Category: Awareness

Label lingo

Learning label lingo

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Christine Manga, a diabetes nurse educator, upskills your label lingo so you know what to look out for when buying food items.

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

Look familiar? Sugar-free, low-fat, healthy, lite, natural, low kilojoule, free range, and the list goes on. This is just on the front of food packages then there is a mound of information on the back as well.

Companies use these slogans and phrases to make you believe that their food is healthy, better than other brands, good for you, and will give you everlasting energy. It’s called marketing. A number of these claims have some truth in them but can be very misleading, confusing, and have even been known to be unsubstantiated. Do not rely on the front of the package only. The back nutritional label and ingredient list are far more informative.

Why is it important to be able to read and understand food labels?

Well, labels give information allowing you to make informed, healthier food choices that will impact not only on glucose management but weight, cholesterol, and overall health. It empowers you, the consumer.

Nutritional label and ingredients

One of the main nutrients people living with diabetes need to be aware of is carbohydrates. These are the nutrients that cause elevation of blood glucose levels. This is not a bad thing. A carbohydrate (carb) is a sugar molecule made-up of starch, sugar, and fibre. These will be converted into glucose as energy for the body.

Fibre is a non-digestible carbohydrate and therefore has no effect on blood glucose levels. As a matter of fact, if the fibre content is >5grams this can be subtracted from the total carbohydrate amount. The more fibre, the better. It’s the total amount of glycaemic carbohydrates/carbohydrates to be considered when making food choices, not the sugar content.

Key pointers

Whilst perusing the nutrition label and ingredients there are key pointers to keep an eye on.

Serving size

On a nutrition label, there are usually two columns showing nutritional information, one for 100g and one for an individual serving of the product. The product package size is not necessarily the serving size. If a package says low kilojoule, it may be because the serving size listed is very small and unlikely that someone would only have a single serving.

As a South African, you surely know Romany Cream biscuits. The serving size is two biscuits. There are very few people I know who only have two biscuits. The small jelly sweets or gums sold in 75g bags are in fact three servings of 25g each. So, in future, please remember the packet should be spread over three days.

A certain South African brand of flavoured water contains 4g of carbohydrates per 100ml and 62,76kJ. That means 20g of carbohydrates and 313.8kJ per bottle of water.

The label may list that you will be eating a certain percentage of a daily recommended amount of nutrients or kilojoules based on an 8368kJ diet. Remember to multiply by number of servings. Not everyone should be consuming 8368kJ a day.

Ingredients

Ingredients are listed in descending order by weight, meaning the first ingredient is the largest amount of the product. Some foods have a boundless list of ingredients.

It’s safe to say, the fewer ingredients, the more natural and less modified a food is. If a product claims to be whole wheat, then whole wheat must be the first ingredient listed. Anything on the ingredient list means it has been added in the production of the food item.

“Sweets for my sweet, sugar for my honey” come in many disguises. Sucrose, corn syrup, fructose, maple syrup, molasses, and nectar are all forms of sugar. The list of sugars is endless. The names of many sugars end in -ose.

Caffeine can also be masked in the ingredient list. Guarana commonly used in energy drinks is high in caffeine, but it’s not always added to the total caffeine amount.

Ingredients necessary to give colour, thickness, anti-caking agents, gelling, and preservatives are some food additives categorised by E numbers. E249 – E250 indicate the use of nitrites. The less of these consumed, the better.

Substitutes

Manufacturers want their food to taste good and appear healthy. This can be done by using substitutes so that the labels low-fat or sugar-free can be used. These claims may be true, but to replace the sugar and fat, other ingredients are added to maintain flavour, very often salt or sugar (to low-fat).

Checking salt (Na) is important as this should be avoided in people with hypertension. Sugar substitutes and artificial sweeteners have been linked to an increase in appetite in some studies. This defeats the object.

Laws

International laws are changing to make labels more user friendly and less misleading. Traffic light colour coding is currently used in the UK. Red means high, amber means medium, and green means low. These are for fat, saturated fat, sugar, and salt. This system allows you to see at a glance which is a healthier option. Helpful for people with low numeracy and literacy

In 2023, the South African Department of Health drafted new restrictions on food marketing, food labelling, and health claims on packaged food and drink. Hopefully, it will be law soon. In our multi-cultural country with eleven official languages, it’s sad that our food labels are written in English only.

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

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

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Whipple procedure

How does a Whipple procedure cause diabetes?

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Meagan Achteson, a dietitian, explains how diabetes develops after a Whipple procedure and offers guidelines to healthy eating thereafter.

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

During a Whipple procedure (pancreaticoduodenectomy), the following are removed: part of the stomach, the small bowel (duodenum), the head of the pancreas, the lower end of the bile duct, and the gallbladder.

After these organs are removed, the surgeon attaches the remaining pancreas, bile duct, and stomach to the intestine. This allows pancreatic juice, bile, and food to flow back into the gut, so that digestion can happen normally.

This surgery normally lasts between four to eight hours. The procedure is used to completely remove pancreatic cancer and give you the best outcome. This lowers the chance of the cancer coming back. However, the chance of the cancer coming back also depends on the type of tumour that you have and stage of the cancer.

Type 3c diabetes

If you’ve had a Whipple procedure to remove pancreatic cancer, you’ll most likely develop Type 3c diabetes (a type of diabetes caused by damage to the pancreas that isn’t autoimmune which affects its ability to produce insulin).

You may also need to take pancreatic enzymes to digest food and insulin or oral medication to control your blood glucose levels.

After surgery, you’ll have to be on a fat-free diet for some time, but you’ll be able to gradually increase healthy fats. Talk to your surgeon and dietitian.

After you’ve recovered from surgery, you may find that your appetite improves and you start to put on weight and get stronger.

It’s recommended to adopt a healthy balanced diet that keeps your blood glucose level in your target range and helps keep you well.

Eating well with Type 3c diabetes 

The aim is to follow a diet that you enjoy that keeps your blood glucose levels stable. Please note: this advice is only for people who are a healthy weight.

  • Aim to have three meals a day with two snacks in between.
  • Don’t skip meals.
  • Cut out added sugars and avoid chocolates, biscuits, sweets, fruit juice, etc.
  • Aim to have at least two fruits and three portions of colourful vegetables a day.
  • When you use fat, use olive-, avocado oil, sugar-free nut butters rather than animal fats, such as butter, lard, or ghee.
  • Eat regular portions of oily fish. Aim for one to two portions each week.
  • Use small amounts of unsalted nuts and seeds as snacks or as part of a meal.
  • Have protein in each of your main meals. Food containing protein include beans, pulses, nuts, seeds, tofu, soya, meat, fish, dairy, and eggs. Eat fruits with a protein (like plain yoghurt) as a snack.
  • Read the nutritional information on packaged foods. Aim for foods that have low or medium levels of sugar, fat, and salt.
  • If you take pancreatic enzymes, make sure you take these when you eat.
  • If you take oral tablets or insulin to manage Type 3c diabetes, make sure you take these as recommended.
  • If you’re struggling with your weight, appetite or blood glucose levels, please see a registered dietitian as soon as possible to help with a meal plan that is individualised to you and your needs.

MEET THE EXPERT

Meagan Atcheson is a registered dietitian who focuses specifically in oncology. She is a plant-centric foodie who promotes a nourishing approach to health and wellness using evidence-based research and guidelines only.

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portion plate wheel

The portion plate wheel

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Kate Bristow, a diabetes nurse educator, simplifies what the portion plate wheel is and how you can make the most of achieving it.

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

Diabetes is a challenging condition where a one-size-fits-all approach does not necessarily work. Medical nutrition therapy, regular physical activity, and medication are important components in managing the complex condition that is diabetes. The American Diabetes Association (ADA) recommends that every person with diabetes engages actively in education about the condition. This includes compliance with medication, a suggested applicable regime of exercise, a plan for long-term treatment, and learning how to self-manage the condition.

Medical nutrition therapy

The ADA suggests that medical nutrition therapy has the greatest impact on the condition following diagnosis and the aim should be to provide a balanced meal plan to provide energy, achieve ideal body weight, and to encourage healthy eating. This will help to achieve good blood glucose control and best outcomes.

There are many ways of learning to manage an eating plan, and various recommended dietary approaches, such as carb counting, Intermittent fasting, and the Mediterranean diet to name a few.

The portion plate wheel

To try to simplify dietary approaches and allow for flexibility for the greater population self-managing their diabetes, the plate model or portion plate wheel was devised.

The portion plate wheel is designed to promote healthy eating habits in a simple visual way. It allows you to create a healthy low-carb meal for better blood glucose control. There is no counting, calculating, or weighing food and all that is needed is a 9-inch (23cm) plate to create a healthy balanced meal which includes protein, vegetables, and carbs.

So, how do you achieve the balance required for a healthy yet interesting eating plan in diabetes?

First, fill half the plate with non-starchy vegetables. These are lower in carbs so have little effect on blood glucose and they are high in fibre and vitamins. They are an important part of a healthy diet.

Examples include: broccoli, cauliflower, Brussel sprouts, cabbage, carrots, celery, cucumber, tomatoes, egg plant, leafy greens (kale and spinach), onions, leeks, green beans, peppers and squash (gems and zucchini).

Second, fill ¼ of your plate with food high in protein, such as fish, chicken, lean beef, cheese, eggs. Soya products, beans, lentils hummus, tofu and edamame are examples of plant-based proteins.

The other ¼ of the plate is for starch or carbohydrate foods.  Keeping the portion of carbs on your plate to this amount can help prevent the rise in blood glucose levels after a meal. Recommended choices would be those carbs that are high in fibre and whole grains.  Remember the bigger the portion of starch on your plate, the higher your blood glucose levels will be.

Examples include: brown rice, bulgur wheat, oats, oatmeal (rolled oats if possible). Any products made with whole grains (low-GI bread or rye bread). Popcorn, quinoa, beans, legumes, lentils, fruit, dried fruit; dairy products, and milk substitutes.

Some vegetables have starch in them too. These include butternut, green peas, potatoes, pumpkins, and sweet potatoes. Take this into account when planning your meal.

Tricky dishes

Some meals like curries, soups, and casseroles, as well as my personal favourite pizza, combine the food groups which make getting that balance more difficult. Try to mindfully break the meal down in your head and work towards where each food type fits on the plate and how you could still achieve that balance that you are looking for.

Let’s look at pizza, for example.

Choose what protein you are having as a topping and then choose a thin base to minimise the carb portion. Balance your plate with two slices of pizza and a big green salad on the other half of your plate.  Obviously, something like pizza is still a high-GI carb but if you can manage the portion size and plate balance, you can improve how you do the treat meals.

Finish off your meal with a low kilojoule or kilojoule-free drink.  Water is always first choice, but other options could include an infused water or sparkling water, unsweetened tea or coffee, or diet sodas or diet squash. Remember that fruit juice, although no sugar is added contains natural fruit sugar, so it’s not a great choice.

In between meals, healthy snacks such as popcorn or nuts are good options to keep hunger at bay.  A small handful of nuts is key into getting healthy fats into your eating plan. They are also good sources of magnesium and fibre. Try to go for unsalted options as too much salt is not good.

Zimbabwe Hand Jive

Another way of making sure that you are getting the correct balance along with mindfully setting up your plate is to use your hands as measures. This is called the Zimbabwe Hand Jive and it goes something like this.

  • Your palm is the size of the protein you should be eating.
  • A closed fist is one portion of carbohydrate (grains and starches) Remember to choose these wisely.
  • Your thumb is equal to a tablespoon of fat-heavy foods, such as peanut butter or mayonnaise.
  • Cupped hands or two handfuls is the portion of non-starchy vegetables.
  • Combining this way of measuring your portion size with the 9-inch portion plate will ensure that you don’t overdo your meal size.

 PHOTO CREDIT: umassmed.edu

References

https://diabetesfoodhub.org/blog/what-diabetes-plate

https://diabetes.org/food-nutrition/food-and-blood-sugar/diabetes-superstar-foods

https://sweetlife.org.za/download-your-free-healthy-eating-portion-plate/

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.

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Aspen

Joint forces: Aspen and SEMDSA

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Aspen and SEMDSA, together as joint forces, highlight the alarming rise of non-communicable diseases in SA and are set to change this narrative.

Aspen Pharmacare Holdings Limited, a global multinational specialty pharmaceutical company, launched an awareness campaign around the alarming rise and associated risks of non-communicable diseases (NCDs), especially diabetes, with the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) on World Diabetes Day.

There has been a notable global increase in NCDs, which are collectively responsible for 74% of deaths worldwide and include cardiovascular diseases, chronic respiratory disease, cancer and diabetes. This trend is being mirrored in South Africa where major NCDs have increased 58,7% over the past 20 years and it is set to continue along this trajectory. Some 71% of global deaths (41 million) are attributed to NCDs with 1.5 million being for diabetes, and with 80% of NCDs being classified as premature.

Stavros Nicolaou, Aspen Group Senior Executive Strategic Trade said, “There is a strong link between obesity, diabetes, and cancer, with the former triggering what has become known as the metabolic-cardio-renal complex of diseases. If left unarrested, the economic impact of NCDs will significantly over-burden an already highly stretched healthcare system and impact lives and livelihoods. On World Diabetes Day, we strongly encourage people to learn about the risks of diabetes and assess their own risk, to understand the differences between Type 1 and Type 2 diabetes, and to seek appropriate support from their healthcare professional if they are concerned about their health.”

“Aspen remains committed to contributing towards the management of NCDs, as has been demonstrated by the Group’s investment of more than R10 billion in sterile manufacturing capacity. This capability has positioned Aspen as an emerging contributor in rapidly expanding the production of treatment options for diabetes.”

“Aligned to this commitment we have also noted, with concern, the increasing lack of suitably qualified medical professionals to treat NCDs, and we are pleased to announce a Fellowship to SEMDSA for medical specialisation in the field of Endocrinology.”

Dr Reyna Daya, SEMDSA President said, “Approximately 50% of South Africans with diabetes remain undiagnosed, and this NCD has reached pandemic proportions. Diabetes treatment requires multiple resources, and we are currently experiencing a shortage of healthcare professionals who can treat diabetes and its complications. Our country also needs to increase awareness and heighten discussions around this disease. These patients are at risk of developing both significant and severe cardiac and renal complications, both of which require access to special care units, which are sadly lacking across our provinces. There is already a significant economic impact to productivity with patients who are presenting diabetes and its complications. Irrespective of a patient’s position on the social ladder, once diagnosed, there is hope with treatment options, albeit that they remain costly and inaccessible to many.”

Aspen’s investment in world class pharmaceutical manufacturing in South Africa has improved supply security and infectious disease prevention in Africa, thereby assisting with the African Union’s overall objective of solving regional health issues through local capabilities. Additional investment has also targeted skills development, talent retention, and new technology, which has positioned Aspen to respond swiftly to breakout pandemics and has become a significant differentiator for the Group.

Diabetes key facts

  • Diabetes, classified as a non-communicable disease (NCD), has reached pandemic proportions.
  • At least 1 in 10 adults has diabetes, 1 in 2 is undiagnosed.
  • Type 2 diabetes is massively on the rise in children and young adults.
  • NCD-related deaths are on the rise and morbidities are becoming more complicated, including cardiovascular events and renal failure (cardio-renal- metabolic syndrome).
  • In South Africa, Type 1 diabetes accounts for 39 healthy years of life lost per person.
  • Diabetes has many hidden faces. We are now seeing a proliferation of young Type 2 diabetes patients (childhood obesity).
  • There is a significant link between diabetes and obesity – approximately 60% of women in South Africa are overweight/obese and 40% of males.
  • As South Africa, we are not doing well in managing diabetes. Left unarrested, this will overwhelm our healthcare system with significant impact on lives, livelihoods, productivity and the economy.
  • Despite multiple treatment options people with Type 2 diabetes still experiences poor glycemic control.

Global Diabetes Key Facts | World Health Organisation (WHO, 2024)

  • NCDs kill 41 million people each year, equivalent to 71% of all deaths globally.
  • Each year, more than 15 million people die from an NCD between the ages of 30 and 69 years; 85% of these “premature” deaths occur in low- and middle-income countries.
  • 77% of all NCD deaths are in low- and middle-income countries.
  • Cardiovascular diseases account for most NCD deaths, or 17.9 million people annually, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (1.5 million).
  • These four groups of diseases account for over 80% of all premature NCD deaths.
  • Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from a NCD.
  • Detection, screening and treatment of NCDs, as well as palliative care, are key components of the response to NCDs.

References:

  • 1 Statistics SA, Report 03-08-01: Non communicable diseases: Findings from death notifications (2008-2018), published
    17 October 2023.
    2 World Health Organisation, Noncommunicable Diseases, Key Facts

References:

  • American Diabetes Association, 2022. 6. Glycemic Targets: Standards of Medical Care in Diabetes—2022. Diabetes Care, 45(Supplement_1), pp.S83-S96.
  • Goedecke, J.H., Jennings, C.L. and Lambert, E.V., 2021. Obesity in South Africa. Frontiers in Public Health, 9, p.715956. Available at: https://www.frontiersin.org/articles/10.3389/fpubh.2021.715956/full [Accessed 12
    November 2024].
  • IDF (2019) Diabetes Atlas – Ninth edition 2019, International Diabetes Federation. Available at: https://www.diabetesatlas.org/upload/resources/material/20200302_133351_IDFATL AS9e-final-web.pdf (Accessed: 12 November 2024).
  • JDRF, 2023. Type 1 Diabetes Index: South Africa. Available at:
    https://www.t1dindex.org/countries/south-africa/ [Accessed 12 November 2024].
  • Lawrence, J.M., Divers, J. and Mayer-Davis, E.J., 2023. Youth-Onset Type 2 Diabetes: The Epidemiology of an Awakening Epidemic. Diabetes Care, 46(3), pp.490-499.
  • Pappachan JM, Fernandez CJ, Ashraf AP. Rising tide: The global surge of type 2 diabetes in children and adolescents demands action now. World J Diabetes. 2024 May 15;15(5):797-809.
  • Usman MS, Khan MS, Butler J. The Interplay Between Diabetes, Cardiovascular Disease, and kidney disease. 2021 Jun. In: Chronic Kidney Disease and Type 2 Diabetes. Arlington (VA): American Diabetes Association; 2021 Jun. Available from:
    https://www.ncbi.nlm.nih.gov/books/NBK571718/ doi: 10.2337/db20211-13
  • WHO (2024) Noncommunicable Diseases, World Health Organization. Available at: https://www.afro.who.int/health-topics/noncommunicable-diseases (Accessed: 12 November 2024).
highs and lows

The highs and lows of diabetes

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Monique Marais outlines both the physical and emotional highs and lows of living with diabetes.

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

Living with diabetes is a complex and multi-faceted journey marked by triumphs and tribulations. On one hand, advancements in medical care and self-management strategies enable you to navigate the condition with greater ease, allowing for moments of normalcy and resilience. The successes, whether mastering blood glucose control, completing a challenging workout, or simply enjoying a favourite meal, foster a sense of accomplishment and hope.

However, the lows can be debilitating: the relentless monitoring, the guilt and shame tied to food choices, the ever-present fear of complications, and the emotional toll of living with a chronic condition. The rollercoaster of emotions, coupled with the physical demands, can leave you feeling drained, isolated, and uncertain about their future.

It’s important to know the risks involved with hyperglycaemia and hypoglycaemia.

Hyperglycaemia

Hyperglycaemia (high blood glucose) can pose significant risks to your health, particularly if left untreated or poorly managed. Here are some potential risks:

Hypoglycaemia

On the other hand, we have hypoglycaemia (low blood glucose) which poses significant risks, especially if severe or untreated. Here are potential risks:

Emotional highs and lows

Just as you can experience highs and lows with your blood glucose levels, you can also experience highs and lows emotionally. Diabetes can significantly impact your mood, leading to emotional fluctuations and challenges.

Managing your well-being can be a continuous challenge, requiring constant vigilance in monitoring blood glucose levels, making careful dietary choices, and navigating decision fatigue.

Additionally, managing weight gain and coping with the emotional strain of maintaining control over diabetes can be overwhelming. Balancing these responsibilities often takes a toll, both physically and mentally, as you strive to manage your condition as effectively as possible.

It’s important to understand that throughout this journey, you may experience fluctuations in both your emotional well-being and blood glucose levels. However, by continually educating yourself about the condition and its management, you will be better able to recognise potential risks and concerns early. This proactive approach empowers you to take preventative actions, helping you to address issues before they escalate into crises.

Emotional coping strategies

Empower yourself by adopting effective coping strategies to manage the emotional and physiological highs and lows associated with diabetes. Some helpful techniques include:

  1. Practicing mindfulness and relaxation methods.
  2. Engaging in regular exercise and physical activity.
  3. Building and maintaining social support networks.
  4. Seeking counselling or therapy when needed.
  5. Participating in diabetes education and self-management programmes.
  6. Utilising stress management strategies, such as deep breathing exercises or yoga.
  7. Connecting with others who are living with diabetes for mutual support and shared experiences.

These strategies can help enhance resilience and improve overall well-being in managing the condition.

Commitment and vigilance

Living with diabetes is undoubtedly a lifelong journey that requires commitment and vigilance, but it’s a manageable condition. By adhering to a prescribed treatment plan, making informed lifestyle choices, and prioritising both physical and mental health, you can effectively manage your diabetes and lead a fulfilling life.

Consistent monitoring, healthy eating, regular exercise, and a strong support network all contribute to better health outcomes. Furthermore, taking care of your mental well-being is equally important, as stress management and emotional resilience play a significant role in overall health.

With the right approach and mindset, diabetes can be controlled, allowing you to live well and thrive. By implementing a positive outlook, and connecting with resources, we believe you will have more positive experiences than negative ones. Good luck on your journey and remember that you are not alone.

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.

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DSA news

DSA News Summer 2024

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– DSA Head Office News –

DSA 55th Anniversary Fundraising Dinner 

Diabetes South Africa held our 55th Anniversary Fundraising Dinner on 9thNovember 2024 at the Century City Convention Centre in Cape Town.

Our MC and Keynote Speaker was Dr Michael Mol. He is a medical doctor, an executive film and TV series producer, a presenter and a health-tech entrepreneur (co-founder of South Africa’s first telehealth platform, Hello Doctor). He is also a global speaker, health consultant, and best-selling author, and a former CEO of TruthTV. Michael is an Oxford Alumni, a South African Brand ambassador and has authored his second book, on the back of his first best-seller Your Best Life. The title of his presentation was It’s your Move.

We so appreciated South African actress Sophie Ndaba’s presence as our second speaker. She played Queen Moroka in Generations and acted in many other TV shows. She has received several awards, namely Best Soap Actress in 2003; Best Comic Actor in 2009, and Woman of Inspiration Award.

Even though Sophie had broken her ankle and had to wear a foot cast, she still made the effort to fly down to Cape Town and do a talk on her experience with diabetes. If anyone can look beautiful wearing a cast it is definitely you Sophie. Thank you so much for sharing our milestone event with us.

Dr Zane Stevens, an endocrinologist, was our third speaker. He has a Fellowship in Endocrinology and Metabolism and is a current SEMDSA EXCO member. Currently he is in endocrine private practice at Christiaan Barnard Memorial Hospital in Cape Town. He has a specific interest in diabetes, thyroid disease and osteoporosis. He spoke about The Highs and Lows of Living with Diabetes, highlighting advances in treatment, current burdens of people living with diabetes, and the hopes for the future.

We were delighted when Jazzart Dance Theatre gave us a 10-minute preview of their forthcoming production at Artscape Theatre. Their performance was amazing. We are sure that your production at will be a huge success.

Thank you to all our wonderful speakers. We received many compliments on our milestone event – saying the speeches were life changing. Attendees said that diabetes is a great cause and DSA should be supported much more than it currently is.

A great big shout out to our speakers, sponsors, exhibitors, volunteers, staff, and attendees for all your amazing support and contributions to our 55th anniversary event.

– DSA Western Cape News –

DSA Rugby World Cup Camp

DSA Western Cape Branch held a camp for children with Type 1 diabetes from 13 – 15th September at Cape Times Fresh Air Camp in Simon’s Town. The theme was Rugby World Cup Camp.

The children were visited by Ivan Solomons (International Rugby Board Educator, UCT coach and Director of Women’s Rugby); Natasha Hofmeester (SA rugby player and coach); Adanan Adams (coach) and Mika-Eel Stemmet (SA rugby player).

The children were taught exercises that the rugby players do at practise and also enjoyed playing rugby with them.

The camp was a great success, the weather was good, and the children got to spend time on the beach. All the children said that the food served was delicious; thanks to our volunteer cooks, Brenda Schippers and her sister, Colleen Johnson.

Sponsors were the Lions Clubs of District 410W, Shoprite/Checkers, Jonathan Ball Publishers, Delite Foods, Futurelife, aQuellé, Caring Candies, Diabetic Accessories, Mrs Rawoot for Fruit and Veg, Dr A Mia, A1 Chicken Hyper, and parents donated towards the camp.

Diabetes Awareness Day in Mitchells Plain

Carol Hendricks, who runs a DSA diabetes support group in Mitchells Plain, handed out water and diabetes literature to the Mitchells Plain community to create more diabetes awareness.

– DSA Port Elizabeth News –

Latest activities

Since October DSA Port Elizabeth branch has been busy with various diabetes awareness campaigns. Each photo is summary of our activities.

We wish all a safe and enjoyable holiday season and may 2025 be filled with good health, joy and peace from all of us at DSA PE branch.

World Diabetes Federation Global Diabetes Walk

The World Diabetes Foundation (WDF) has a global diabetes awareness campaign annually in November. Since 2004, more than 5 million people joined the Global Diabetes Walk to support the prevention of diabetes, one of the largest global public health concerns.

In Port Elizabeth, we held our first Diabetes Walk on 13 November 2010. Michael Zoetmulder and his remarkable team from Zsports Events SA helped us with that first walk and every Global Diabetes Walk since then.

This year Michael battled to find sponsors and a suitable venue, and we only knew on 5 November 2024 that we were having a walk on 16 November. Great excitement as we promoted it as much as we could.

On the day of the walk, the weather was beautiful, the participants ready to do their best and to enjoy the fellowship, exercise, and fresh sea air. Michael and his wife, Sandy, surprised us as they also participated in walking for diabetes this year.

aQuellé was our generous hydration sponsor of water along the way and at the finish line, as well as sponsoring many lucky draw gifts.

DJ Tubz kept us moving to the beats with music from start to finish that kept us energised and hyped as we walked for a world without diabetes.

We are now looking forward to next year’s Global Diabetes Walk.

– DSA Pretoria News –

Call for a volunteer treasurer

Diabetes South Africa Pretoria Wellness Support Group is looking for a volunteer for a position of a treasurer. The responsibilities are:

  1. To approve transactions submitted on bank account.
  2. Draw monthly statements of bank account.
  3. ⁠Reconcile bank account monthly.
  4. ⁠Do entries from bank account to applicable accounts on Excel spreadsheet.
  5. ⁠After monthly support meeting, reconcile petty cash account and do necessary entries.
  6. ⁠Do monthly finance report and distribute to board members.
  7. ⁠Compile necessary reports to finalise annual financial reports.
  8. ⁠Submit AFS as well as supporting documents to external auditors.
  9. ⁠Submit final AFS to secretary to submit her required reports.
  10. ⁠Attend monthly board meetings (normally online).

For further enquiries, contact:

  • Frans  +27 81 354 4900
  • Brian +27 82 496 1030

Volunteering is a wonderful way to give back to the community, gain new experiences and develop valuable skills.

Benefits of volunteering

  1. Makes a positive impact on your community.
  2. Enhances your resume and career prospects.
  3. Develops new skills and experiences.
  4. Expands your professional and social network.
  5. Improves mental and physical health.

Remember, volunteering is a great way to make a difference while gaining valuable experiences and skills. Start small, be open-minded, and have fun.

World Diabetes Day

DSA Pretoria supported and provided brochures and booklets to the Arwyp Medical Centre in Kempton Park to create awareness and dissemination of information on diabetes, on World Diabetes Day, 14 November. The event was successful; blood glucose testing and blood pressure was done.

September Wellness Support Group meeting

People living with diabetes and who have uncontrollable blood glucose levels are susceptible to wounds that take long to heal or are difficult to treat.

It’s against this background that the guest presenter, Sarita Van Wyk, a representative from Trifectiv Plus, was invited on 7 September to enlighten all the members on the benefits and effectiveness of a wound and burn care product.

Trifectiv Plus Wound and Burn Care is produced by Trifectiv Pty Ltd in an internationally certified facility. The wound spray can be used to treat a broad range of wounds, burns, and skin conditions. The product has been on the market for several years, and is backed by numerous studies proving its efficacy. Trifectiv Plus is endorsed by Diabetes SA.  

Trifectiv Plus is safe for all ages, simple to use, heals fast with minimal scarring. It’s also pet friendly.

October Wellness Support Group meeting

A special thanks to the members of the Pretoria Diabetes support group who attended a session on understanding diabetes 5 October.

This session was different from the normal meetings in the sense that people living with diabetes openly shared their journey and experiences. The discussions highlighted the impact of support which is based on the fact that those who live with chronic illnesses can learn and share experiences amongst themselves. Experiences ranged from being first diagnosed, diet, reactions to medication, admission in hospital, low and high blood glucose levels.

Also discussed was neuropathy, diabetic ketoacidosis (DKA) which is a life-threatening problem that affects people with diabetes, where the body produces excess blood acids (ketones).

The sharing was reflective of the trust built over time knowing that members of the support group have first-hand understanding of the diabetic condition.

Being part of the community and collectively dealing with challenges is encouraging, gives all of us strength, value, and a greater sense of belonging. We all learnt from each other.

Diabetic macular oedema

Diabetic macular oedema explained

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Dr Enslin Uys, an ophthalmologist, unpacks the symptoms, causes, and treatment for diabetic macular oedema.

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

Diabetic macular oedema (DMO) is one of the leading, preventable causes of central vision loss. It’s a complication of diabetes that causes fluid build-up in the macula (the part of the eye responsible for the central, detailed vision). This can lead to blurred vision, double vision, and even total loss of vision.

What is the cause?

The retina is the thin nerve layer in the back your eye, like the film in a camera, that receives the image in your eye and sends it to your brain allowing you to see. High blood glucose levels cause damage to the small blood vessels in the retina, leading to fluid leakage and swelling (oedema).

What do you experience?

There are a variety of symptoms, most commonly blurred vision.  You can also have double vision, distorted colours, and blind spots.

How is it diagnosis?

You will need a comprehensive eye examination by an ophthalmologist. Your visual acuity (vision) will be recorded and your eye examined from the front to the back. Your pupils will be dilated, by inserting drops, to give the ophthalmologist a better view of the back of your eyes. Special lenses are used to look at the back of your eyes; this is called a fundoscopy or fundus examination. Special tests or investigations are also performed to assist in the diagnosis, for documentation and monitoring. These tests include:

  1. Colour fundus photos

Image: Left colour photo – DMO circled

  1. Optical Coherence Tomography (OCT)

This is a non-invasive detailed scan of the back of the eye, the retina, almost like a CT scan of the retina.

Image: OCT right – normal.


Image: OCT left – CMO.

  1. Optical coherence tomography angiography (OCTA)

This is also a non-invasive medical imaging technique used to visualise the blood vessels (microvasculature) in the retina.

  1. Fluorescein angiography

This is similar to doing an angiogram of the heart. A drip is inserted in your hand and a dye (fluorescein) is injected into the vein that travels very quickly through the body and gets to your eye within 20 to 30 seconds.

Numerous pictures are taken over a 10-minute period to see if there are areas of ischemia (poor blood supply), or leakage of the dye (as it is not supposed to escape the blood vessels) and where it’s leaking from.

Image: Left fluorescein angiography with leakage circled.

 Risk factors

  • Duration of diabetes: The longer you have had diabetes, the higher the risk of developing DMO.
  • Poorly controlled blood glucose levels: Inadequate control of blood glucose levels over time can increase the risk of diabetic retinopathy and DMO.
  • High blood pressure: Hypertension can exacerbate the damage to blood vessels in the retina, increasing the risk of DMO.
  • High cholesterol levels: Elevated cholesterol levels can contribute to the development and progression of DMO.
  • Pregnancy: Pregnant women with diabetes may be at increased risk of developing DMO due to hormonal changes and fluctuations in blood glucose levels during pregnancy.
  • Other factors: Factors such as smoking, obesity, and genetic predisposition may also play a role in the development of DMO.

Regular eye examinations are important for early detection and treatment to preserve your vision.

How is DMO treated?

Once the diagnosis has been made, a treatment plan will be discussed by your ophthalmologist. The current, most common, form of treatment is anti-vascular endothelial growth factor (VEGF) injections.

Anti-VEGF injections

  • These injections have become the gold standard for treatment of many retinal diseases of which DMO is one of them.
  • Anti-VEGF treatment is given as an injection into the white part of your eye (sclera). The drug is injected directly into the vitreous, the jelly that fills your eye. This is called an intravitreal injection. Your eye is numbed with drops prior to the injection and betadine is inserted to prevent an infection. Although it sounds terrible, the procedure is generally straightforward, quick, and not painful.
  • Initially these injections are repeated every four weeks. This is called the loading dose. The vision and OCT scan are then repeated and the response to the injections evaluated.
    • If a good response was obtained: the interval between injection can then be increased.
    • If a poor response was obtained: you might be switched to a second-line treatment option.
  • For DMO, these injections are usually ongoing over a two to three year-period. All depending on the response.
  • The current anti-VEGFs available in South Africa are bevacizumab, aflibercept, ranibizumab and faricimab-svoa.
  • Although bevacizumab is not registered (used off label), it’s ten times cheaper than the registered drugs and is used as first-line treatment. It has been used for more than 15 years worldwide and has an excellent track record with multiple studies to prove this.
  • Second-line treatment is introduced only when bevacizumab failure has been shown.

Other treatment options include corticosteroid injections, implant or triamcinolone injections, focal laser photocoagulation, or vitrectomy surgery.

Prevention

Manage your diabetes through:

  • Lifestyle changes (see a dietitian, follow a healthy eating plan and exercise three to four times per week).
  • Medication to control your glucose levels.
  • Regular eye examinations.
  • Early treatment of DMO.

If you are experiencing symptoms or have concerns, consult an eye specialist or healthcare professional for personalised advice.

Dr Enslin Uys (MBChB; DA (SA); Dip Ophth (SA); FCOphth (SA)) is a general ophthalmologist with a strong interest in disease affecting the retina. He is the co-founder of the Pietermaritzburg Eye Hospital, where he is currently in full time private practice, and is the current president of the South African Vitreoretinal Society (SAVRS) that represents ophthalmologists in SA involved in treating and managing retinal diseases.

MEET THE EXPERT

Dr Enslin Uys (MBChB; DA (SA); Dip Ophth (SA); FCOphth (SA)) is a general ophthalmologist with a strong interest in disease affecting the retina and the co-founder of the Pietermaritzburg Eye Hospital, where he is currently in full time private practice. He is also the current president of the South African Vitreoretinal Society (SAVRS) that represents ophthalmologists in SA involved in treating and managing retinal diseases.

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DSA news

DSA News Spring 2024

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– DSA Western Cape News –

Clicks’ Head Office Men’s Wellness Day

Diabetes SA Western Cape together with aQuellé Water partnered and formed part of the Clicks’ Head Office Men’s Wellness Day in Cape Town in June.

We provided diabetes management materials to the corporate staff attending. The attendance was excellent, and a large number of staff asked about diabetes complications and good diabetes management practices.

The staff were very grateful for the information provided regarding Diabetes SA’s mission, key services, and objectives by the Western Cape Branch Manager, Caine Tibbs.

Total Wellbeing Event

 Total Wellbeing, organised by Redeem Christian Church of God, Heaven’s Gate in Parklands, was held in July. The event’s purpose was to enlighten and educate men and women about physical health and healthy living. The topics of discussion were diabetes, diet, hypertension, and stress management.

Sister Onyinye Nwaulu from Milnerton Diabetes Support Group was the main speaker and gave a talk on hypertension and management.

Caine Tibbs, Western Cape Branch Manager shared his personal story as well as a health talk on diabetes, diet and management.

DSA Western Cape provided the education materials for this outreach.

– DSA Port Elizabeth News –

Exercise Workshop

This free workshop, held at Vesalius House, Mount Croix on 10 August, was open to all people interested in diabetes. The DSA Port Elizabeth branch was represented by Martin, Elizabeth, and Mariette Prinsloo, Pamela Molefe, Ndileka Rasmeni, Themselves Dlula, Thandi Mazodwa, Patricia Nelo, and Joshua Lamont-Turner.

Telkom Health Day

Martin and Elizabeth Prinsloo were invited to attend a Telkom Health Day. Notwithstanding the bitter cold weather and gale force wind, this event was well-attended and so many either had diabetes or a family member or friend who had diabetes.

– DSA Pretoria News –

June Support Group Meeting

DSA Pretoria’s guest speaker was Dr Karien Strydom. She spoke about the Kollage Clinic in Cornwall Hill, Centurion.

This clinic was started by the Kollage church with volunteers of doctors, nursing sisters, and other healthcare professionals who give their time and services to help those who do not have medical aid. The services at the moment are basic needs but as time goes on they are hoping to increase their services to the needy.

DSA Pretoria is planning to join them at their next open day. We were all encouraged by the information.

July Support Group Meeting

Dr Padayachee gave a talk on pharmaceutical medicines, how such medicines are categorised into schedules, and how each schedule is stored, secured and dispensed.

She also encouraged us to take stock of what has surpassed its usefulness. Medicines are no exception. The expiration date is a critical part of deciding if the product is safe to use and will work as intended. Using expired medical products is risky and possibly harmful to one’s health.

Once the expiration date has passed, there is no guarantee that the medicine will be safe and effective. If the medicine has expired, do not use it. We learnt how to safely dispose of old medications.

Finally, expired medicines are also not just a risk to the person they were prescribed for and can harm children. For all these reasons, proper disposal of unneeded medicines is essential.

Dr Padayachee spoke about how to identify counterfeit medicines, which she said was an increasing phenomenon in the South African market and poses health risks to the population.

She gave us a glimpse of the future of prescribed medication which could be improved through the analysis and application of genetic testing. It is hoped that through this approach, individual solutions could be provided to ensure effective treatment.

community

Harness the power of community support

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Monique Marais, a social worker, highlights the power of community support when living with diabetes.

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

Living with diabetes can be challenging, but you don’t have to do it alone. Community support plays a vital role in effectively managing diabetes. By tapping into the strength of community connections, you can find not just emotional support but also practical strategies to manage your condition better.

Three main forms of support

There are three main forms of support: behavioural, educational and psychological.

The benefits

There are many benefits to having a community to support you in your diabetes management, such as:

You can harness the above benefits by joining support groups, meeting with healthcare professionals, and including your family in your journey.

Support groups offer valuable insights, inspiration by shared experiences, and helps you to make informed decisions and take accountability for your health.

In addition to support groups, community resources are essential for diabetes patients. These resources encompass a wide range of services and initiatives that aim to improve diabetes education, access to care, and overall quality of life.

Here are key community resources:

There are various diabetes communities, such as:

  • In-person support groups
  • Online support groups
  • Social media networks and platforms
  • Non-profit organisations such as The International Diabetes Federation (IDF) and Diabetes South Africa.
SUPPORT GROUP INFORMATION
Diabetes South Africa (DSA)
  • Website: diabetessa.org.za
  • Description: DSA is a non-profit organisation that provides support and information to people with diabetes and their families. They offer educational resources, support groups, and advocacy for diabetes awareness.
  • Activities: Regular meetings, educational workshops, and community events.
Centre for Diabetes and Endocrinology (CDE)
  • Website: cde.org.za
  • Description: CDE is a comprehensive diabetes care organisation that provides clinical services, education, and support for individuals with diabetes.
  • Activities: Support groups, educational programs, and individualized diabetes management plans.
 
Facebook support groups There are various groups available, you can search and join a group where you feel comfortable.

Examples:
Local Hospital and Clinic Support Groups Many hospitals and clinics across South Africa offer diabetes support groups for their patients. It’s beneficial to inquire at your local healthcare facility about any support groups or educational programmes they may offer.

Final thought

In conclusion, the benefits of support groups and community resources for patients with diabetes can’t be overstated. These resources provide emotional support, shared knowledge, motivation, and practical assistance that is vital for effectively managing this chronic condition. By embracing a holistic approach to diabetes management that includes both medical care and community support, people living with diabetes can lead healthier, happier lives despite the challenges of diabetes.

References

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.

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Why language matters

Why language matters

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By fostering a language of support, empathy, and clarity, we can contribute to a more positive and effective diabetes experience for everyone involved. Kate Bristow expands on this.

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Visit our channel mypod.zone/diabetessa

“Words stick in our minds and our hearts.”

Remember the saying, “Sticks and stones may break my bones, but words will never hurt me?” We were taught this growing up and we believed it – it made us brave – or did it?

We were not taught that words do damage, often deeper and for longer. Sticks and stones do hurt, for sure. They leave scars, sometimes big ones and the wound left can be cared for and treated because we can see it.

The trouble with words is that they leave no visible scar, nothing to show for the hurt caused. Words dig deep inside of us and can whisper back to us over time eroding confidence and extending the hurt. Words stick in our minds and our hearts.

How does this relate to diabetes?

Diabetes Australia has this to say about the language of diabetes, “Our language matters. The words we choose, and the way we use them, influence, persuade and affect how people view the world. Words do more than reflect reality: they create reality.”

Words make people feel valued, understood, and supported but they can also show bias, whether it be conscious or unconscious.

Sometimes we don’t realise the effect that our words and how we say things have on people. Language is crucial in shaping perception, our behaviour, and health outcomes. Diabetes management is no exception.

Diabetes management is a multi-faceted journey involving medical, lifestyle, and emotional components. One often overlooked yet profoundly impactful aspect of this journey is language. The way we talk about diabetes—whether in clinical settings, personal conversations, or public discourse—can significantly influence outcomes, attitudes, and overall quality of life for people living with the condition.

The International Diabetes Federation (IDF) as well as other diabetes organisations around the world have started the #LanguageMatters movement, encouraging us to think about how we communicate with people, and specifically with people with diabetes.

Let’s dig deeper

How we approach what we say affects those of us in healthcare as well as those who have diabetes. Language shapes how people understand and manage their condition. Terms and phrases used by healthcare professionals, support networks, and even the person with diabetes (PWD) themselves, can impact self-perception and emotional well-being.

For example, labelling diabetes as a “battle” or a “struggle” might contribute to a feeling of constant conflict, potentially leading to burnout and frustration. Conversely, framing it as a “journey” or “part of life” might foster a more positive and resilient mindset.

We (the public and healthcare) put stigma into our interpretation of the challenges faced by those with diabetes. For example, “Diabetes is a result of poor lifestyle choices” or “just control your sugar” can also lead to feelings of shame and guilt. Comments like this show lack of understanding of the complex condition which is diabetes, and how genetics, environment, and other aspects of life may influence diabetes.

Unfortunately, comments like this will affect a person’s self-esteem and discourage them from asking for help, or perhaps even sticking to a treatment plan.

As a diabetes educator I’ve often heard, “I got diabetes from eating too much sugar” or “He got diabetes because he eats too much.” We need to change the mindset in the public space and take away stigma and blame; it’s destructive and doesn’t help someone who is coming to terms with and trying to manage a chronic condition.

Supportive and empathetic approach

In healthcare, we need to have a supportive and empathetic approach to increase trust and engagement in the process. For example, managing diabetes as opposed to controlling diabetes gives a better sense of teamwork and partnership instead of an approach which is strict or punitive.

Be aware of body language, tone, and attitude

It’s also not just about the words we use, but our body language, tone, and attitude. A good example for body language is sitting behind a desk which gives a position of authority and control. This may be intimidating for the person with diabetes, especially a child or young person. A better approach may be to remove the barrier completely and create the impression of a safe space. Our whole persona needs to be non-judgemental and welcoming.

Avoid medical jargon

If we look at our diabetes definitions, often those of us in healthcare use medical terminology, such as hyperglycaemia and insulin resistance versus high blood glucose and difficulty in managing diabetes. Effective education for people with diabetes relies on clear and accessible language. Medical jargon can be confusing, leading to misunderstandings and less compliance with treatment.

Simplification of medical terms and providing clear, easy language will help people understand their condition and the steps they need to take for better self-management.

Think also about the word testing – I test, I’m testing, I’m being tested – it sounds like an exam or something to stress about. Replace that with the word check – how different does that feel?

Choose a positive approach

Diabetes burnout is real, and people with diabetes have so much to manage their condition already. All of us involved in their lives (healthcare team, family and friends) need to try to choose our words to impact them in a positive and encouraging manner to reduce diabetes distress.

Diabetes Australia suggest that we change the conversation around diabetes – be aware of how you say things and how they may be interpreted and approach every interaction consciously and without any bias. We are encouraged to challenge inappropriate words and change the thinking. Words have power and although it may take time for habits to change, it’s not rocket science. We just need to practise the new language of diabetes.

Words need to be:

  • Curious – Show care and interest in how the person is doing.
  • Be accurate – Use plain language that encourages change without judgement.
  • Be respectful – Provide information in a way that the person can understand with respect for cultural practices and values.
  • Acknowledge that they are doing the best they can.
  • Empathic – Show understanding of the person and their circumstances.

Words need to take away:

  • Blame – Prevents a person from doing their best or accessing care for fear of blame or shame.
  • Irreverence – Using diabetes as a punchline in jokes is offensive and insensitive and shows lack of respect.
  • Authority – Words such as should, must or allowed aren’t going to make people change. Instead, they make the person with diabetes feel like they are failing.
  • Stigma – People with diabetes often feel judged, criticised and misunderstood so they hide their condition and how they manage it. This is negative from an emotional and physical perspective.

A few examples of how we as carers, family, and friends of someone can change our language.

Possible negative connotations Suggested better choices
Compliant, non-compliant, non-adherent Takes this medication about half the time
Diabetic, sufferer, patient Person with diabetes, person living with diabetes
I want you to Can I suggest
Refused Declined
Cheating, sneaking, good, bad, poor Making choices or decisions
Test, test blood glucose, test strips Check, check blood glucose, glucose strips
Disease Chronic condition
In denial, difficult patient Finding it difficult, has concerns about
Failed to, failure on treatment Did not, has not, does not
Should not, can’t, have to, must not You could try, let’s consider your options, you could choose to

Survey results

A 2019 survey found that the following words were deemed negative to many people with diabetes. The % of PWD found these words unacceptable.

  • Victim – 99%
  • Sufferer – 96%
  • Consumer – 95%
  • Normal – 84%
  • Cheating – 95%
  • Uncontrolled – 75%

Language is more than just a means of communication; it’s a powerful tool that shapes our understanding, emotions, and actions. In the context of diabetes, choosing words carefully can make a profound difference in outcomes, emotional well-being, and the overall management of the condition. By fostering a language of support, empathy, and clarity, we can contribute to a more positive and effective diabetes experience for everyone involved.

I found a lovely article about the damage words can do and I loved the conclusion they wrote: “And so tread carefully with the words you speak on others. You know not the damage you cause. Speak only good things into the universe. About yourself and about others.”

We need to choose our words with care, however we are involved with a person living with diabetes.

“Be sure to taste your words before you spit them out.”

References

https://anonymouslyafroirish.wordpress.com/2019/04/17/sticks-and-stones-

https://diabetesjournals.org/care/article/40/12/1790/36977/The-Use-of-Language-in-Diabetes-Care-and-Education

https://www.england.nhs.uk/long-read/language-matters-language-and-diabetes

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.

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