and must again be given before meals. They are usually given twice daily before breakfast and before supper. In some instances, they may be used for the breakfast dose and other insulins used for the rest of the day. This is particularly the case with children when trying to cover food eaten at school.

How is Type 1 diabetes monitored?

Trying to manage Type 1 diabetes without regular measuring of blood glucose levels is like trying to drive a car with a blindfold on.  There are excellent glucometers available which allows accurate testing with results in seconds.

The advent of continuous glucose monitoring devices has truly improved the burden of glucose testing.  Not only does it mean less, or no finger pricks, but so much more information can be seen on the continuous sensor. Everyone living with Type 1 diabetes knows that no two days are alike. Being able to ‘see’ the glucose and take immediate action gives much better overall control.

It is still valuable to look at averages, patterns and, of course, HbA1c (three-monthly test). Most people with Type 1 diabetes should be aiming for a HbA1c of <6,5%. Guidelines tell us that this means keeping fasting blood glucose between 4 mmol/L and 7 mmol/L and the two-hour mealtime glucose should be less than 8mmol/L.

For those people fortunate enough to use a continuous glucose sensor, we look at a new parameter called Time in Range. This measures all readings from 4mmol/L to 10 mmol/L.  A Time in Range above 70% is considered good control.

Can Type 1 diabetes be cured?

Although many advances have been made to manage Type 1 diabetes, we cannot claim yet to have a cure. Research has focused on a biological cure, but it is technology that is making the greatest strides.

The age of the ‘artificial pancreas’ is here in the form of insulin pumps that respond to glucose readings from continuous glucose monitoring systems. The most sophisticated of these have almost closed the loop in diabetes control with only the calculation of carbohydrate content of a meal and the timing of food boluses still needing to be done by the person with diabetes. There is no doubt that these systems help achieve better and consistent glucose levels.  Unfortunately, they are expensive and not available to most people living with diabetes.

This means that instead of just supplying the body with insulin, a biological cure would need to supply the body with the functioning islet cells needed to make insulin. However, these islets need to be protected from being attacked by the same autoimmune process that caused the diabetes in the first place. The race is on to create the ideal barrier to protect the transplanted islet cells. There is, in addition, a need to produce large volumes of islet cells that does not rely solely on organ donation. And there is debate about the ideal site to introduce the new islets cells to, ranging from the liver to subcutaneous fat.

Much to be grateful for

I’m grateful that insulin was discovered 100 years ago and has allowed people to continue living with Type 1 diabetes. I’m grateful that there is still so much dedication and research in this field. And I’m hopeful that a cure will be found. In the meantime, managing blood glucose levels with a healthy lifestyle and access to insulin and glucose measuring should be something all people with Type 1 diabetes have the chance to do.


Dr Angela Murphy is a specialist physician working in the field of Diabetes and Endocrinology in Boksburg. She runs a busy diabetes practice incorporating the CDE Programme, Discovery Diabetes Care Programme and an accredited insulin pump centre.

Header image by Adobe Stock

Daniel Sher – Happy, healthy and making a difference

Daniel Sher tells us how he has managed his diabetes successfully and how his diagnosis influenced his career path.

Daniel Sher (32) is lives in Cape Town with his partner and two fur-babies.

At the age of 18 months, Daniel was hospitalised after lapsing into a coma from hyperglycaemia. He was diagnosed with Type 1 diabetes and was put on Actrapid insulin.

When asked if he struggled to accept his diagnosis, he responds, “Not that I can recall. Then again, I didn’t have much of a hippocampus at that time, so my memories for that period aren’t too well-formed. Having been diagnosed soon after birth, my parents played an integral role in keeping me healthy and supporting me to foster healthy attitudes towards my lifestyle.”

It seems that the support from his parents built a solid foundation and led Daniel to achieve good management of his diabetes. The 32-year-old attributes his well-managed diabetes to“reliance on support from my medical team, friends and family. I’ve also relied heavily on meditation, psychotherapy and exercise (martial arts and surfing).” Adding that he exercises religiously.

However this doesn’t mean that he doesn’t face obstacles. He explains one of the hardest parts of having diabetes is “when plans need to be re-formulated due to diabetes. For example, having to turn back mid-hike due to having insufficient low supplies.”

Though, he is thankful for all the medical advances, “Insulin has evolved wonderfully, as has blood glucose monitoring technology. He currently uses Humalog and Lantus insulin and a Freestyle Libre CGM.”

Career path

Daniel admits that diabetes diagnosis influenced his career path; he became a psychologist who counsels people with diabetes. “Having had this condition for 30 odd years, I’ve become keenly aware of how important it is to consider the psychological side of diabetes. I’ve also become aware of how difficult it is for people with diabetes to access the right sort of specialised psychological support.

Public healthcare for diabetes needs more focus

In Daniel opinion’s, he thinks that we are getting there in terms of diabetes awareness. However, like many, he feels the public sector where the majority of South Africans receive diabetes care needs to be amped up. “Advocacy efforts need to be focussed on making diabetes education, care, management and psychological input more accessible to those who rely on public healthcare.”


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]

Olivia Smargiasso – Walking the road to success

Olivia Smargiasso is the perfect example of living her best life with diabetes. This young lady has achieved so much already and her future is bright.

Olivia Smargiasso (18) lives in Brakpan with her parents and two younger siblings.


I was diagnosed with Type 1 diabetes at the age of two and a half, in November 2005. My mom had noticed the classic symptoms of thirst and excessive urination. She tested my blood glucose at home, and it was 16,6. By the end of that day, I had seen an endocrinologist and started using insulin.

I think at about five years old, I understood that I had something extra I always had to think about. It was then that I realised I needed to test my glucose and bolus for food (I had gone on to an insulin pump six months after I was diagnosed). This was also the time I became aware that other people in the class did not tell the teacher they were feeling low. A low usually left me feeling sweaty, irritable and very emotional. These mood swings were definitely difficult to regulate.

Aim for a dart board rather than the bullseye

I think because I was diagnosed at such a young age, living with diabetes is all I’ve ever known. Whenever I feel that I don’t want to have to deal with my diabetes anymore, I remind myself that I don’t need to be perfect, only aim for perfection. Living with the challenge of diabetes is more about aiming for a dart board rather than the bullseye, and it’s more than okay to miss here and there.

I’m currently on a Medtronic 670 pump. Before this I used the Medtronic Veo and before that injections. I have used Novorapid short-acting insulin for the last 15 years. My treatment hasn’t changed much in that time, only the carb ratios and other settings on my pumps.

As a child, I saw an endocrinologist, and a diabetes nurse educator, who also has a son (now grown up) with diabetes. Thus, she could empathise with my family, especially my mom. In more recent years, however, my mom, Dr Angela Murphy, has become my doctor; she is a specialist physician

Olivia Smargiasso: Walking the road of success

Dr Mom

I always joke that I couldn’t get away with anything because my mom knew when I wasn’t telling the truth. It was definitely challenging at times, having a doctor as a mom, because I knew she expected me to manage my diabetes with accuracy and precision.

I have also been very fortunate, though. My mom will often tell me about the launch of a new diabetic drug, or an advancement in research. She also sees how well I manage the many challenges of diabetes compared to patients or colleagues’ patients. I feel encouraged that perhaps I do manage my diabetes reasonably well.

Achieving in abundance

I was always encouraged not to let diabetes hold me back. I have Protea colours for karate after competing in Zimbabwe, Botswana and at the Commonwealth Karate Games. I’m a keen runner and Running Captain at school. I used to be an avid waterpolo and netball player too.

When I went onto continuous glucose monitoring (CGM), I found that playing sport became much easier as I was always aware of any change in my glucose levels. Before sensors, however, I would aim for a glucose level of 7,5-9 before playing sport in the afternoon and below 6,5 when swimming in the morning. This way I avoided experiencing a high after morning training and a low during netball or waterpolo practices after school.

I also make sure I always have something sugary close by. Game or Powerade have worked best for me; small sips throughout the training or match to replace any energy I’ve used while exercising. I also eat something with slow-releasing energy, like a banana, before training sessions or matches.

I don’t find that my diabetes affects my academic performance too much. If I go low or high in class, my teachers are always happy to let me eat something or bolus to correct my glucose. I am currently 4th in my grade, I was recently awarded the Best All Round Matric trophy and I’m the top senior public speaker too.

Next year, I’m moving to Stellenbosch to study environmental sciences. I’m really looking forward to this.

Diabetes camps

I have attended three diabetes camps; one as a camper and two as a leader. I absolutely love these camps and encourage every child with diabetes I meet to attend at least one. These camps not only equip kids with the practical and medical skills they need to live a full life with diabetes, but also instil a sense of belonging, showing kids that they are not alone in this very difficult journey.

Children get the chance to meet others with similar and different experiences, exchange stories and come up with new ideas and different approaches to the most common obstacles. These camps also show children that they can have a normal life and enjoy normal activities, they do not have to stop eating sweets or give up their favourite sports because of diabetes. I hope post COVID, camps will be able to happen again.

Supportive teachers 

My teachers were always patient, caring, and compassionate when it came to handling my diabetes. My Grade 00 teacher was particularly loving in helping me add up the amount of carbs I was planning on eating at lunchtime. I was always allowed to have a quick snack or go fill up my water bottle. Some teachers went as far as giving me nuts or fruit instead of cupcakes and biscuits when it was a birthday.

My Grade 2 teacher also has a child with diabetes and was involved in the diabetes support group my mom helped establish when I was a child. At the start of every year until I reached Grade 9, my mom met with the new teachers and chatted about my diabetes management. This was never a burden for them and they were always supportive. There have been other girls in my school with diabetes over the years, currently there are four of us in different grades. I’m always happy to chat to them if I can help them in any way.

I have heard stories of children being treated badly at school, by teachers and peers, because of their diabetes. I think more awareness is needed so that phrases like “you can’t eat that” and stigmas of diabetes being a result of an unhealthy lifestyle, are abolished.

Understanding friends

Most of my friends have been with me since preschool and have grown up knowing I have diabetes. When I explain the condition to people I have just met, I often use an analogy: the good soldiers in my body (my immune system) got confused and attacked their own castle (my pancreas) and destroyed it. Now it doesn’t work so I have to get insulin from this pump.

I also explain that it’s a genetic disease and there is nothing I could have done to avoid getting it. Nobody did anything wrong, my parents did not give me too many sweets when I was little. The condition was always in my DNA, it was only a matter of time before it activated.

I also say that I can live a completely normal life and do everyday activities like any other person. All I have do is simply be careful that my insulin covers my carbs, the correct amount and given in time. I need to be aware of the different effects of food and activity on my life.

Love of fruit

I absolutely love fruit, watermelon, pears, and oranges in particular. Whenever I have a sweet craving, I try to go for a fruit rather than a sugary snack. While sticking to a healthy diet is important, treats like KitKats or ice lollies are my go-to when I need something slightly less nutritious.

Good advice

For anyone that has just been diagnosed with diabetes, I would say the most important thing to remember is that life with this condition is a balancing act. It’s impossible to be perfect all the time and constantly have a blood glucose reading of 5,6 but luckily CGM has taught us if most of our readings are in the range of 4 to 10, overall control will be good.

But it’s normal and perfectly okay to miss the target range sometimes. The important thing is that we focus on the positives more than the negatives because that way we will see how well we are doing. Something I live by is, “Today I will do what others won’t do that tomorrow I can do what others can’t”.

Thea de Gruchy – Why I chose to become a DSA volunteer

Type 1 diabetes patient and postdoctoral research fellow, Thea de Gruchy, shares why she chose to become a Diabetes South Africa volunteer.


I was diagnosed with Type 1 diabetes on 26 December 1999. While the rest of the world was waiting to see what Y2K would mean for computers and alarm clocks, my family was anxiously trying to figure out how to adapt to life with a diabetic eight-year-old. My prevailing memory from this time was looking intently at the front pocket of my doctor’s coat, knowing that there was a lollipop in there and not quite understanding why I wasn’t getting it.

Interesting experiences

Since being diagnosed, I’ve had a lot of experiences that I’m sure people with diabetes all over the world share. The insulin pump rep who took the battery out of my pump even after I told her that whenever I took the battery out the whole pump resets, and who was then surprised when the whole pump reset.

The new GP I went to for a throat infection who told me my HbA1C wasn’t good enough, and then admitted that he hadn’t seen a patient with diabetes since the 90s.

The friend of a friend who told me not to eat a very delicious looking piece of cake at a birthday party. The barrage of messages every time there’s a newspaper article that talks about a ‘cure’ for Type 1 diabetes.

Limited access of care

Although I don’t believe the ‘there will be a cure in five years narrative’, I do feel incredibly lucky to be diabetic at a point in history where there are sufficient pharmacological and technological developments that enable me to live and enjoy a good quality of life. But I also know that although insulin has been around for 100 years, access to it, and other life-saving and life-improving tech and medicine, is limited to just a few of us.

Barriers to healthcare, in addition to the narratives around ‘deservingness’ that often permeate conversations about diabetes and terms like ‘co-morbidity’ or ‘underlying health conditions’ that have served to explain away the deaths of people with diabetes during the pandemic, are all completely unacceptable, but all completely accepted as part of how society operates and thinks about illness.

Pandemic has made me feel ‘diabetic’

Reflecting on her experiences with cancer, Susan Sontag famously wrote, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick. Although we all prefer to use only the good passport, sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” (Sontag, Illness as metaphor, 2002)

I’ve just turned thirty. So, I’ve now lived in the ‘kingdom of the sick’ for a lot longer than I ever lived in the ‘kingdom of the well.’ For most of my life, however, I’ve always understood myself as being well or healthy, just having diabetes. It’s only been more recently that I’ve started to understand that I don’t just live with diabetes as an added extra (another item on my to do list). But rather that diabetes is all-encompassing; an integral part of my life that affects everything I do, and which is affected by everything I do. Trying to get through the last two years of the pandemic has definitely made me feel diabetic in a way that nothing has before.

Offering help to DSA

This feeling prompted me to reach out to Diabetes South Africa (DSA) in early 2021 and ask if I could be of assistance in anyway. I reckoned that if I was feeling isolated and frustrated, others would be to, and I wanted to know if there was anything I could do.

People living with chronic illnesses, specifically diabetes, are often referred to as ‘patient experts’ in recognition of the amount of expertise and agency that goes into living with a chronic disease on a day-to-day basis. I was interested to know if there was anything I could do as both a patient expert and someone with professional expertise in understanding barriers to healthcare in South Africa. And I’m so glad that I did. I’m learning so much about diabetes and people living with diabetes in South Africa and supporting an organisation like DSA feels increasingly important in the current context.


Living with diabetes has definitely become a more important part of my identity as I’ve grown up. Learning to accept that diabetes does in fact define me and does create limitations has been an important step is figuring out how to live the life I want to and do the things I want to do with diabetes. Except for eating pizza. I gave up on that fight a long time ago.

Instead of seeing the things I do as a person with diabetes as a chore, I try (although not always successfully I must add) to see opting out of pizza, needing extra sleep or extra time to recover from a run, ensuring I always have extra meals in the freezer as reminders that “The fight is still going on, and I am still a part of it.” (Lorde, Cancer Journals, 2020).

Thea de Gruchy
Thea on a hike, her insulin pump is precariously attached to her shorts.


Thea de Gruchy is a postdoctoral research fellow at the African Centre for Migration and Society, Wits University, where she works on migration and health. She represents DSA on the NCD Alliance.

Jin Shin Jyutsu – Harmony in your hand

Noy Pullen educates us on Jin Shin Jyutsu and how it achieves harmony in your hand.

Ever really looked at your hands? The soft generous palm with four distinct fingers raying out: the pointer or index finger traditionally shows the way. It’s also known as the teacher, the prayer finger or even the pot-licker.

The expressive and powerful middle finger, or tall poplar, is often employed to gesture anger.

According to medieval belief, either a nerve or artery connected the ring finger to the heart which gave the finger a prominent role in medical practice. Doctors would use the ring finger when applying treatments. As a make-up artist, I have always done this unconsciously when applying any cream. Similarly, when applying any ointment to my family’s wounds. Our beauty therapy trainer said that it was the most delicate finger and would not pull the skin. This finger is called doctor finger, healing finger and heart finger. Because of its healing and pious reputation, our gentle ring finger is also known as the finger that no-one dares speak its name.

The amusing pinkie, so called for its diminutive size and because pink means ‘small’ in Dutch. This finger also bears the titles of youngest daughter or ear-finger for its ability to remove wax from the ear.

The dexterous opposable thumb gets its name from the word, tum, meaning swollen, being thicker, stronger and shorter (with only two joints instead of three) than the fingers. It’s also referred to as chief finger or grandfather, or even lice finger for obvious reasons.

The fingers are recognised for their roles in praying, hunting, healing, cursing, licking pots, and squashing pests.1 Our hands create the most beautiful works of art, a flourishing vegetable garden, a superb meal or they can soothe and comfort one in distress.

Harmony in your hand

We also shake hands, press our hands together or clap hands for communicating, for worship or contemplation, or cogitating walking slowly with hands clasped behind the back. We hold hands, interlock or press together for prayer, or even pressing down on the earth. Enjoying a relaxing head massage, both you and the one doing the massage, benefit from this gentle acupressure of the fingers.

Managing a difficult diagnosis

My integrative medical doctor, while discussing a serious diagnosis and the accompanying feelings with me demonstrated a simple yet effective technique called Jin Shin Jyutsu to practice when those debilitating companions – worry, fear, anger, sadness or apathy – threaten to overwhelm me. Everyone who has some difficult or tragic news has met these feelings.

Jin Shin Jyutsu (pronounced Jin Shin Jitsu)

This ancient healing art from Japan, Jin (meaning man of knowing and compassion) Shin (creator) Jyutsu (Art), translated into English might translate as The Creative Art of Harmony.

The idea is to hold each finger with all the fingers of the other hand wrapped gently around that finger for a few minutes until you feel a gentle pulse, breathing deeply. Repeat with each finger then to complete the process, press the palm of the hand with the thumb while supporting that palm with the other fingers. Repeat for the opposite hand.

This brings a sense of well-being to the whole body. You may wish to focus on one emotion. For example, fear, if it’s the over-riding emotion, wrapping and holding the appropriate finger till you feel the pulse together with the positive energy, peace of mind, in this case, washing over you. Repeat on the other hand.

Some practitioners take only the tip of the finger gently squeezed by the index finger and thumb of the other hand, ‘dripping’ the negative energy downwards towards the ground so it can ‘run out.’

The main dis-ease which focuses on each finger meridian

  • Thumb (earth) – worry (also stress, tension, headaches)
  • Index finger (water) – fear (addictions, back pain)
  • Middle finger (wood) – anger (impatience, indecision)
  • Ring finger (air) – sadness (grief depression, asthma)
  • Pinkie (fire) – low self-esteem (overwhelmed, anxiety, criticism)

Organs associated with each finger

Thumb – stomach, spleen, skin
Index finger – kidney, bladder, digestion
Middle finger – gall bladder, liver, blood
Ring finger – lung, large intestines
Pinkie – heart, small intestine, bone
Palm – diaphragm is a special harmonising point

A positive response is released after holding each finger:

Thumb – trust
Index finger – peace of mind
Middle finger – joy
Ring finger – comfort
Pinkie – truth
Palm – for nourishment and intuition

This gentle form of acupressure develops an awareness of the life force (energy body) within yourself and can bring harmony to your body and mind, also calming the spirit. Your hands can perform this healing art by addressing physical symptoms or latent emotions that could be hindering your own sense of well-being.

How to get your own Jin Shin Jyutsu vinyl mat

Agents for Change has developed a beautiful vinyl mat that you could paste up on a wall for easy access, or as a placemat or mousepad, to remind you of this valuable accessible method of creating harmony. Mine goes in my bathroom door as a regular reminder of how wisely we are created.

For your very own Jin Shin Jyutsu mat/s, contact Linoia Pullen 0722587132 [email protected] for any orders.




Please contact Noy Pullen if you would like more information: [email protected] or 072 258 7132.

DSA new logo

How to manage your medical aid

Jeannie Berg, pharmacist and diabetes nurse educator, offers good practical tips on how to manage your medical aid.

Healthcare has become hugely expensive. Even a minor operation can have you digging into your long-term savings. The high cost of hospital stays, specialist fees and other medical expenses (including medication) makes it important to have at least some form of medical cover: medical aid or medical insurance.

Let’s start off by differentiating between medical aid and medical insurance. Although, these terms are often used interchangeably, there are significant differences between them.

Medical aid

A medical aid scheme focusses on providing members with cover for expenses associated with necessary medical treatment. Members are often obliged to use healthcare specialists who belong to a provider’s network, and conditions rule which treatments are covered, but taking scheme tariffs into account, the amount you’re paid out will depend on what medical attention you need.

Medical insurance

Medical insurance, however, is intended to ensure that when you need funds for medical purposes, you receive a fixed lump sum. This amount won’t differ, regardless of the type of treatment that’s required or which healthcare providers you use. Here you would pay the health providers up front and the insurance will give you the agreed upon lump sum and you have to sort it out.

Governed strictly in SA

Both medical aid and medical insurances are governed very strictly in South Africa. All medical aid schemes are regulated by the Medical Schemes Act and governed by the Council for Medical Schemes. Medical insurance is regulated by the long-term insurance act and governed by the Financial Services Board.

By law, medical aid providers are required to provide prescribed minimum benefits (PMB) for a list of chronic disorders, such as asthma, cardiac conditions, diabetes, hypertension, etc. There are 26 conditions that are covered.

However, medical aids still decide what drugs are on their ‘essential drug list’ for a certain condition. If you use a drug for a condition that is not on this list, chances are that you might have to pay in full for it, or a bigger co-payment is required.

So, how do you manage your medical aid?

  • It’s like a bank account. You have a certain amount of “money” in it and you need to take care that you don’t waste it. You need to check all the claims that go through it.
  • Use your options carefully. Do you need to see a doctor, or can a pharmacist help you? Pharmacists are highly trained and many have done courses on primary healthcare. This means that they are able to help you with OTC medicine for conditions like sinus, colds and pain, without you having to see a doctor and use your doctor visits unnecessarily. Pharmacists are drug specialists. Many drugs have generic alternatives and are often priced at a fraction of the cost. Usually, medical schemes will pay in full for generic options. Generic medicine has the same active ingredient as the original brand, and should be just as effective with the same strength and dosage. Your pharmacist can guide you for the best generic options, especially if you are on chronic medication. If you do still insist on the original drug, you will have to pay some or all of it.
  • Gap cover is a good idea if you have any worries about potential co-payments. This cover could help avoid costly out-of-pocket in-hospital medical fees. Gap health insurance works with your medical plan to close in-hospital payment gaps if your medical aid benefits are exhausted. Some medical aids also offer Gap cover. It’s worthwhile looking into this.
  • Managed Care Benefits are offered by medical aids and it’s a good thing to look into this. These programmes typically help those who need to manage chronic conditions, such as diabetes, cancer, and HIV/AIDS. They are usually funded by your medical contribution’s risk portion and not from your savings account, meaning that you are getting the most from your benefits while receiving the medical care that you need.
  • Always ask questions. You are the client/patient and entitled to ask what you are unsure of.
  • If you need to be hospitalised for a routine procedure, ensure that the hospital and doctors are on your medical scheme list.
  • Ask your doctor or specialist how much they will charge and ask them to explain the bill in terms of your medical aid coverage. If your medical aid doesn’t cover enough of the doctor’s fee, ask him if he would be willing to negotiate a lower rate.
  • Ensure that you have obtained the necessary pre-authorisation for procedures and that the correct ICD-10 codes are being used.
  • Remember that you’re the owner of your medical aid “bank account”. Use it wisely. Check your statements to make sure that your funds are being well spent by yourself and your beneficiaries.
  • Don’t buy OTC medicine unnecessary, because your medical aid pays for it. Remember that when medical aids budget for the following year, they also take into consideration the spending trend of the patients. This affects your following year’s contribution.
  • Don’t do someone a favour by buying something on your medical aid. This is fraud and can get you into serious trouble.
  • The best you can do for yourself is to have a good medical aid that is right for your style of living. If you have many chronic complications, you need a more comprehensive plan. If you are young and healthy, you can opt for a lower plan. All plans include a hospital plan.

Looking after your health by having a good lifestyle, which includes healthy eating, stress management and exercise is already a great way to save on medical expenses.

Jeannie Berg


Jeannie Berg is a pharmacist and accredited diabetes educator. She served as Diabetes Education Society of South Africa (DESSA) chairperson for four years and was a committee member for many years and served on an advisory board for South African diabetes guidelines as well. She also does online tutoring in diabetes management for The University of South Wales.

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Kitchen makeover

Dietitian, Annica Rust, educates us on what to purge and what to stock up on while doing a kitchen makeover.

A kitchen makeover for a person with diabetes can be quite daunting. However, by going back to the basics and being able to read and understand food labels can assist when distinguishing between what is healthy and unhealthy foods. Incorporating label reading into your shopping routine will empower you to make the best, healthiest food choiceswhen purchasing groceries. Simply use the following steps to guide your decisions:

Step 1: Back to the basics

The makeover will set out to achieve the following health goals:

  • Improve glycaemic control
  • Improve and control cholesterol and blood pressure
  • Maintain a healthy body weight
  • Increase and reach required vitamin and mineral requirements

Kitchen makeover (adapted from SEMDSA guidelines)1

Food item to purge


To stock up on



Refined starches: white bread, white rice, white pasta, cereals (Corn Flakes, Rice Krispies).


Contains empty calories and has a high glycaemic index (GI) that leads to a poor glycaemic control. Wholegrain starches: corn, barley, pearl wheat, rolled oats, bulgur wheat, millet, spelt, quinoa, unrefined maize, wild/brown rice and wholegrain breads and cereals. Contain B vitamins, vitamin E and fibre that improvesglycaemic control and satiety.


Refined sugars: table sugar (any type of sugar), honey, sugar sweetened beverages, fruit juices, sweets, desserts and baked goods. Low nutrient content, high GI that leads to poor glycaemic control, increaseslipid profiles, obesity and inflammation.


Canned fruit in sugar.


High-GI that leads to a poor glycaemic control. Low-GI fresh fruit or canned fruit in juice. Lower in GI that improves glycaemic control.
Commercially hydrogenated fats: Commercially deep-fried foods, fast foods, and baked items.



Coconut and palm cornel oil.

Contains trans fatty acids that raise total and LDL (bad) cholesterol, decrease HDL (good) cholesterol and increase inflammation.



High in saturated fat.

Healthy fats: nuts and seeds, avocado pear, olives, plant oils (canola, olive, sunflower etc.).



Replacing saturated fatty acids with unsaturated fatty acids can reduce the risk of cardiovascular disease (CVD).


If alcohol is consumed, it should be in moderation: wine, spirits, beer etc.


A high intake aggravates blood pressure, triglycerides and glycaemic control.
Products high in sodium (salt) such as salt, spices, sauces, commercial stockand ready-madesoups. Increased blood pressure. Dried or fresh herbs, garlic, ginger, onion or vinegars. Low sodium content.


Legumes: soya beans, a variety of dry beans, lentils, split peas and chickpeas. Improves lipid profile, good source of fibre and protein.


Canned vegetables: gherkins, beetroot, onions, peppers.


High in sodium. Fresh fruit & vegetables.


Increase intake of fibre that enhance satiety, phytonutrients, vitamins and minerals that combat oxidative stress.
Full fat dairy products.


High in saturated fat.


Low-fat plain yoghurt and low-fat milk. Provide calcium and magnesium. Good source of protein with a low saturated fat content.


Ice cream.


High in saturated fat and has a high GI. Frozen ice lollies. Lower in saturated fat.


Processed meat (bacon, sausages, polonies & deli meats), full fat mince, chicken with skin, red meat. High content of salt, nitrates and saturated fat. Fatty fish: Fresh tuna, sardines, trout or salmon.

Lean meat: Extra lean meat, chicken breast and red meat (remove visible excess fat)

Low saturated fat content, good source of protein, omega 3-fatty acids, selenium, magnesium and vitamin D.

Step 2: Read the Food Label

Usually, the food label will be located on the back of the product under the heading: Typical Nutrition Information which is represented in a table format.

One of the most important things to remember when reading food labels is to look at the correct column. You will notice that the quantities of all the nutrients and the energy of a product are always listed in two columns: one being ‘per 100g’ (or ‘per 100ml’) and the other ‘per serving’. To accurately compare similar products, you need to look at the quantities listed in the ‘per 100g’ column. The ‘per serving’ column will list the respective quantities of nutrients and energy in accordance with the suggested serving size of the product which is usually set out by the manufacturers.

You can compare the labels of different food to the table below to decide whether a product is high, moderate or low in sugar, total fat, saturated fat and sodium. Foods that fall mainly in the high group should be rarely eaten or kept for special occasions whereas foods that fall mainly in the low group should be eaten as often as possible.

NUTRIENT                                          Per 100g Sugar Total Fat Saturated Fat Sodium (salt)
HIGH                                                      Avoid – eat occasionally > 15g > 20g > 5g > 600mg
MODERATE – eat seldom 5 – 15g 3 – 20g 1.5 – 5g 120 – 600mg
LOW                                                        Healthier option  –  eat often < 5g < 3g < 1.5g < 120mg
Dietary Fibre > 6 g per 100g

Step 3: Look out for the following logos on food items:


Food items with the ‘green’ mark are endorsed by the GI Foundation of South Africa which certifies that the product has a minimal effect on blood glucose, cholesterol and/or blood pressure levels. Low GI food list can be found on their website.2

Items with the Diabetes South Africa logo are approved products that are suitable for people with diabetes to consume.

Food with the heart logo is approved by the Heart and Stroke Foundation as part of a healthy eating plan. These food items are healthier and will have a lower salt content than similar food items.3

Knowledge is power. When in doubt, contact a registered dietitian for more information.


  1. SEMDSA Type 2 Diabetes Guidelines Expert Committee. JEMDSA 2017; 22(1)(Supplement 1): S2-S17
  2. GI Foundation:
  3. The heart and stoke foundation:


Annica Rust is a registered dietitian practicing at the Breast Care Unit in Netcare Milpark Hospital as well as in Bryanston. She assists with medical nutritional therapy for cancer prevention, treatment, survivorship and palliation. She gives individualised nutritional care to prevent or reverse nutrient deficiencies, nutrition-related side effects and malnutrition to maximise quality of life.

Header image by Adobe Stock