Highs and lows of diabetes

Aiden Nel, a teenager living with Type 1 diabetes, tells us about the highs and lows with diabetes.


The highs and lows of diabetes is a well-known term for any household that houses a person living with diabetes.

How many times have you, as a person living with diabetes, heard, “Is your reading high or low?” from a member of your family or friends. Yes, we have all experienced this at some stage and will continue experiencing it.

Well, the term ‘highs and lows of diabetes’ is not only associated with the blood glucose readings. To me, the highs and lows of diabetes can also be associated with experiences of living with diabetes but have the opposite meaning.

The ‘highs’ of living with diabetes can include the attention and concern that you receive from family and friends. It is a good feeling when your family and friends check on you and show concern. However, a ‘low’ would be when this is overdone and you feel that your family and friends don’t trust you.

Another ‘high’ is that you can control what you eat as a meal. If you don’t like the food that is being served then you can always say that you should not be eating that particular food. (Sneaky I know!)

The ‘low’ is that there are food items that you really want to eat, but these are the food items that you should not eat.

Though, regardless of how we feel about the highs and lows of diabetes, it’s a very important part of living with diabetes. If we are experiencing a high or a low in our readings or experiences, this statement of highs or lows will not change or disappear from our lives. Therefore, embrace this statement and live your life to the fullest.

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Aiden Nel lives in Port Elizabeth. He is 15 years old and has Type 1 diabetes.


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Breastfeeding with diabetes

As a mom to be, we all want what is best for our baby. There is a huge amount of research that shows breastfeeding is best for baby and for mom. But, is this true when it comes to a mommy who is living with diabetes? The good news is, absolutely! 


Firstly, we know that breastfeeding can reduce the risk of the baby developing diabetes, as well as less likely to be overweight later in life.1It has been shown that breastfeeding protects against both Type 1 and Type 2 diabetes.2,3 Breastfeeding is also thought to play a role in reducing the risk of a mom developing Type 2 diabetes later in life.1

However, a mom already living with diabetes may be concerned that she may face different challenges when it comes to breastfeeding.

Mothers with gestational diabetes

When a mom develops diabetes during pregnancy (known as gestational diabetes mellitus), the impact can be a delay in her mature milk (growing milk baby needs until the day they wean) coming in.4 Under normal circumstances the mature milk comes in on day three. However, a mom who has developed gestational diabetes – her mature milk may only come in on day five to seven.

This means that baby gets colostrum (first stage of breast milk) for the extra few days, resulting in baby feeding often, or not settling after feeding. Although colostrum contains many nutrients, it isn’t really growing milk and some babies on colostrum will lose weight. Up to 10% weight loss is considered normal. Because of this, parents introduce formula top-up which can further delay the mature milk coming in. Formula top-ups can also result in lower milk supply long-term.

  • Differences in colostrum and mature milk

Mature milk and colostrum differ in the nutrient content. Colostrum being higher in fat and certain minerals whereas mature milk has a higher carbohydrate percentage. Colostrum comes in very small volumes with baby needing only about 5ml a feed whereas mature milk is found in much greater volumes.

On day 3, when the mature milk comes in, baby needs about 30ml per feed. However, a baby getting colostrum at this stage won’t be getting this volume from the breast. So, they don’t fill their tummy as easily. These babies need to eat more often to keep their tummy full on the smaller volume of colostrum.

Your body will provide what baby needs with slightly more frequent feeds and a mom who is aware of this will be happy to give baby the extra feeds needed. A mom not aware of this change may feel she is not making enough milk for her baby and may be tempted to give formula top-up. Working with a lactation consultant at this stage can help give mom peace of mind and a plan to ensure baby receives enough breast milk.

  • Caesarean section

Another challenge we see with moms who have gestational diabetes is that they are more likely to need a caesarean section birth. This can cause delays in initiating breastfeeding and contribute to a delay in the milk coming in. The good news is that this isn’t always the case, but it is important to be aware that it may happen.

To help with milk supply, mommy needs to feed baby often after birth, about every 2 – 3 hours. This will also help with the other challenge we find with baby after the birth if a mom has gestational diabetes: hypoglycaemia (low glucose levels).5

Feeding often will help to keep baby’s blood glucose levels up. When we look at a mom who had gestational diabetes, her post-birth glucose levels stabilise, and breastfeeding has an additional benefit in that it can help prevent the onset of Type 2 diabetes later in life. This is a known risk factor of gestational diabetes.6,7

Mothers with Type 2 diabetes

Studies have shown that mothers with Type 2 diabetes are more likely to experience low milk supply or at least a delay in increased milk volume.8 This is because insulin plays a role in milk metabolism.5,9

Breastfeeding, however, may help to stabilise a mom’s blood glucose levels. Mothers with Type 2 diabetes may be able to reduce their hypoglycaemic medication while breastfeeding. Most medication required to treat Type 2 diabetes is safe to take while breastfeeding.8

To be certain though, discuss this with your healthcare providers before your baby is born. Moms do need to monitor their glucose levels closely to start with, as breastfeeding can reduce maternal glucose levels which may in turn lead to mom experiencing hypoglycaemia.5As with gestational diabetes, we do find a delay in the onset of mature milk in moms living with Type 2 and Type 1 diabetes.10

Mothers with Type 1 diabetes

Breastfeeding rates in moms with Type 1 diabetes have been shown to be lower. The reasons are usually related to caesarean birth; delay in initiation of breastfeeding; and babies being born earlier in the pregnancy.

Earlier birth dates are associated with challenges with sucking coordination and latching issues.10 However, breastfeeding can assist in stabilising glucose levels in moms with Type 1 diabetes. These moms can then reduce the amount of insulin they are using.11

Managing milk supply with galactagogues

When looking at managing milk supply, many moms want to take medication to increase their milk supply. This is especially common when the milk is delayed as with diabetes. This medication is known as a galactagogue and it may be medical or natural.

Moms living with diabetes need to be particularly careful about taking galactagogues, unless guided by a healthcare provider. Many of the natural forms are readily recommended and easily available. However, some of them can impact a mom’s blood glucose levels.

Goat’s rue is an herbal medication used to increase milk supply, but it is also used to lower blood glucose levels. It may present as a benefit to moms living with Type 2 diabetes, but moms living with Type 1 diabetes should not use it. 12,13

Likewise, fenugreek, milk thistle and alfalfa to name a few have been used to increase milk supply and are also associated with reducing glucose levels. 14,15,16,17 It is strongly recommended that moms consult with their healthcare providers before taking any form of natural supplements to increase milk supply.

Lactation consultant

Working with a lactation consultant is important to rule out any other underlying issues that may cause low supply, such as a poor latch. Lactation consultants can also guide mothers with practical steps she can take to increase her milk supply, as well as assist in making sure baby is exclusively breastfed. Most importantly, moms living with diabetes can breastfeed and will reap the rewards of doing so.


References

  1. Erica P Gunderson. Breastfeeding and diabetes: Long-term impact on mothers and their infants. 2008 Aug: 8(4): 279-286 [NCBI]
  2. Gouveri E, Papanas N, Hatzitolios Al, Maltezos E. Breastfeeding and diabetes. Curr Diabetes Rev 2011 Mar; 7(2):135-42 [PubMed]
  3. Stage E, Hogardd H, Damm P, Mathiesen E. 2006. Long-term Breast-feeding in women with type 1 diabetes. Diabetes care 2006 Apr; 29(4): 771-774
  4. Wallenborn JT, Perera RA, Masho SW. Breastfeeding after gestational diabetes: Does perceived benefits mediate the relationship
  5. Diabetes and breastfeeding. https://www.laleche.org.uk/diabetes-and-breastfeeding/#gestational
  6. Diabetes and breastfeeding: what to know. https://www.webmd.com/diabetes/breastfeeding-and-diabetes#1
  7. Wein, H. Breastfeeding may help prevent type 2 diabetes after gestational diabetes. 2015. NIH research matters. National Institute of Health.
  8. Thursday’s tip: Breastfeeding if you are Diabetic or Insulin resistant. 2015. https://www.lllc.ca/thursdays-tip-breastfeeding-if-you-are-diabetic-or-insulin-resistant
  9. Factors leading to diabetes may contribute to milk supply problems for new mothers. 2014. https://www.sciencedaily.com/releases/2014/05/140505211037.htm
  10. Sparud-Lundin C, Weenergren M, Elfvin A, Berg M. 2011. Breastfeeding in women with type 1 diabetes. Diabetes Care 2011 Feb; 34(20): 296-301
  11. Breastfeeding with type 1 Diabetes. https://beyondtype1.org/breastfeeding-type-1-diabetes/
  12. Using Goats rue to increase your milk supply. Very well family. https://www.verywellfamily.com/goats-rue-and-increasing-the-supply-of-breast-milk-431841
  13. Goat’s rue. Drugs.com. https://www.drugs.com/npp/goat-s-rue.html
  14. Fenugreek and Diabetes. https://www.diabetes.co.uk/natural-therapies/fenugreek.html
  15. Ranade M, Mudgalkar N. 2017. A simple dietary addition of fenugreek seed leads to the reduction in blood glucose levels: A parallel group, randomized single blind trial. Journal List Ayu v.38(1-2); Jan-Jun 2017 PMC5954247
  16. Kazazis CE, Evangelopoulos AA, Kollas A, The therapeutic potential of milk thistle in diabetes. 2014. Rev Diabet Stud. 2014 Summer; 11(2): 167–174. Published online 2014 Aug 10. doi: 10.1900/RDS.2014.11.167
  17. Amraie E, Farsani MK, Sadeghi L, Khan TN, Babadi VY, Adavi Z. 2015. The effects of aqueous extract of alfalfa on blood glucose and lipids in alloxan-induced diabetic rats. Interv Med Appl Sci. 2015 Sep; 7(3): 124-128.
Laura Sayce

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Laura Sayce is a certified lactation consultant (IBCLC) and doula in private practice. She is also the mom of two gorgeous girls. With both personal and professional experience, Laura has a passion to help moms meet their breastfeeding goals. She has been working in the birth and breastfeeding industry for 11 years.


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What are the best sweeteners for people living with diabetes?

There is a lot of controversy regarding  sweeteners (sugar substitutes) and which is better for people living with diabetes. Retha Harmse simplifies the facts.


Sugar consumption

The dangers of excessive consumption of sugar is well-documented. Including how it negatively affects the health status of individuals but even more so for people living with diabetes.

The typical South African consumes 24 teaspoons of sugar daily. More than double of the World Health Organization guidelines for daily intake. Added to that, 7% of the South African population has diabetes (3,85 million people, aged between 21 – 79 years old).

In 1985, 30 million people had diabetes. Its prevalence has increased six-fold and today  425 million people worldwide are currently. If nothing is done now to prevent this, this number will continue to increase to 629 million people by 2045.

Sugars that increase blood glucose levels

Some foods will be labelled “no added sugar” but will still be high in natural sugar (e.g. fruit sugars). These natural sugars also raise blood glucose levels and should be monitored for people with insulin resistance and diabetes.

Sugar Forms & uses Other things you should know
  • Brown sugar
  • Maltodextrins
  • Icing sugar
  • Agave syrup
  • Invert sugar
  • Brown rice syrup
  • White sugar
  • Corn syrup
  • Dextrose
  • High fructose corn syrup
  • Fructose
  • Maple syrup
  • Glucose
  • Fruit juice concentrates
  • Lactose
  • Honey
  •  Maltose
  • Molasses
  • Sucrose
  • Barley malt
  • Used to sweeten foods and beverages.
  • May be found in certain medications.
  • There is no advantage to those with diabetes in using one type of sugar over another (in other words, one teaspoon of sugar has the equal effect of one teaspoon of honey).
  • Sugars may be eaten in moderation. Up to 5% of the daily caloric requirement can come from added sugar.
  • High-sugar diets are not recommended, since such foods could replace more nutritious foods and lead to deficiencies.

Sugars that don’t affect blood glucose levels

Non-nutritive sweeteners, such as aspartame, sucralose, saccharine, stevia, xylitol, and neotame, are so popular due to it being approximately 300 to 13 000 times sweeter than sugar. Though, they don’t have any nutritional value (meaning no or low kilojoules).

Although artificial sweeteners may help to reduce total energy intake, the effectiveness in weight loss or diabetes management has not yet been established. We think fewer calories consumed equals less weight gained or more weight lost, right?

However, according to a recent review, regular consumption of non-nutritive sweeteners is related to an increase in BMI. This might be explained by sweeteners being associated with an amplifying of general cravings and appetite.

Despite this, and this is imperative: sweeteners are not all the same. They have different biochemical structures, with different routes of metabolisation and absorption. Certain sweeteners metabolise differently and are therefore better than others in maintaining blood glucose and weight management. Let’s look at a few different sweeteners and how they weigh up.

Sucralose

Sucralose (sold as Splenda) is 600 times sweeter than normal sugar. It’s mostly secreted which means it does not get absorbed in the body.

Although this might sound great, don’t be so quick to jump on the bandwagon. Sucralose has been associated with inflammation, and there is still ongoing research on whether it increases blood glucose level. The data is leaning towards a ‘no’ for people living with diabetes, as long-term use can cause insulin resistance.

It’s also worth mentioning that added table sugar, if consumed in excess, also causes inflammation and has also been associated with insulin resistance.

Conclusion: Consuming sucralose (or normal sugar) in excess over a long period of time has been linked to inflammation. Sucralose should rather be avoided if you’re diagnosed with any inflammatory diseases such, as rheumatoid arthritis or Crohn’s disease, as it can worsen the inflammatory state.

Aspartame

Aspartame is mostly used in sugar-free or low-sugar drinks and Iced Tea lite.

After the big media frenzy of aspartame causing cancer, recent human studies proved aspartame had no carcinogenic effect. However, it’s worthwhile to note that it’s still not beneficial for your health. More specifically gut health, as aspartame increases certain bacteria in your gut that are directly associated with weight gain.

Furthermore, the long-term (more than 10 years) use of aspartame has been negatively associated with cardiac health. Lastly, aspartame also leads to an increase in carbohydrate cravings, which can lead to increased appetite.

Conclusion: Although aspartame was set-free from being cancer causing, it still increases carbohydrate cravings and the effect it has on gut- and cardiac health shouldn’t be neglected.

Remember that moderation is key. Try to replace diet drinks with infused water or homemade iced teas (rooibos is such a good option). But if you still plan to consume aspartame, be sure to include extra fibrous vegetables, or even a probiotic, to keep the microbiota in balance.

Stevia, erythritol and xylitol

These three sweeteners have been categorised as natural sweeteners. The benefits of these sweeteners are that they don’t need insulin to be metabolised. Therefore, improves glucose tolerance and reduces insulin levels.

Stevia does have an undesirable bitter aftertaste, and erythritol and xylitol are quite expensive (roughly R150-160p/kg). But it seems worth it, because when consuming these natural sweeteners, the rewards system is activated leaving you feeling satisfied. And, in contrast to the previous mentioned sweeteners, they do not increase cravings.

Conclusion: Stevia, erythritol, and xylitol are superior. They can improve glucose levels and aid in weight management, in comparison to the other artificial sweeteners.

Still, moderation remains a key factor in any healthy diet. Therefore, using it sparingly will benefit your health as well as your wallet.

MEET OUR EXPERT


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


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Make time to move

Physiotherapist, Saadia Kirsten Jantjes, gives us practical moves to up your everyday exercise and move.


A few weeks ago, while scrolling through social media, I came across the following quote: “If you do not make time for your wellness, you will be forced to make time for your illness.”

It dawned upon me that so many of us wait to be told by a doctor or medical professional, “You have diabetes/high cholesterol/high blood pressure, so you need to move and start exercising and taking better care of your health.”

After attending a diabetes workshop last month, I realised how much time and effort really goes into managing diabetes. Constantly checking blood glucose levels; being conscious of the amount of food consumed; how eating different food groups will affect your blood glucose at different times of the day; and adjusting doses accordingly. It definitely is time consuming.

Add that to all your day-to-day activities, means that you have very little ‘me-time’. Yet, your doctor and dietitian constantly tell you to add exercise to your routine. So, when and where are you meant to do this?

Make movement a part of your lifestyle

Our bodies are meant to move and not be sedentary. If we look back to our old friends, the cavemen, they were hunting, dancing around fires and exploring their surroundings. Ah what a life!

Unfortunately, in this day and age, we must schedule time for movement otherwise our day just runs away with us. But it shouldn’t have to be like that. Making movement an integral part of your daily living will result in more active calories been burnt throughout the day and, essentially, more time for yourself.

Start with baby steps…literally. Take the stairs.

Skip the lift and elevators and take the stairs whenever and wherever you can. Studies show that climbing just eight flights of stairs lowers early mortality risk by 33%; seven minutes of stair climbing a day can half the risk of heart attack over 10 years; and just two minutes of extra stair climbing a day is enough to stop middle age weight gain.

There are numerous other benefits like improving muscular tone, strength and balance as well as increasing your cardiovascular fitness. Riding the elevator up three flights burns 3kcal while walking up three flights of stairs burns over 20kcal.

Get in touch with Mother Nature…in your backyard

Gardening can be a relaxing and rewarding and it is particularly exerting. Using a leaf blower for 30 minutes burns 115kcal but raking leaves for 30 minutes burns 175kcal.

Add some simple exercises to your gardening regime to increase your calorie count. For example, performing a deep squat every time you bend down to water the flowers. Standing on your toes to pair the leaves. Doing some overhead presses with the watering can. Or, if you’re up for it, add a jog around the garden or some high knees on the spot. So, not only are you working out while gardening, but you’ll reap the benefits of some fresh air too!

Move at work

You probably spend most of your waking hours at work. So, what if you could workout while you work, without having to carve out a big chunk of your time?Try these quick moves in the workplace:

  • If you sit at a desk, make it a habit to stand up every time you make or answer a phone call. March on the spot or pace in a circle to keep moving.
  • Need an energising break? Stand up and do some basic strength and balance exercises. For example, squats, desk push-ups, wall sits, calf raises, tree pose and chair pose.
  • Walk to a nearby restaurant for lunch instead of driving or ordering in.
  • Alternate sitting and standing throughout the day, with lots of walking and stretching breaks.
  • Explore your options for using a standing desk, treadmill desk or sit-stand desk riser.

These are all practical tools to get you moving throughout the day. It can also be a great way to figure out what you may actually enjoy in terms of exercise. So, that when you’re able to set time aside for exercise, you’re able to do so with something that you enjoy.

MEET OUR EXPERT


Saadia Kirsten Jantjes is a physiotherapist with a passion for health and wellness. With a second degree in Sport Science, exercise is one of her favourite rehabilitation tools, to not only rehab injuries but prevent injuries too. Saadia has her own private practice in Morningside, Gauteng, SKJ Physiotherapy while working at a Sub-Acute Clinic and furthering her studies in Pilates.

 


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The keto diet – what you need to know

Recently, the ketogenic diet (keto for short) has been in the spotlight as the new diet to try. With that dietitian, Retha Harmse, educates us on the ‘latest craze’ diet.


The keto diet is everywhere; it’s difficult to avoid seeing it on influencers’ Instagram stories; keto options in supermarkets and on restaurant menus; and even friends or relatives speaking about their wonderful results. But, let’s take a closer look at the ketogenic diet

What it the keto diet?

The ketogenic diet is a high fat, low carbohydrate and low to moderate protein diet that changes the body’s metabolism into ketosis. Any diet where fat is metabolised instead of carbohydrate is essentially a ketogenic diet.

Understanding ketosis

During a ‘normal’ or well-balanced diet, the body’s main source of energy is carbohydrates. More specifically, glucose which is the end-product of carbohydrate metabolism/digestion.

But the body is also able to burn fat for energy, and this is utilised in the form of ketones. Ketones are molecules produced by our liver when fat is metabolised; this metabolic switch is called ketosis.

However, the body doesn’t go into ketosis if there is enough carbohydrates available. Consequently, carbohydrates need to be drastically reduced or eliminated to move towards ketones as the primary energy source.

What does it involve?

Generally, on the ketogenic diet, the macronutrient ratio varies within the following ranges:

  • 65 – 80% of calories from fat.
    • Fat-intake is often over 150 grams (double the usual intake of fat).
  • 20 – 25% of calories from protein.
  • 5 – 10% of calories from net carbohydrate.
    • Roughly 20 – 50 grams a day (compared to the recommended daily amount of 200 – 300 grams per day).

What does this mean in non-dietitian language?

The keto diet prescribes high amounts of fat (both animal and plant sources), low-carbohydrate vegetables, nuts, seeds, and modest protein in the form of meat, fish and eggs. It excludes grains, dairy, legumes, soy, most fruits and starchy vegetables.

Meticulous planning

Ketogenic diets require meticulous planning to ensure the liver continues producing a constant supply of ketones to supply the body with energy.

To maintain ketosis, an individual’s diet needs to be precisely planned and tracked daily, as limiting carbohydrates and increasing fat is not the only focus of the ketogenic diet.

It’s also imperative not to consume protein in excess, as proteins can also be broken down to glucose (through a process called gluconeogenesis). This will in turn inhibit the ability for the body to move into ketosis. Also, if carbohydrates are not restricted enough, it might result in ketonuria (ketones in the urine and not used as energy). This is detectable by urinary dipstick analysis.

The history of keto diets

Although ketogenic diets might seem like the new ‘craze’; they are nothing new. Ketogenic diets have been around from the early 1900s, when they were discovered to have an efficacy in the treatment and management of epilepsy in children.

It is still used for this purpose; although more recently these diets have gained popularity for the management of obesity and Type 2 diabetes.

However, it’s important to note that the macronutrient ratios and recommendations for the ketogenic diet in the management of paediatric epilepsy are substantially different than those advocated for the management of obesity and Type 2 diabetes.

What are the benefits?

In terms of weight loss, evidence suggests quicker initial weight loss. This might be due to the initial use of glycogen stores (glucose stored in the muscle and liver), or reduced energy intake due to increased satiety from eating a large amount of fat and protein.

But long-term differences in weight lost showed no significant difference in comparison to other diets.

As mentioned previously, ketogenic diets have been used for decades to treat epilepsy. But, more recently, research has suggested that they might have a role in treating Type 2 diabetes and inflammatory conditions, such as chronic pain. That been said, there isn’t sufficient evidence just yet to support ketogenic diets for these conditions in terms of its long-term safety and efficacy.

Lastly, research has found that people consuming fewer calories from carbohydrate tend to eat fewer foods high in added sugars, such as soft drinks, doughnuts, etc. Yet, other research has found that the more carbohydrate consumption is restricted, the greater risk there is for poor nutrient intake. 

Potential side effects

  • High fat diets, especially when it’s high in saturated fat, increases total cholesterol. More specifically LDL cholesterol which is the “bad” cholesterol.
    • Both total and LDL cholesterol are both biomarkers for poor cardiovascular health.
  • Reduced energy and decrease in performance in activities that use short bursts of power, because ketogenic diets depletes the energy stores in your muscles (glycogen as mentioned previously).
  • Fatigue, general weakness, headaches and sluggishness, or brain fog.
  • Due to the very low fibre intake of ketogenic diets, you may experience constipation, increased risk of digestive problems and microbiota imbalances.
  • Limited fruit, vegetables and grains consumption – thereby limiting nutrient intake that might lead to deficiencies.
    • Nutrients (lack of) of particular concern on the ketogenic diet are calcium, vitamin D, selenium, magnesium, zinc and phosphorus.
  • Increased oxidation and inflammation in the body.
    • Recent evidence has shown that high fat diets, especially saturated fat, may promote inflammation and lead to the progression of inflammatory diseases, such as Alzheimer’s disease.
  • Possible loss of lean muscle mass.
  • Dry mouth, frequent urination, halitosis (bad breath = acidic, fruity odour).

Take-home message

Currently, there is a lack of strong evidence for ketogenic diets, based on their health claims about longevity, gut microbiome and heart health. Diets that are higher in carbohydrates and lower in protein, in fact, have the strongest links to longer lives and happy guts.

There are various probable side effects when following a ketogenic diet, which is why there is a need for ongoing monitoring and consistent assessment by a qualified dietitian.

Overall, unless medically indicated, I do not recommend following a ketogenic diet. Considering fat and carbohydrates, it’s all about balance.

  • The types of fat you include and the quantities you consume does matter.
  • Carbohydrates does form part of a healthy balanced diet.

My tactic is always to look at sustainable changes you can make that doesn’t include elimination of entire food groups.

MEET OUR EXPERT


Retha Harmse (née Booyens) is a registered dietitian and the ADSA public relations portfolio holder. She has a passion for informing and equipping the field of nutrition. She is currently in private practice in Saxonwold, Houghton, and believes that everyone deserves happiness and health. To achieve this, she gives practical and individual-specific advice, guidelines and diets.


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Losing 25kg with Slender Wonder

Michael Green, a person living with Type 2 diabetes, tells us how he lost 25kg in six months by using Slender Wonder – a medical weight loss programme.


Michael Green (55) lives in Randburg, Gauteng. He is divorced and has two adult sons and one grandchild.


When were you diagnosed with Type 2 diabetes?

I was diagnosed during an insurance medical examination when I was 28 years old. I was put on Glucophage for many years. More recently, I was prescribed Galvus Met 50/1000 (two tablets daily).

What made you decide to lose weight?

I always knew that a large part of my Type 2 diabetes was due to bad eating habits and bad hydration. I have seen how my father has suffered and is suffering now (in his seventies) due to many years of undiagnosed and untreated Type 2 diabetes problems. So, I decided to do something about my health on my own.

How did you find out about Slender Wonder?

I bumped into a friend who I hadn’t seen for about twenty years. He looked great and I complimented him. Then he showed me before and after photos. I was blown away and decided to try Slender Wonder.

Tell us about the Slender Wonder programme you followed?

I started Slender Wonder on 7 April 2016, with Dr Gerda Scholtz, weighing 110,3kg with a body mass fat of 30,3%

I done the Slender Wonder Simeon B Programme which consists of six weeks of injections and a very strict meal plan, followed by a two week ‘Go moderate’ rest period which has no injections and slightly more food. This repeats until the goal weight is achieved.

As the weight came off and I had increased energy, I stepped up my physical training, which was not necessary but just something that I wanted to do. I must say that I was super strict. I weighed every meal and never cheated once.

By 23 September 2016, my weight was down to 84,7kg and my body mass fat was 12,9%.

From a diabetic perspective, the more important thing was that my visceral fat level (fat around the organs) dropped from 15 to 5. I had lost 25kg in six months.

Was your diabetes medication stopped or the dosage lowered once you lost weight?

No, I stayed on my diabetes medication as it has just become habit over many years. My HbA1c level dropped from around 7,5% on medication to under 5%. Slender Wonder is by far the best thing that I have ever done in my struggle against Type 2 diabetes.

How did you feel once you lost the weight?

I felt fantastic! Like I had a new lease on life. Full of energy and motivated. Though, I got tired of people asking me if I was sick as I was always a stocky guy and now I was quite skinny. I went from 38-sized jeans to a 32.

You have gained weight recently. Are you disappointed?

No, Slender Wonder is a change of lifestyle more than a diet. I went back to my old eating habits and if you eat what you ate before going on Slender Wonder then you will weigh the same as you did before. For some reasons, I needed to prove that to myself, and I still do.

I currently weigh 97kg again and though better than when I started, it is a continuous process.

Would you go back on Slender Wonder?

Yes, absolutely! I am back using Slender Wonder. My goal, at this point, is to weigh 90kg and be healthy. I am less hard on myself and I cheat a bit which shows on the scale.

Before

After

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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


The sky’s the limit for Marius Schutte

Last year Marius Schutte placed third in Virgin Active’s The Grid Games national event. He then came first, out of 687 athletes, in the sprint event of the first-ever Spartan Race held in South Africa. Recently, he took part in the Warrior Race and placed 11thoverall and second in his category. His aim is to show people that if he can achieve this as a person living with diabetes, so can anyone else.


Marius Schutte (32) lives in Krugersdorp, Gauteng. He was diagnosed with Type 1 diabetes at the age of 25.


When were you diagnosed?

I had a roller coaster experience when I was initially diagnosed as was first treated as a Type 2 diabetes patient.  Symptoms were something I never experienced, or rather I never noticed symptoms as I always drank a lot of water (because it’s healthy) and in turn had to go to the toilet a lot.

I got flu just before a big competition and went to the doctor to see if I could get better before the competition. Being very thorough, the doctor did a urine test and picked up that there was glucose in my urine. He explained it should not be like this and did a random glucose test. It was at 11mmol/L which is way too high. He then sent me for tests and diagnosed me with Type 2 diabetes and prescribed oral treatment.

I did not understand my diagnosis so I went to different doctors to get a better understanding of why I got diabetes. I had so many questions but I did not get many answers. That was until I went to another doctor who said I was on the wrong treatment as I do not produce enough insulin and the tablets will not work. I did not have Type 2 diabetes but Type 1 diabetes. In her opinion, the only way I managed without insulin was because of my strict diet and gym programme.

I was then diagnosed with Type 1 diabetes in December 2012. Insulin was prescribed. I am currently using Lantus insulin and inject myself. I am also on Glucophage XR, Liaglucide MR and Adco Simvastatin. Though my doctor is currently reducing the doses of Glucophage XR and Liaglucide MR so soon I won’t be using them.

Tell us more about The Grid Games

The Grid Games started at my local gym, Virgin Active Little Falls. We had an in-house competition. The competition requires participants to perform eight exercises in four minutes in a 2m x 2m grid. The aim is to accumulate as many reps (calories in rowing) within 20 seconds, with only a 10 second rest in between exercises. The winners of the male and female category went on to represent the club at the regional competition.

I succeeded in winning the regional competition and was given the honour to represent Gauteng at the national event of The Grid Games. There were more than 14 000 athletes competing through all The Grid Games stages.

It was an extremely tough competition as we had to go through knock out stages. The winner of each round would progress to the next round. We had to go through three stages on the day. I found it very difficult to recover in the small time between the rounds.

My peers without diabetes could energise themselves with supplements and energy drinks whist I only had water to drink and ate chicken. I could not have any of the products on offer though I managed to finish in third position overall.

The organisers of The Grid Games insisted that I have a paramedic in my lane when I competed. This drew a lot of attention. The officials, competitors and the crowd could see that I was different. Many enquired afterwards as to the state of my health. This was a blessing in disguise and it gave me an opportunity to share my experience with diabetes and to make people aware of the condition. Most of all, I could show that diabetes is not a death sentence and you can still live life to the fullest.

How did you become involved in sports?

I’ve always had a love for the outdoors and being active. I never believed in sitting in front of the TV. I would rather go outside and do something in nature.

But after being diagnosed with diabetes, it became more of a lifestyle. I had to be active so I took it upon myself to set an example and help motivate other people to get off the couch and get active.

I want to show people living with diabetes that diabetes that you can still have a full active life. It takes a bit more planning, etc. but it is totally possible and totally worth it. We have to look after our bodies, we only have the one and there are no spares available.

What is your art of living with diabetes?

The first word that comes to mind is consistency. Dedication and commitment follow. You need to be committed to a healthy lifestyle and dedicated enough to carry you when motivation is low.

What does your exercise regime consist of?

I absolutely love sport and being active and this can be seen in my exercise routine. I train five days a week, twice a day. The morning sessions consist of cardio training and is mixed between running and cycling. The evening sessions consist of CrossFit and weight training. On weekends, I go for active rest. This will include swimming, rowing and hiking.

What does your diet consist of?

Like mentioned before consistency is key. I try not to be adventurous with food and rather stick to the basics.

I start my day with boiled eggs for breakfast. My morning snack will usually consist of berries or an apple and mixed tree nuts. I found that the fruit does not spike my sugar when eaten with a protein.

For lunch, I have a chicken salad in summer and in winter I prefer cooked chicken and veggies. My snack between lunch and dinner is biltong.

I have an avocado before I go to gym and eat dinner straight after gym. This consists of protein (chicken, fish or red meat) and veggies. I stay away from carbs as much as possible. The only carbs I have are the veggies. I don’t eat any pasta, rice, bread or potatoes.

Do you suffer with any other side effect related to diabetes?

Diabetes affects me immensely. I suffer from a range of side effects from both the condition itself as well as the medication. It affects my mental and physical well-being. Mental – because I suffer from severe insomnia. This alters my whole countenance when I am sleep deprived. Plus, I experience immense feelings of irritability when my blood glucose levels are high. Physical – because of the muscle spasms and the body aches I experience.

What helps motivate you?

I read all the time, anything and everything about diabetes. The more informed I am, the better I can manage my condition. I find reading stories of other people living with diabetes helps me. Sometimes it feels like you’re fighting alone but then reading about someone else struggles and how they got through them motivates and encourages me to keep on fighting.

What is the reality of diabetes?

Type 1 diabetes is a lifelong condition. It is the first thing I think of when I wake up in the morning and the last thing I think about when I go to bed. This is how it will be for the rest of my life. You don’t have any days-off. A day-off can mean a trade-off with my life. Thus, it is a condition that forces me to be extremely disciplined and strict.

People in general have a limited understanding of this condition and think that I can’t eat sweets or chocolates. That is not true. Diabetes is affected by everything, from the food I eat to the weather I experience and my emotional condition, etc. In short, it is a forced lifestyle change, that if not taken seriously can mean my life can be lost.

What is next?

I am a very adventures person and love living. I hope to inspire other people to do the same. Even people without diabetes. It is just so easy to say that something is difficult and to just give up. I want show that anything is possible. If I, with my diabetes, can do it, so can any other person.

I have two big dreams that I would like to achieve to bring more awareness to diabetes. Firstly, I would like to climb Mount Kilimanjaro and to complete an Ironman (I will start with Ironman 70.3).

MEET OUR EDITOR


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