Don’t let the cold win: exercise

Retha Harmse explores safe outdoor exercise activities to keep you active in the colder months.

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Physical activity plays a critical role in maintaining optimal health, particularly during the winter season.

For those managing diabetes, staying active isn’t merely a suggestion, it’s a fundamental aspect of effective diabetes care. However, the colder weather brings its own set of challenges, impacting blood glucose levels and overall well-being.

During winter, the shorter daylight hours and cooler temperatures can deter even the most dedicated individuals from engaging in regular physical activity. Additionally, fluctuations in blood glucose levels due to the cold weather pose additional hurdles for those with diabetes. Therefore, it’s essential to explore a variety of indoor and outdoor exercise options tailored to various preferences and fitness levels.

Whether you prefer indoor workouts or outdoor adventures, there’s something for everyone to stay active and healthy throughout the winter season. Let’s delve into these options to help you maintain your physical fitness and blood glucose control during the colder months.

Outdoor exercise ideas

Benefits of outdoor exercise in winter

While South Africa’s winter may not have the concern of snow-covered landscapes, it may still be really hard to continue the exercise habit, but exercise remains crucial for people managing diabetes.

Venturing outdoors during winter allows you to benefit from exposure to natural light, which can regulate your sleep-wake cycle and improve mood. Breathing in fresh air can also boost your energy levels and overall sense of well-being, making outdoor exercise an excellent choice for maintaining physical and mental health during the cooler months.


Walking outdoors in winter offers numerous health benefits. It provides an opportunity for physical activity while allowing you to enjoy the beauty of nature. To ensure a safe and enjoyable walking experience in cooler weather, dress warmly in layers, wear appropriate footwear and consider walking during daylight hours for maximum exposure to sunlight.


Winter hiking allows you to explore scenic trails and connect with nature while reaping the health benefits of physical activity. Choose trails suitable for your fitness level and take precautions, such as wearing sturdy hiking boots, packing adequate water and snacks, and checking weather conditions beforehand.


Consider activities such as trail running, mountain biking, or beach volleyball, depending on your location and preferences. These outdoor sports provide opportunities for cardiovascular exercise, muscle strengthening, and co-ordination improvement while enjoying the beauty of the South African landscape.

Tips for safe and effective winter exercise

Blood glucose management

Maintaining stable blood glucose levels is crucial during winter exercise. Before physical activity, check your blood glucose levels to ensure they are within a safe range. Monitor regularly during exercise, as cold weather can affect insulin sensitivity and glucose utilisation. Have fast-acting carbohydrates on hand for hypoglycaemia and be ready to adjust insulin dosage as needed. After exercise, monitor again for post-exercise fluctuations and take appropriate action.

Dress appropriately

Proper attire is essential for comfort and safety during outdoor exercise in winter. Dress in layers to trap heat and regulate temperature effectively. Start with moisture-wicking base layers, insulating layers for warmth, and finish with a waterproof and wind-resistant outer layer. Wear thermal socks, gloves, and a hat to keep extremities warm and choose breathable fabrics to prevent overheating.

Hydration and nutrition

Stay hydrated by drinking water regularly before, during, and after exercise, even in cooler temperatures. Fuel your body with healthy snacks containing carbohydrates and protein before and after winter exercise sessions to replenish energy stores and support muscle recovery. Choose nutrient-dense options, such as fruit and nut butter, yoghurt with granola, or a small handful of biltong and cheese sandwich.

Safety precautions

Exercise safely by checking weather forecasts and avoiding extreme conditions. Dress appropriately, use reflective gear and lights in low-light conditions, and inform someone of your exercise plans. Consider exercising with a buddy or group for safety and motivation and be prepared to modify or postpone your workout if conditions become unsafe.

Insulin storage

During the winter months, proper insulin storage becomes even more crucial for people managing diabetes. Fluctuating temperatures can affect the efficacy of insulin, potentially leading to inadequate blood glucose control. It’s essential to store insulin at the recommended temperature range of 2°C to 8°C (36°F to 46°F) to maintain its potency.

However, extreme cold temperatures, such as those experienced during winter, can cause insulin to freeze, rendering it ineffective. To prevent this, store insulin in a cool but not freezing environment, away from direct sunlight and sources of heat. Insulated bags or containers can help protect insulin when travelling outdoors in colder weather.

Additionally, be cautious when storing insulin in vehicles or other unheated spaces during winter, as temperatures can drop significantly, compromising insulin quality. By following these guidelines, people with diabetes can ensure that their insulin remains effective, enabling them to manage their condition successfully throughout the winter season.

Support, share and care

In conclusion, prioritising physical activity during the winter months is essential for people managing diabetes. Through a variety of indoor and outdoor exercise options, you can maintain physical fitness and blood glucose control during the colder months. Remember to prioritise safety, monitor blood glucose levels, dress appropriately, stay hydrated, and take necessary precautions when exercising outdoors.

As you embark on your winter exercise journey, share your favourite activities and tips. Your insights may inspire others in your community to discover new ways to stay active and thrive with diabetes during the winter season. Let’s support each other through our wellness journeys and enjoy the benefits of a healthy, active lifestyle year-round.

Retha Harmse is a Registered Dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping the 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.


Retha Harmse is a Registered Dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping the 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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Unlocking the hidden healing potential of the human body

Veronica Tift enlightens us on the hidden healing potential of the human body and how you can tap into it.

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Have you ever stopped and actually thought about the marvel that is your body? What it is capable of and the amount of regeneration and healing potential that occurs every day without you even being aware of it happening?

Your body is constantly trying to find balance, its working hard to fight off infection, maybe as you read this it’s digesting lunch or eliminating the waste from breakfast. Your heart is pumping blood around your body as your lung’s breathe in the air, all while cells regenerate and repair. There is function of the human body that science is still discovering, and the full capabilities of the body is underestimated and unexplored.

For me, this is the most apparent when thinking of the placebo effect and the nocebo effect. Never heard of the nocebo effect? Well, it’s the phenomenon were when you are told you might have a symptom from a treatment or intervention and you actually manifest those symptoms, even if that treatment was harmless. It’s kind of the opposite to the placebo effect, instead of having a positive effect from a belief you have a negative one.

In the book Mind Over Medicine, author Lissa Rankin writes about patients who were mistakenly informed that they had only a few months to live and died within that time frame, even when an autopsy found no physiological explanation for their death.

If the mind has been proven time and time again to have such a vital role in the ability to heal and even in how humans experience illness, then why are we not practicing more in-depth body-mind connection?

The power of regeneration of the body

One of the most powerful healings is the body’s ability to regenerate tissues and organs. You don’t need to ask the minor cut or bruises to heal, your body knows what to do and gets to it. More complex regeneration processes in the liver and stem cells are crucial without us even being aware of it.

The immune system became a hot topic during lock down. What I found fascinating is how little we actually understand what is considered the first-line of defence against harmful pathogens and foreign invaders. This protection function plays a key role in health and recovery from injury or infection.

We have hundreds of different immune cells at work within us. Making this system even more complex to study is the fact that every person’s immune system is unique. What is similar about the immune system in most people is that stress or exhaustion will have an effect on how we fight infection.

Nutrition and lifestyle, we know, has an important role to play in the body’s ability to heal. However, when looking at people who had experienced spontaneous remissions, Dr Joe Dispenza, a physician and scientist, found in years of interviews, that nutrition isn’t the major factor. He believes that while these can play a role in healing, changing the inner state of the mind will have a deeper impact on the body’s ability to heal.

While we can say “you are what you eat” and that proper nutrition, good quality sleep and physical exercise are the building blocks for healing and regeneration, it’s not the only factor. I would even argue that when humans have an inner state that is healing and processing emotions, rather than suppressing feelings and without anxiety taking over, humans are more capable of making better choices around nutrition and sleep habits, leading to better health overall.

The mind-body connection

The field of psychoneuroimmunology is a field of study that explores the complex connection between the brain, nervous system and immune system. Factors like stress, emotions and social structure all influence the immune function and healing. There are many factors that have been shown to help the body, like meditation, yoga and a variety of body work.

When stress is reduced, inflammation lowers, enhanced immune function is seen and these all help the healing processes. These all complement conventional medical treatment and support overall health and well-being. Please note: while I absolutely believe in the body’s ability to repair itself, I’m in no way suggesting that you should not seek medical advice of modern medicine.


Reflexology is an ancient healing practice which can help unlock the hidden healing potential of the human body. This gentle art of applying pressure to the reflex points on the feet can stimulate the body’s natural healing mechanism, aid in relaxation and help to restore balance to the body.

Part of my education as a coach, we learn the importance that self-care has on our mental well-being and while things like body work, coaching, or even time to journal might seem like luxuries, its actually self-love and caring for your body and mind, and in turn give yourself the space and time to heal.

Harnessing the healing potential

There is little doubt that the body is able of remarkable healing and I’m sure we can all think of an instance when someone was given little chance of healing and made a miraculous recovery.

Unlocking the body’s full potential while still not fully understood, we know where to start. A holistic approach to physical, emotional and environmental factors is needed. Conventional medicine with complementary approaches, optimising nutrition, managing stress, positive relationships and emotional support can all help the body heal and thrive.

The body really is resilient and has a range of sophisticated mechanism for healing and regeneration that we are still trying to understand. We can tap into this healing potential of our bodies and support it with the right tools, tools that you can discover for yourself through exploration of supportive modalities, like reflexology.


The Four Pillars of Healing (

Adding Nutrition to Balance the Body (

Rankin, Lissa. Mind Over Medicine. Hay House. Kindle Edition.

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.


Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

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How to balance body positivity, weight, and diabetes

Finding the balance between body positivity and managing your diabetes but it’s important to approach it in a holistic and sustainable manner. Monique Marais explains further.

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Finding this balance is applicable to newly diagnosed diabetes, as well as those who have been managing it for a prolonged period. Your body’s response to food may change over time, your access to resources might improve, and your own knowledge of your diagnosis will empower you to make better decisions, but it remains something that you actively need to seek out and implement in your life.

It’s fundamental for you to address your emotional well-being along with your physical health. Here are tips that may help:

  1. Manage your expectations regarding your goals

  • Don’t focus on the scale – Sometimes your achievements might not be reflected by the number on the scale, and this can be demotivating.
  • Shift your focus from weight to health and set your goals based on what you deem as good health for yourself.
  • Recognise improvements in energy levels, mood, blood glucose control, and overall health as meaningful milestones.
  • Set small, realistic goals and keep track of your progress.
  • Seek professional support from your doctor, dietitian and possibly a mental health professional, so that you have a holistic approach to health and wellness, and they can support your goal setting.
  1. Follow a balanced diet

  • Educate yourself on what a healthy weight is for you; this is very person-specific and will differ from those around you.
  • Shift your focus from a restrictive diet to a diet that nourishes your body.
  • Also educate yourself on how your body processes certain types of food and the impact it has on your blood glucose levels. The more you know, the better you’ll be able to manage a sustainable diet.
  • Adopt a balanced and nutritious diet that supports both weight management and diabetes control.
  • Focus on whole foods, including fruits, vegetables, lean proteins, and whole grains and combine this with smaller portions.
  • Monitor your carbohydrate intake and choose complex carbohydrates to manage blood glucose levels.
  1. Identify a support system

  • Surround yourself with positive influences but be selective when taking advice from people who mean well but aren’t experts.
  • Communicate with your family and friends on how they can support you in this journey.
  • Be open with your family and friends when you’re struggling, you don’t need to do it alone.
  • Be wary of diabetes fatigue. You are constantly confronted with what you are allowed to eat and what not, and how you’ll be impacted, but your family members who don’t have diabetes can manage their diet with less restrictions and less challenges. By identifying these feelings, you can prevent isolating yourself from them, and rather make use of their support.
  • Practice self-compassion. Be kind to yourself and remember that living with diabetes involves continuous adaptation.

Remember that every person is unique, and what works for one person may not work for another. It’s crucial to find a balance that suits your body and lifestyle while prioritising your overall well-being. By seeking support from healthcare professionals, joining support groups, and involving loved ones in the management process can all contribute to a more positive emotional outlook.

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.


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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Alcohol: drink safely and smartly

Is it possible to enjoy alcohol if you have diabetes? Yes, however, the key message is to drink safely and smartly. Dr Paula Diab elaborates.

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Diabetes is a disease synonymous with behaviours and activities that you can’t do. Most people still walk into my office wanting a diabetic diet sheet, a list of foods that they can and can’t eat. Thankfully, we’ve moved on from there.

It’s also a disease that places so many restrictions on your health and makes you keenly aware of all the bad habits that people enjoy and the differences between people with diabetes who can’t do something and those without diabetes who can do whatever they like. This is also not completely true.

It is true that most people with diabetes tend to drink about half as much as other adults. Why? Perhaps they have been advised that alcohol and diabetes don’t mix. Perhaps some have health conditions that are incompatible with alcohol. Or maybe they’re just concerned about all those kilojoules and carbs.

But is the occasional glass of wine or beer really so bad? Is it possible to enjoy a few drinks with friends even if you have diabetes? The key message is you need to drink safely and smartly.

What can you drink? 

These are the bare facts. For women, one unit of alcohol a day is considered moderate and for men, up to two units.

A unit of alcohol is 200ml wine, a 340ml beer or 40ml spirits. And you can’t bank your daily allowance and save it for the rugby game on Saturday afternoon. (Although if last year’s Rugby World Cup was anything to go by, you may need to!)

A few cautionary tales 

All alcohol, regardless of whether it’s a lite beer or an expensive whiskey, is made from carbohydrates. Hops and barley are fermented to make beer, wine comes from grapes and spirits are also made from grain or malt; all carbohydrates.

The simple reason that diabetes and alcohol aren’t good friends is that all these drinks will rise your blood glucose levels.

Many of the mixers used in creating drinks are also sugar-containing beverages. These will also raise blood glucose levels. It’s possible to have sugar-free sodas but then glucose levels may drop.

It’s perhaps a lesser known fact that alcohol and glucose compete for metabolism in the liver. What this means is that the liver will preferentially metabolise alcohol over maintaining your blood glucose levels. This is, in part, a survival mechanism to prevent you from becoming over-intoxicated.

It’s also particularly pronounced when your stomach is empty. The result of this being the risk of hypoglycaemia (low blood glucose) after you have been drinking. That is why many clinicians will suggest a high fat meal or snack (peanuts, milk, cheese sandwich) before drinking. Obviously, this food will cause a rise in your blood glucose reading but at least it may help prevent a serious and complicated low glucose level.

The liver is also fairly slow at metabolising alcohol and generally each unit of alcohol will take one to two hours to be fully eradicated from your body. This timing will also depend on your body weight and the frequency that you’re used to drinking.

Reaction of medication and alcohol

Taking insulin or oral anti-diabetic medication combined with the glucose-lowering effects of alcohol can have a combined effect of significant hypoglycaemia.

In addition, the use of a glucagon pen to treat the low glucose level may also not be effective. This is because glucagon works quickly but only for a short time whereas alcohol may cause the glucose levels to drop for up to two hours. Often repeated doses of glucagon are required to counteract an alcohol-induced hypoglycaemic event. Certainly, a better option is to ensure adequate kilojoule intake through liquids and other foods.

Another problem is that many of the symptoms of hypoglycaemia (slurred speech, drowsiness, confusion, or difficulty walking) are also symptoms of being drunk and it can be difficult to tell the two apart.

The added concern of hypoglycaemic unawareness (a condition in which you don’t recognise you’re going low), makes drinking especially difficult.

Alcohol after exercise

What about those people who play a round of golf and then head off to the 19thtee or those who play tennis and then enjoy a glass or two of wine afterwards?

Again, the added effect of aerobic exercise dropping the glucose levels and alcohol-induced hypoglycaemia can be very dangerous. Depending on the type and duration of exercise, this combined double-hit may only manifest a few hours after exercising so you do need to be very careful.

Dehydration and alcohol

Drinking is often associated with a balmy summer’s day by the pool or engaging in water sports at the dam. Another potentially disastrous combination is alcohol and dehydration. This is because your body fluid volume becomes depleted due to dehydration and the effects of the alcohol are all the more pronounced.

A good rule of thumb is to follow each unit of alcohol with a glass of water to ensure you stay well hydrated. If you’re out in the sun or doing physical activity, you can add another glass of water on. 

Faster glucose level reaction

And finally, drinks are liquid. That seems like a simple enough fact. But liquids are absorbed more quickly by the body than solid foods so whatever effect the alcohol is going to have on your glucose levels, it’s likely to happen quicker than what you can treat it with a few peanuts or cheese sandwich. In fact, you can probably expect your glucose levels to peak about 30 to 90 minutes after drinking. 

How to drink safely 

If you’re going to have a drink, here are a few things for you to consider.

  • Firstly, speak to your doctor or diabetes educator and ask him/her to advise you on your specific needs and risks. Discuss your concerns with your healthcare team and ensure that you have the correct information relating to your specific condition.
  • Always take your glucose testing equipment with you when you are drinking and be sure to test regularly (every hour if necessary) as glucose levels can fluctuate rapidly when you are drinking.

Discuss with your doctor when and how to intervene and you’ll also start to be more aware of what effects the alcohol is having.

  • Limit your drinking to the recommended daily limit and to drinks where you know the effects on your body. Drink sizes and carbohydrate portions vary per drink so finding your preferred drink and knowing its effect on your body is probably very wise advice.
  • It’s also a good idea to ensure that the people that you’re drinking with know that you have diabetes and that you have all your essential supplies with you. Make emergency details and arrangements known to those that you’re with (a list of your medications, your regular doctor, where your glucometer is, who should they contact). All this information can be recorded and placed in a safe place in your wallet or on a medical alert device so that it’s easily accessible each time.
  • It may also be a good idea to have a formal discussion with your family about the conditions of safe drinking. Issues such as only drinking when your glucose levels are stable, only with trusted friends and having a distinct emergency plan may be very helpful to discuss in the sober light of day. Alcohol clouds judgement and making decisions when you already have a few units of alcohol can be very challenging.

The takeaway

Drinking is individualised and there’s no universal rule for how to do it safely when you live with diabetes. The best advice is to talk to your healthcare team and your family and make decisions based upon what is best for your health.

Dr Paula Diab


Dr Paula Diab is a diabetologist at Atrium Lifestyle Centre and is an extra-ordinary lecturer, Dept of Family Medicine, University of Pretoria.

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Spend time with friends for your mental health

We learn why spending time with your friends is so important for your mental health.

Friendship is a deeply rooted and essential part of human life. From childhood to old age, the bonds you form with friends shape your experiences, provide support during difficult times, and contribute significantly to your overall well-being.

While friendships offer numerous benefits, one aspect that often goes underappreciated is their positive impact on your mental health.

  1. Social connection and loneliness

Studies have shown that engaging in social activities and maintaining a network of close friends can reduce feelings of isolation and loneliness. These interactions trigger the release of oxytocin, often called the love or cuddle hormone, which enhances feelings of trust and bonding.

  1. Stress reduction

During stressful periods, having friends by your side can be incredibly valuable. Spending time with them allows you to share your concerns, vent your frustrations, and seek advice or comfort. Laughter, in particular, has been shown to have therapeutic effects, releasing endorphins and reducing stress hormones like cortisol.

  1. Emotional support

Friends can provide valuable emotional support by offering a listening ear, empathy, and understanding. Feeling heard and understood by friends can boost self-esteem and self-worth. Knowing that you have people who genuinely care about your well-being and are willing to stand by you in difficult times can provide security and reduce feelings of hopelessness or despair.

  1. Boosting self-esteem and confidence

Trust, respect, and mutual support are the foundations of healthy friendships, and being a part of such relationships maintains a good self-image. Spending time with friends who appreciate and value you for who you are fosters a sense of self-worth and self-assurance.

Friends can serve as mirrors, reflecting on your strengths, accomplishments, and positive qualities. Their encouragement and affirmation can boost your confidence and help you tackle life’s challenges with greater self-belief.

  1. Encouraging healthy habits

Friends that prioritise physical and mental well-being may encourage you to adopt healthier practices. One way to make exercise more fun and stay motivated is by joining group fitness activities with friends. Friends may also introduce you to mindfulness practices like meditation or yoga, which can positively impact your mental health.

  1. Sense of purpose and fulfilment

Planning social outings, celebrating milestones, and being part of each other’s lives contribute to a feeling of meaning and connectedness. Sharing experiences and creating memories with friends add depth and richness to your life, enhancing your happiness and contentment.

  1. Coping with life transitions

Transitions, both positive and challenging, mark life. Whether starting a new job, moving to a new city, getting married, or going through a difficult breakup, friends are crucial in helping you navigate these transitions. They provide support, guidance, and stability during times of change.

Tips for how to make new friends

It’s worth noting that friendships can extend beyond the people already in your social circle. Consider people you’ve met, even if just briefly, who left an effect on you.

To expand your social circle and enhance existing relationships, consider the following strategies:

  • Keep in touch with people you’ve worked with or studied with.
  • Reconnect with former acquaintances.
  • Reach out to people you’ve met on social occasions.
  • Get to know your neighbours.
  • Take the time to communicate with family members.
  • Participate in community events. Look for organisations or clubs that meet to discuss a common interest or activity. 
  • Volunteer your time at a hospital, church, museum, community centre, charitable organisation, or another organisation. 
  • Say yes when asked to a social event. Return the favour to someone who has recently invited you to an activity.
  • Take up a new hobby. Participate in a class at a local gym, senior centre, or community fitness centre.
  • Join a faith-based organisation. Take advantage of new member activities and get-to-know-you events.
  • Take your children or pets outside. Chat with members of your community who are out and about or go to a local park and start a chat.
  • Above all, have a good attitude. You may not make friends with everyone you meet, but being friendly will help you enhance your connections. 

*This article is attributed to Affinity Health.