Russell Smith – Big in Japan

Russell Smith, a professional photographer, shares his food experience while travelling in Japan and how he had to adjust his insulin dosages.

Russell Smith (52) lives in Cape Town with his wife and two young sons.

Type 1 diagnosis

I was diagnosed with Type 1 diabetes when I was 13 years old and currently inject four times a day, using a combination of rapid-acting insulin (insulin lispro and insulin aspart) as well as long-acting insulin glargine.

When I was newly diagnosed, I started off injecting only twice a day but have found using this current method, I have more control and flexibility around my meals and their times of day.

Professional photographer

For the past 21 years I have been a professional photographer. I discovered that I preferred photography while working as an art director with photographers which I did for several years both in South Africa and abroad.

I love playing with light and have delved into almost all of the genres of photography over my career but have finally stuck to portraiture, lifestyle, still life and food, both in studio and on location.

As part of my non-commercial passion for taking pictures I love to travel with my camera. Every few years I have been fortunate enough to visit places on my own or accompanied by a friend without the responsibilities of family life and free to wake early for sunrise or make long trips on a whim. Things I could never do with young kids in tow.

I’m extremely grateful to my wife who lets me explore and gives me this time to shoot travel.

I love that travel photography is a combination of everything. It’s a little reportage of street photography, interiors, food and portraiture as well as landscape and still life. Being in new environments wakes the senses and makes me see what I sadly probably take for granted at home where I live.

Cherry blossom season in Japan

In late March, early April this year I went to see and photograph Japan during the cherry blossom season. I had done extensive research beforehand by reading what photographers’ rate as worthy of precious time and even the time of day to be there.

The blossoms are magical and make for great subjects to shoot. The weather was a little overcast and even rainy during this period, so I had a little time to shoot with blue skies. The time of the blossoms is also fleeting and moves up and down the country. When I left Tokyo to visit Kyoto and Osaka, the blossoms had already disappeared in Tokyo on my return a week later.

Travelling with diabetes

Having diabetes when travelling, I’m constantly aware that routine is my friend and that regular meal times and correspondingly injections are helpful in keeping my blood glucose in check. I can predict the meals and times, and with the familiarity of that I know how much to inject every day.

However, this is also made more complicated by the different food and ingredients in different countries. I also tend to walk a lot more so there is a lot more exercise, and sometimes I am not even aware of it.

Low glucose levels in Japan

My experience in Japan as a person with diabetes was pretty interesting and unique.

I carry a lot of sweets with me when I go abroad so that when I experience hypoglycaemia (low blood glucose), I have them on hand where ever I may be, up a mountain or in a remote village. I thought I had enough for my whole trip. Side note: I find Mentos easy to carry and don’t melt in hot weather.

After a few days in Japan, I found my glucose levels dropping all the time and I was having to dip into my sweets supply and constantly lower my insulin intake. But this didn’t help, it kept dropping until after a week of being in Japan, I needed to buy a new supply of sweets to see me through. It was very confusing at the time and I only managed to gauge the correct dose of insulin near the end of my trip. I had significantly reduced the amount of insulin I was taking by this time.

It was only when I returned to South Africa and decided to share my new passion for Japanese cuisine with my wife at a local restaurant that I realised what was different.

No added sugar was the difference

Due to having diabetes for so long, I’m very sensitive to the taste of sugar in food and drink and immediately could taste the sugar in the Japanese ingredients in Cape Town. Almost as if our western palates needed the sugar to enjoy the food. Or perhaps masking something else?

What I became to realise is that in Japan they put emphasis on quality ingredients and don’t sweeten or add much else to their food. This goes across the board in Japan, even street food. I’m talking about savoury dishes but marvelled how subtle yet tasty the flavours were. Texture is also important in Japan and this can be experienced usually in small tasting bowls, again a substitute for strong flavour.

I wear a sensor patch now as well to test my glucose levels which has been an absolute game changer. This allowed me to not only read the rising glucose levels after the Cape Town Ramen (Japanese dish) but also to give me early clues to my lowering levels in Japan.

Low-carb dishes

The other big dietary interest in Japan was the low-carb food. It’s mainly seafood rice and noodles. I may be wrong and in parts of Japan it may be different, but I was cutting out on a lot of bread and heavy starch which I think added to the change of diet.

It made me really think about South African food and how it’s modified according to different palates. With so many people living with Type 1 and 2 diabetes in South Africa, why are we being exposed to high sugar foods constantly? Especially when we go to a restaurant and place responsibility on a kitchen to keep sugar as low as possible.

It took a trip to Japan and a big change in my levels to realise that it could be different and yes, we may be used to sweeter or more flavoured foods. Maybe this needs to change, and we will learn to change with it?


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


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

Images supplied