Emmanuel Rajah – My bestie

We hear why Emmanuel Rajah chose to volunteer at DSA and about his experience of sharing the role of caregiver to his younger brother, Joshua Mhlanga, who has Type 1 diabetes.


Emmanuel Rajah (30) lives in Parow Central, Cape Town. He plans to finish a Pharmacist Assistant Learnership Programme and would like to practice paramedicine. He is also a full-time international fashion model.

I call my younger brother, Joshua, my bestie. He will be turning 13 this year and is in Grade 7. When he was diagnosed with Type 1 diabetes, I had no knowledge of diabetes. It was a complete new chapter that we, my mother and I, had to adapt to. I was now not only his brother but my role changed to caregiver.

In the early days, I watched him cry when we administered his injections. It was in this time that I learnt to be strong for him and  would kindly remind him that checking his blood glucose levels is crucial, that if we check it, it will help to be well-managed and would help him to be and live happier just like a child without diabetes.

It was a difficult time for everyone in the family, as we all had to learn how to give the right dosage and learn more about what a balanced diet consists of.

Expressing my love for him

Being a caregiver to him was an opportunity of expressing my love for him and to provide him with full unconditional love that reassures him that he matters and that being different from other children is okay.

Some of the difficult times is when he is extremely energetic and at the same time frustrated. I try to teach him to practice patience. This is a time where he needs someone around that he trusts to calm him down and rejuvenate him.

The scary situations are when his glucose levels are extremely low and this shows in various body reactions. I have accepted that panicking is normal and stress levels starts to rise as we don’t want anything to happen. But thankfully through the years, I have learned to be calm and have faith.

We give him a couple of sweet treats or banana loaf with milk, and after 15 minutes we suddenly hear his loud voice and know he is okay. Sometimes when it’s too hot he falls asleep in the car; that is also a sign that his glucose is low.

Impact on my health

Joshua’s diagnosis has had a good impact on my own health. It was so much easier to follow a food plan. My love for food grew, and I focused on adopting a well-balanced diet. I learnt how to make different dishes tasty without meat and it helped me stay in shape.

Honestly, cooking became therapeutic for me and I healed from past traumas through cooking healthy meals for someone close to my heart.

DSA volunteer

Not only has my knowledge of diabetes grown due to my brother’s condition but I’m now assisting the diabetes community by volunteering at DSA Cape Town branch.

I assist wherever help is needed but the best description is office assistant. It’s an environment where teamwork is essential and I see it as an achievement that I can add to my service to humanity.

From being my bestie’s caregiver to becoming a caregiver to every member of DSA organisation, it takes a lot of courage, faith, consistency, and dedication to learn about diabetes and make an impact to the whole of South Africa where we have family, friends, loved ones, colleagues, and the list goes on, living with diabetes.

The National Manager of DSA, Margot Mc Cumisky, is a great mentor and one of the reasons why I love working at DSA. I’m proud to say I started the new Instagram account

We will also soon be releasing the 2023 T1 Youth warrior camp information. I will be a youth leader at the camp, and I work closely with Cain Tibbs and Robin Breedeveld in organising the camp.

Advice to caregivers

Diabetes is a condition that is just like any other sickness, it can be diagnosed without even expecting it. How you beat it, is based on a simple yet hard decision to make: what you eat. Everything you put in your mouth can either advance your longevity of life or rob you of the most precious time with your loved ones.

You can beat diabetes by carefully trying to practice and follow the suggested meal recipes available on diabetessa.org.za  and signing up for DSA’s monthly newsletters for more tips on how to beat diabetes. Drinking lots of water helps and constantly monitoring your glucose. It’s vital to understand how your body or your child’s body functions. The quicker you understand this, the better it becomes for monitoring and knowing the different symptoms they feel.

Healthy habits

For me, healthy habits means staying true to your journey. You are what you eat. It means exercise, being present in your day-to-day activities; meditate, be grateful, believe, and continue to allow yourself to experience the imagination of your creativity. Take it day by day. Be conscious of your thoughts and mind, and keep them directed on your goals.

You also must have a resilient mindset to stay disciplined to a routine of success. When you eat healthy, you feel healthy, when you talk healthy, you act healthy and your skin glows.

When you have created healthy habits within you, you spread healthy habits. Everything that is good is contagious; everyone around you will start following your habits and that creates an impact in the community.

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

MEET 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 [email protected]


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DSA represents Southern Africa Region

Margot Mc Cumisky was elected Vice President of Southern Africa Region, International Diabetes Federation. She tells us how this came about at the 2022 IDF World Diabetes Congress held in Lisbon, Portugal in December.


Diabetes South Africa (DSA) has been a member of the International Diabetes Federation (IDF), based in Belgium, for many years.

Every two years the IDF organises a World Diabetes Congress to which each member country is invited. Margot Mc Cumisky, DSA National Manager, was delegated to attend the IDF World Diabetes Congress 2022 held in Lisbon, Portugal. Lisbon is a beautiful city and Portugal is a lovely country that welcomed all the delegated representing diabetes organisations around the world.

The IDF World Diabetes Congress 2022 was attended by over 4 000 delegates from around the globe, consisting of professors, scientists, doctors and other health professionals, as well as patient organisations like DSA.

It was so interesting to hear the latest information on medication, diabetes devices, treatments and learn from other diabetes organisations and their activities.

Each part of the world is divided into regions and on the first day of the congress each region holds their regional congress. DSA falls under the IDF Africa Region and so all the representatives from all the countries in Africa held their annual regional congress.

At this regional congress, challenges, access to medication, patient outreach and reports on each country and member associations are discussed and many successful projects are adapted as we all learn from each other.

IDF Africa new incumbents

During the regional congress, voting takes place on the new incumbents, for the President of IDF Africa Region, and the President-elect who will take over from the President after two years.

President of Africa Region is Professor Jacko Abodo (Ivory Coast).

President-elect is Sister Elizabeth Denyoh (Ghana).

IDF Africa is divided into four regions: East, West, Central and Southern Africa. The voting then proceeds for the Vice President of each of these four regions. The results of these elections were as follows:

Vice Presidents for regions

Western Africa Region – Dr Ibrahim Nientao (Mali).

Eastern Africa Region –Dr Murthy Pillay (Seychelles).

Central African Region – Dr Davidson Nkwenti (Cameroon)

Southern Africa Region – Margot Mc Cumisky (South Africa)

The Southern Africa Region consists of:

  • Angola
  • Botswana
  • Lesotho
  • Malawi
  • Mozambique
  • Namibia
  • South Africa
  • Eswatini
  • Zambia
  • Zimbabwe
  • Madagascar

Focus and action plan for Africa region

The focus and action plan for the next two years will be:

  • To strengthen existing associations and assist with developing new diabetes associations in countries where there are none.
  • To create a network of health professionals specialising in diabetes in each country, both in public and private sectors for patients to have access to expert treatment.
  • To develop a Diabetes Registry – the first stage will be done in 2023 in French-speaking countries in Africa; followed by English-speaking countries in Africa in 2024.
  • To update and implement guidelines for Type 1 and Type 2 diabetes.
  • Training of peer educators.

Follow-up conference

A follow-up conference was held in Ivory Coast in February 2023 where the implementation of the action plan was discussed, and planning commenced.

Should any of our members have contacts in the Southern African countries with an interest in diabetes, your assistance would be greatly appreciated.


Contact: Margot Mc Cumisky Email: [email protected] 

Cell:  072 345 0086

Did you know?

In 2006 the World Diabetes Congress was hosted in Cape Town and DSA was part of the local organising committee. This congress was attended by 14 000 delegates from around the world and was an exciting time as it was the first World Diabetes Congress to be held in Africa. We did ourselves proud and many people still talk about how well-organised it was and how much they enjoyed attending.

Clint Baron – It is what it is

Four years into living with Type 2 diabetes, we hear how Clint Baron has adjusted to this diagnosis.


Clint Baron (56) lives in Johannesburg South, Gauteng with his wife. They have two adult children and two grandchildren.

Four years ago, in October 2019, Clint woke up in the morning with blurry vision, so he went to see his GP and was diagnosed with Type 2 diabetes.

Even though there is a history of diabetes in his family, with his grandmother and uncle having had it, his diagnosis still came as a shock to him. However, he says, “But there wasn’t much I could do but take the next steps to deal with it. It is what it is, so I had to accept it.”

The grandfather was prescribed vildagliptin, metformin, gliclazide and atorvastatin. He was surprised that the hospital plan that he is on covers chronic medication. “My medication was reassessed in March 2022 when my blood pressure went up but no other changes since then.”

Since being diagnosed, Clint has made small adjustments to his diet such as eating lots of green vegetables, changing to low-GI bread and he adds that he eats dinner a lot earlier than he used to.

He says that his family offers good support. “They all make sure I don’t eat chocolates and that includes my six-year-old grandson. Plus, my GP is awesome, and he too gives valuable support.”

Thankfully due to the nature of Clint’s work (he has an electrical fence business), he walks a lot with added physical activity. “I install electrical fences which requires me to be on and off the ladder, walking the length of the fences, etc.”

Healthy habits

When asked what healthy habits means to him, he responds by saying healthy breakfast, nibbles and dinner as fuelling the body in the correct way is important.

“I’m proud to say that most of the time my blood glucose levels are well-managed. However, stress is a big contributor to it fluctuating.I test once a day with a finger-prick test; but when my vision becomes blurry, I know I need to check it out,” Clint explains.

Thankfully, he hasn’t experienced any other diabetes complications other than needing glasses when using the computer.

He concludes by saying diabetes has taught him to make a change to his lifestyle, eat healthier, eat greener and make the most of life.

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

MEET 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 [email protected]


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Adrenal fatigue syndrome: myth or menace?

Dr Angela Murphy describes how the term adrenal fatigue syndrome came about and sets the facts straight about it.


What are adrenal glands?

The adrenal glands sit on top of each kidney, measuring 5cm x 31cm and weigh up to 10g. They produce hormones that are involved in the regulation of blood pressure, metabolism, immune function, and the body’s response to stress. These hormones are listed below.

  1. Cortisol is essential for processing carbohydrates, proteins, and fats, and also contributes to blood pressure control. It’s an important stress hormone as it helps to suppress inflammation and increase energy sources available for the body’s fight response. Cortisol levels are controlled by both the hypothalamus in the brain and the pituitary gland.
  2. Adrenalin and noradrenaline are our flight and fight hormones activated at times of stress. They cause an increase in heart rate, blood pressure and metabolism.
  3. Aldosterone is a hormone integral to water balance in the body and thus, blood pressure control.
  4. Androgen steroid hormones are weak male sex hormones that are precursors to either oestrogen which is then made in the ovaries and testosterone which is made in the testes.

Disorders of the adrenal glands

Various conditions can affect the adrenal glands and cause either over production of these hormones or a relative or absolute deficiency.

Overactive adrenal glands

  • Excess of cortisol – Cushing’s Syndrome
  • Excess of aldosterone – Conn’s Syndrome
  • Excess of adrenalin – Pheochromocytoma

Adrenal insufficiency

  • Addison’s disease – primary damage to the adrenal glands.
  • Secondary to pituitary disorders.
  • Congenital adrenal insufficiency – genetic.

Each of these conditions present with suggestive signs and symptoms that would be investigated and then treated appropriately.

Adrenal fatigue syndrome

Adrenal fatigue syndrome was first described by American chiropractor, James Wilson, in 2001. He proposed that the excessive stress of 21st century-living causes a progressive decline in adrenal function.

Dr Wilson lists a collection of symptoms that suggest the condition: fatigue, weakness, body aches, weight loss or gain, depressed mood and cravings are a few. He drew up a questionnaire, which can even be done at home, to assess these symptoms and confirm the diagnosis of adrenal fatigue. He then published a protocol of treatment for this condition consisting of four adrenal supplement formulations that he developed and sold.

Dr Ian Ross, South African endocrinologist and adrenal expert wrote, in 2018, in The South African Medical Journal that the cost of equivalent supplements in our own country is up to R1200 per month.*

There are no confirmed diagnostic tests or evaluations for adrenal fatigue syndrome. No endocrine society has endorsed the term adrenal fatigue syndrome. In addition, no scientific study has proven that patients with symptoms of adrenal fatigue syndrome have biochemically impaired adrenal function.

The Endocrine Society of the USA, among others, has issued a warning that the adrenal fatigue syndrome doesn’t exist. However, the symptoms that people present with do exist and it’s important to diagnose what the cause of these symptoms may be.

The following are conditions which may present with a similar spectrum of symptoms as adrenal fatigue syndrome:

  1. Chronic fatigue syndrome

This complex condition, also known as myalgic encephalomyelitis, is characterised by severe fatigue that is not improved by rest and is significantly worsened by exercise. Associated symptoms such as muscle pains, recurrent infections and poor concentration also occur.

This is a clinical diagnosis made once other possible conditions are excluded, e.g. thyroid disease, primary adrenal insufficiency, anaemia and sleep disorders. In many cases there is also evidence of a mood disorder such as depression or post-traumatic stress disorder.

It’s thought to be caused by a variety of triggers on the background of genetic susceptibility. The most common triggers are infections, particularly viral, and trauma which can be physical or emotional. There has been a significant increase in cases after COVID-19 with many overlap features with long COVID. Chronic fatigue syndrome is treated with a combination of medication, psychotherapy, and lifestyle.

  1. Mood disorder

Depression, anxiety, post-traumatic stress disorder and burnout are all conditions with overlapping symptoms. These can be diagnosed clinically, and the correct management prescribed.

  1. Menopause

In women, many of the symptoms being discussed such as fatigue and weight gain occur at menopause (a time when the ovaries are no longer producing oestrogen). Oestrogen replacement therapy can be extremely effective in treating the symptoms. The choice of therapy must be discussed with your healthcare provider.

  1. Andropause

Men can experience low testosterone levels although this doesn’t occur as definitively as menopause. Risks for low testosterone include obesity and metabolic diseases such as diabetes. Testosterone replacement therapy is an effective option in relieving symptoms in men with biochemically low testosterone levels.

  1. Thyroid disease

Both under and overactive thyroid disease can cause symptoms as described in adrenal fatigue syndrome and should be tested for.

  1. Sleep disorders

The most common one we see is obstructive sleep apnoea. This is diagnosed by doing an overnight sleep study. If present, people are prescribed a CPAP machine which delivers air under increased pressure. It’s sometimes necessary to refer a person to the sleep specialist for a full overnight sleep study.

Management of the symptoms associated with adrenal fatigue syndrome

If a specific condition is found, this must be treated. In most cases, there will be significant benefit adding a healthy lifestyle as well. A healthy lifestyle incorporates:

  • Healthy diet including all food groups and especially fruit and vegetables.
  • Regular exercise – aim for 150 minutes per week.
  • Maintain a healthy weight.
  • Get a good night’s sleep.
  • Stop smoking.
  • Keep alcohol intake to safe values: 2 units daily for a woman; 3 units daily for a man.
  • Stress management – this can be done with medication and/therapy.

Summary

As Dr Ian Ross and colleagues wrote in the 2018 article, * “Until there is objective, reproduceable clinical evidence for its diagnosis, adrenal fatigue does not exist, and patients should be appropriately investigated and managed for their symptoms.”

Most of the symptoms ascribed to adrenal fatigue syndrome are non-specific. It is thus, essential for the healthcare provider to take a detailed history, perform a thorough examination and order appropriate laboratory tests. A working diagnosis of the likely cause of the symptoms should always be made. In this way an appropriate treatment plan can be prescribed with the aim of alleviating the symptoms.


Reference

*We are tired of ‘adrenal fatigue’ | Ross | South African Medical Journal (samj.org.za)

Dr Angela Murphy qualified as a specialist physician in 2000 and joined the Department of Endocrinology and Metabolism at Charlotte Maxeke Johannesburg Academic Hospital. Currently she sees patients at Sunward Park Medical Centre. She retains a special interest in endocrinology and a large part of her practice is diabetes and obesity. She is a member of the Society of Endocrinology and Metabolism of South Africa and the National Osteoporosis Foundation and is actively involved in diabetes patient education. Living with diabetes in the family for 17 years has shown her that knowledge is power. Basic principles in diabetes must always be applied but people living with diabetes should also be introduced to innovations in treatment and technology which may help their diabetes journey.

MEET THE EXPERT


Dr Angela Murphy qualified as a specialist physician in 2000 and joined the Department of Endocrinology and Metabolism at Charlotte Maxeke Johannesburg Academic Hospital. Currently she sees patients at Sunward Park Medical Centre. She retains a special interest in endocrinology and a large part of her practice is diabetes and obesity. She is a member of the Society of Endocrinology and Metabolism of South Africa and the National Osteoporosis Foundation and is actively involved in diabetes patient education. Living with diabetes in the family for 17 years has shown her that knowledge is power. Basic principles in diabetes must always be applied but people living with diabetes should also be introduced to innovations in treatment and technology which may help their diabetes journey.


Header image by Adobe Stock

Connect for diabetes coaching

Did you know you can get personalised diabetes coaching with Accu-Chek Instant and the mySugr app?

Dedicated support from experienced diabetes care and education specialists.


Connect your Accu-Chek Instant meter to the mySugr app and activate the mySugr Coaching Bundle. You can count on an experienced mySugr diabetes care and education specialist for just the right balance of motivation and support-based on the information you choose to share.

In our last post, we covered the significance of tracking your blood glucose levels and how a tool like the mySugr app may help.

Personalised diabetes coaching is another element of the mySugr app (PRO version*). If you have enrolled in the mySugr Coaching Bundle, you can reach out to your diabetes coach through the mySugr app anytime, anywhere. It’s as simple as the tap of a finger.

Ask all the questions you have about your diabetes and your coach will dive into your data. Within a single business day, your coach will reply with some feedback and ideas about your questions or problem areas. Together, you’ll work on your diabetes management and any goals you want to set for yourself.

Getting started is as easy as tapping Coach in the side menu and sending messages back and forth. You can even ask what type of information would be helpful to log.

Great starter questions

Here are some great starter questions for you to ask:

  • I was just diagnosed with diabetes, where should I start?
  • What is the goal for my blood glucose levels?
  • I want to work on my diet, can you help me?
  • My blood glucose levels are always higher in the morning, why does this happen?
  • My doctor told me I have Type 2 diabetes, how is this different from Type 1?
  • I just started taking insulin and I’m a little scared. Why do I need to take it?
  • I know exercise is good for me, but I always dread it. How can I make it more enjoyable?
  • My doctor told me I need to watch my carb intake. What foods have carbs?
  • Why are my blood glucose levels always high after I eat?
  • I’m trying to lose weight, but it’s been really hard. Can we talk about diabetes and weight loss?

And just like that, you are on your way. Your diabetes coach will take a look at your question, analyse your information, and pull together a detailed reply just for you. You’ll get a notification when you have a new message. You can go back and forth with your coach as often as you like, and you can ask your coach for help as often as you want to.

Please note: The Coach service is not proactive, meaning that they do not look into your data unless you reach out to them. Your privacy is our top priority, and we want to maintain that even though your data is available to the Coaches when you enrol.

*Accu-Chek Instant users get a free upgrade to mySugr PRO.

For a limited time, the mySugr Coaching Bundle is available for free.  Sign up for a mySugr Coaching Bundle voucher today. Scan the QR code or visit rdiabetescare.com/mysugrcoach/ to get started.

T’s and C’s Apply.

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

 

 

 

To check if your mobile device is compatible with the mySugr app, please contact our customer support team. For more information, contact your healthcare professional.

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

Ways to lighten your mental load

Monique Marais says balance is the key when managing your mental load and offers practical tips to achieve this.


There are many techniques and opinions on how to manage mental load, but only you are the true expert on yourself. You need to start by knowing yourself: what works for you, what motivates you, and why it’s important to you to manage your mental health. This is often complicated, if you’ve multiple aspects to juggle, including work life, children, relationships, socialising and health. The key is balance. 

Here are some ideas on how to manage your mental load and the balance in your life:

  1. Be true to yourself – Know yourself well enough to know if someone’s suggestion isn’t going to work for you, but also be open to trying new things.
  2. Be willing – The first step is to admit that you want to change certain aspects, or even just the focus of your attention and then commit to the process.
  3. Educate yourself – Knowledge is power. Once you have identified an area which you would want to work on, read up on the topic, find out what the experts say, as well as connecting with people in similar situations and learning from their experiences.
  4. Know that you are unique – What works for one person, won’t necessarily work for you. Do regular introspection to investigate if your plan of action to maintain your mental health is effective and achieving the goals you would set out to achieve.
  5. Know when to move on – Sometimes you can try something, and because you’re committed, you want to see it through, but it isn’t always helpful, and you need to know when to quit when you’re ahead.
  6. Exercise – This doesn’t always mean going to the gym seven days a week, doing rigorous exercise, it might just mean becoming more active. This can include walking, spending time outdoors, or taking up a new sport you can invest in, and you can gradually increase the intensity as you progress.
  7. Setting realistic goals – You know what is practical, achievable and at the same time, what will still challenge you. Set small, achievable goals, and adapt your goals as you continue your journey.

Practical tips

  1. Mindfulness – Spend time daily/weekly to review how your week went, identify what you did well, where you can improve and where you have grown.
  2. Connect with resources – Know who the right person is to ask about a specific question you have (and know who you should avoid).
  3. Identify one thing you enjoy doing – This can be reading, walking with your dog, spending time with family. Commit to doing it at regular intervals.
  4. Positive affirmation – If you have a negative thought about yourself (for example: to stick to your diet or healthy eating choices), counter it by giving yourself positive feedback and name two things you do well.
  5. Peer support – Identify a person in your community (either a family member, friend or colleague) that has the same aspirations or goals you have and support each other.
Monique Marais is a registered social worker at Care@Midstream sub-acute, specialising in physical rehabilitation for the past 11 years. She has a passion for the medical field and assisting people to understand and manage their diagnoses and the impact on their bio-psychosocial well-being.

MEET THE EXPERT


Monique Marais is a registered social worker at Care@Midstream Sub Acute, specialising in physical rehabilitation for the past 11 years. She has a passion for the medical field and assisting people to understand and manage their diagnoses and the impact on their bio-psychosocial well-being.


Header image by FreePik

Influenza vaccination: the great debate

There is always a debate regarding whether you should receive a yearly influenza vaccine. Dr Theresa Coetzer and Monique Marais highlight the facts, myths and why it’s of benefit for people with diabetes.


The biggest myth

Most people have repeatedly heard some people say, “After receiving my influenza vaccination I became so ill; it took weeks to get over it. I’ll never be vaccinated again. It causes infection, it doesn’t prevent it!”

This is a myth, although it’s extremely difficult to convince those who firmly believe this myth. The fact is, the vaccine is made from dead virus material, and doesn’t have the ability to cause active influenza infection. There are other reasons people become ill after vaccination.

Why should you be vaccinated?

Everyone, especially people living with diabetes, can become extremely ill from influenza. Diabetes affects your immune system, as well as causes damage to organs like kidneys, heart, nervous system, etc. Due to this, the risk of severe complications accompanying influenzas are extremely high.

It’s always better to prevent disease than cure it. Complications, such as viral pneumonia, can lead to hospital, and most likely ICU admission.

Who should be vaccinated?

Everybody should be vaccinated yearly against influenza, but especially people with compromised immune systems, like those with diabetes.

Elderly people with comorbidities, such as cardiovascular or renal impairment, are even more at risk for serious complications accompanying influenza infections.

Another group we forget about is young children. Every mother knows that once your child starts nursery school, you’re constantly in your GP’s office with one upper respiratory tract infection after another.

The elderly, and the population with diabetes can easily contract influenza this way. Everybody in the family thus needs to be vaccinated to allow herd immunity to develop. Your family and your community will certainly reap the benefits of something as simple, as a yearly flu shot.

When should you get your shot?

It’s recommended that you get the newest flu vaccine yearly as soon as it becomes available; normally this is early autumn in South Africa.

Because viruses mutate, and new viruses constantly appear, the vaccine is adapted yearly to cover the three or four most virulent strains. This is the reason everyone needs a yearly vaccine, and not just a once-off.

The benefit of receiving it yearly, is that you maintain immunity to certain viruses that don’t form part of that year’s vaccine.

Advantages of vaccination

The vaccine doesn’t make you immune to influenza, you might still become infected, especially if it’s from a virus that doesn’t form part of that year’s vaccine, but by having some immunity, the severity of an influenza infection will be reduced, as well as possible complications like pneumonia.

You can’t always prevent contracting an infection, but with excellent control of diabetes, target organ damage can be prevented, and this leads to better immunity and other health benefits. Patients with diabetes need to be proactive in controlling their disease and complications that can accompany serious illness, like influenza.

Possible side effects

The vaccine will stimulate your immune system to form antibodies. It takes about two weeks, and during this time you can still be infected and become ill from influenza.

During the period of forming antibodies, you can have side effects. The most common side effects are tenderness around the injection site, and then symptoms like fever, headache, general body pains and nausea.

Allergic reactions are uncommon, but possible. If you’ve serious allergies, discuss them with your GP before receiving the vaccine.

Pregnant women can get vaccinated but discuss it with your gynaecologist to be certain. Antibodies can be transferred to the foetus, as well through breastfeeding, and this is a great benefit to your tiny bundle of joy.

The COVID-19 pandemic has taught us all valuable lessons. Vaccines work; the amazing worldwide vaccination programme allowed us to return to our normal way of living.

One very crucial fact we can’t ever forget is: prevent getting affected. Vaccines are effective and is strongly advised but remember the wonderful habits we learned with COVID: sanitise your hands and wear a mask if you feel you need protection.

Knowledge is power. Make informed decisions, based on clinical and scientific information to keep yourself and your loved ones safe.


References

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/flu-jab

https://pubmed.ncbi.nlm.nih.gov/28807608/

Monique Marais is a registered social worker at Care@Midstream sub-acute, specialising in physical rehabilitation for the past 11 years. She has a passion for the medical field and assisting people to understand and manage their diagnoses and the impact on their bio-psychosocial well-being.

MEET THE EXPERT


Monique Marais is a registered social worker at Care@Midstream Sub Acute, specialising in physical rehabilitation for the past 11 years. She has a passion for the medical field and assisting people to understand and manage their diagnoses and the impact on their bio-psychosocial well-being.


DR THERESA COETZER

MEET THE EXPERT


Dr Theresa Coetzer is a general practitioner at the ClaytonCare Group, specialising in the treatment of medical complex patients in the physical rehabilitation field. She has a passion for people and ensuring the best possible medical outcome for her patients.


Header image by FreePik
Influenza vaccinations: the great debate

DSA News Autumn 2023

– DSA Port Elizabeth News –

Aveng Trident Steel Wellness Day

Although no Diabetes Wellness meetings were held during December and January, DSA Port Elizabeth branch was invited to attend the Long Service Awards Ceremony and Annual Wellness Day at Aveng Trident Steel PE branch on 2 December 2022.

Thank you aQuellé

We thank aQuellé for sponsoring DSA memberships for new members. aQuellé supplied the bags, bottles of water and an information pamphlet, as well as paying the membership fees. Other items in the bag included: FOR A glucometers, mohair socks from Cape Mohair, Diabetes Focus A to Z booklets plus other literature, and special savings offer from SpecSavers.

First Diabetes Wellness meeting for 2023

The first Diabetes Wellness meeting for this year was held on the evening of 8 February. Lisa Luckman, a biokineticist, encouraged us to enjoy a healthy lifestyle in her presentation: Great ways to create a healthy lifestyle in 2023.

We started in the soft light of candles and lanterns until load shedding ended at 8pm. Then we had to endure the harsh lights again, but we also had the benefit of the many ceiling fans.

Making 2023 a healthy lifestyle year

Lisa Luckman gives a biokineticist’s perspective of making this year all about living a healthy lifestyle.


With it being a new year, surely most of you have made a goal list? How many of these goals are part of making 2023 a healthy lifestyle year?

Do you know the attributes of good goal setting? The simple word SMART is a popular acronym in assisting when wanting to create a sustainable goal.

S – Specific: Is your goal detailed and distinct enough, with no ambiguity?

M – Measurable: Does your goal have quantifying characteristics?

A – Achievable: Is your goal possible to achieve?

R – Realistic: Is your goal within reach?

T – Timely: Does your goal specify a time by which you want to achieve it?

These are all attributes that can assist in setting you up for successful outcomes to achieve a healthy lifestyle.

Set yourself up for success

When it comes to your health and well-being, you want to create sustainable lifestyle changes that will benefit you for years to come. So, how do you set yourself up for success?

Some tips that may work include:

  • Focus on implementing one change or new habit at a time to avoid feeling overwhelmed.
  • Make the new change simple and easy to allow it to be achievable.
  • Use an obvious clue as a reminder throughout your day to reinforce the new habit, such as, placing the water bottle in a place where you walk by often so that every time you do so, you’re reminded to drink some water.
  • Remind yourself that it’s okay to restart anytime you may have fallen off the routine.
  • Build discipline within yourself, as intrinsic motivation may be swayed from time to time.
  • Join a community with similar goals where others may assist in maintaining your accountability, but also provide motivation.

Sit less and move more

If you’re short of health and wellness goals, sit less and move more is a great starting point.

 According to the World Health Organization (WHO), “Insufficient physical activity is the fourth leading risk factor of death.” This is astounding because your degree of daily movement is something that you have direct control over.

 WHO goes on to say, “People who are insufficiently physically active have a 20% to 30% increased risk of all-cause mortality compared to those who engage in the minimum recommended amount of movement per week.”

What is the minimum recommended amount of exercise per week? Thirty minutes of aerobic and resistance activity performed five days per week at moderate intensity.

Moderate intensity is easily defined by the ability to maintain a conversation while being active. This shows that there’s no need to be huffing and puffing, but rather movement at a level that is possibly more enjoyable, thus creating a sustainable routine.

There’s always a way to move and there’s always a way to modify

Two of my favourite sayings are: there’s always a way to move and there’s always a way to modify. Being a biokineticist, I have become a problem solver, finding a solution to a perceived excuse or obstacle as to why one can’t move.

No gym membership? You’ve got your home, backyard, suburb streets or park.

No weights? You’ve possibly got water bottles or canned food, never mind your own body weight as a constant weight; use that.

Using your environment and what you have with some creativity, I guarantee there are many ways to move.

Is your perceived excuse that you’re bedridden, wheelchair or homebound? There are entire exercise routines to these specific restrictions which can be prescribed by biokineticists. There are ways to move no matter what your limitations are; meaningful movement is possible for everyone.

If you’re able to join a community or find a physical activity that you enjoy, your chances of creating a sustainable lifestyle change drastically improves.

Easy ways to move

Here are simple ways you can incorporate the recommended minimum of 30 minutes of activity per day.

  • Playing with kids is a great way to keep moving.
  • Enjoy a dance party alone or with some company.
  • Take the stairs, and park further away from the shop entrance
  • Catch up with a friend while walking instead of sitting down for coffee.
  • Doggy meet-ups at a park.
  • Skip or hula hoop.
  • Deep clean your home or garden.

One bite/step at a time to a healthy lifestyle

With a list of goals, you may be inclined to feel overwhelmed before starting. However, small steps lead to great results, just start. The catchphrase How do you eat an elephant? One bite at a time has so much truth to it.

As a biokineticist in the medical profession, I often use the strategies above to motivate the clients in my care to move more, no matter what that looks like to them. With disability comes ability. The main focus of biokinetics is to assist you in improving your quality of life and well-being through movement.

Remember to show yourself kindness as you start and potentially restart your sustainable healthy lifestyle changes.

Lisa Luckman has been in private practice since 2018. This is where she found her love for helping others who are homebound, bedbound or wheelchair-bound, and giving them equal movement opportunities to those who can freely attend gyms or therapists for health and wellness assistance.

MEET THE EXPERT


Lisa Luckman has been in private practice since 2018. This is where she found her love for helping others who are homebound, bedbound or wheelchair-bound, and giving them equal movement opportunities to those who can freely attend gyms or therapists for health and wellness assistance. Follow her on Facebook

Header image by FreePik

Are you aware of insulin shock?

Diabetes nurse educator, Kate Bristow, educates us on what insulin shock is, the causes and how to spot it before it leads to hypoglycaemia.


What is insulin shock?

Insulin shock is caused by having too much insulin in your bloodstream. It can lead to hypoglycaemia (low blood glucose).

It can happen if you:

  • Ignore the signs of an early hypoglycaemic event.
  • Mistakenly take too much insulin.
  • Miss meals or eat too little to cover the insulin dose (fasting).
  • Do more exercise than usual and have not eaten enough carbohydrate (CHO) to cover the exercise or changes to a new exercise routine.
  • Drink alcohol without eating any, or enough food.
  • Have hypoglycaemic unawareness which can happen sometimes if you have had diabetes a long time. In other words, you don’t feel the low coming on.
  • Are unwell.
  • Are working so hard at managing your diabetes well (but don’t ever stop working at this).

Insulin shock is a diabetic emergency and can lead to diabetic coma, brain damage and even death.

How does it happen?

Insulin is normally made in the pancreas and is a necessary ingredient to allow the glucose in the bloodstream to enter the cells.  In someone without diabetes, the body does this automatically without you knowing about it, but in people with diabetes, it’s your job to give your body just the right amount of insulin to move the glucose from the bloodstream to your cells where it gives you the energy to function. Tough job, right?

Remember glucose is fuel for the body. If you have too much insulin in your system or you have done more physical activity and used up more of your glucose store, or perhaps not eaten enough carbs to cover the insulin you have injected, you may have a low or a hypo.

How do you recognise the signs of insulin shock?

If your blood glucose drops just a bit below normal (4mmol/L), your symptoms may be mild (Mild hypoglycaemia)

  • Dizziness
  • Shaking
  • Sweating or a clammy feeling
  • Hunger
  • Anxiety
  • Irritability
  • A rapid pulse

This is where normally you can reverse the symptoms using the 15/15 rule.

  • Have 15g quick-acting CHO (sugar, sweets, Coke, or fruit juice).
  • Have a small healthy snack to help your body recover.
  • After 15 minutes test your blood glucose again to see if it has improved.
  • If it still has not increased, then have another 15g of quick-acting CHO.
  • Keep testing until your blood glucose has stabilised.

A blood glucose level that is dropping fast can also cause:

  • Headaches
  • Confusion
  • Fainting
  • Tripping, falling and lack of coordination
  • Muscle tremors and seizures
  • Possible coma
  • If it happens when you are asleep, it may also manifest as nightmares, crying out in your sleep or waking with sweating and confusion and possible aggression.

How do we treat insulin shock?

  • If the person is experiencing the symptoms above, treat with the 15/15 rule.
  • But if they are unconscious, call emergency services immediately.
  • Don’t give an unconscious person something by mouth as they may choke.
  • Administer glucagon if you have it available. If not, the emergency response team will have some.

How to stop insulin shock from occurring?

Prevention is always better than cure. So, always carry a hypo kit with you so you can respond immediately if your blood glucose dips too low. Your hypo kit should include your test meter, some quick-acting CHO as well as a longer-acting snack in case you are out and about (Futurelife High Protein Bars or a piece of fruit are good options).

Eat after taking your insulin and work to count carbs correctly so you don’t give too much insulin.

If exercising, you may need to adjust your insulin dose before and after the session. Discuss how to do this with your diabetes team, doctor or diabetes nurse educator.

Be cautious when drinking alcohol.

Test your blood glucose often; a continual glucose monitor (CGM) can be useful too.

Test your blood glucose levels before you drive or operate heavy machinery.

Teach your family and friends about hypoglycaemia and how to help you fix it should it occur.

Always have a glucagon injection available.

Wear a medic alert identification; ICE medical bracelets have a great range to choose from.

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

MEET THE EXPERT


Kate Bristow is a qualified nursing sister and certified diabetes educator. She currently runs a Centre for Diabetes from rooms in Pietermaritzburg, providing the network support required for the patients who are members on the diabetes management programme. She also helps patients who are not affiliated to a diabetes management programme on a private individual consultation basis, providing on-going assistance and education to assist them with their self-management of their diabetes.


Header image by FreePik