Put your best foot forward with socks

Podiatrist, Dennis Rehbock, educates us on the history of socks and how they have advanced over the years.

The history of socks

Socks have been worn on the feet of humans since the 8th century BC in Greece. They were made from matted animal hair or leather, called piloi. The earliest known surviving pair of socks, created by nalbinding, dates from 300-500, and these were excavated from Oxyrhynchus on the Nile in Egypt. A thousand years later in the 2nd century AD, the Romans were the first ones to sew woven fabrics together and make fitted socks.

Modern socks

Socks today are vastly different to the early historical models. Modern fabrics, technology and the latest fashion has transformed them into a necessity for humans to wear for protection and as great looking fashion accessories.

The functions of socks are:

  • Protection of the feet
  • To insulate feet from the cold weather
  • To absorb and dissipate sweat from the feet in warm conditions and during sport
  • Odour control
  • To protect the feet by preventing chaffing from shoes
  • Comfort
  • Fashion

Sock materials

Traditionally socks were made from wool or cotton with a little bit of nylon in it for strength.Wool and cotton are still used in socks, but modern materials are far better.

Modern socks contain materials like Drynamix, mohair, bamboo, Merino wool, Coolmax, elastane, polyamide, nylon, spandex and polypropylene. Some socks have silver or copper infused yarns for the antimicrobial function.

Bamboo is one of the softest, if not the softest sock material you can buy. It’s much smoother than cotton, and feels more like a high-quality silk or cashmere, making them extremely comfortable to wear. Bamboo has incredible moisture-wicking capabilities, being able to keep feet dry even if there is excess sweat.

Most technical sports socks contain mostly Drynamix and some nylon for strength.

Diabetic socks contain mixtures of cotton, bamboo, Merino wool, mohair and some nylon for foot protection and sweat control.

Other modern sock technologies

  • Left foot and right foot specific shape
  • Seamless toe design
  • Seamless comfort
  • Full foot cushioning
  • Lightweight construction
  • Soft comfortable feel
  • Extra heel and toe cushioning
  • Deeper heel pockets
  • Ventilation panels
  • Blister resistant materials and construction
  • V-tech arch support system
  • Silver thread for antimicrobial function
  • Non-elastic stay-up. Low compression, non-restrictive top with extra cross stretch to not impede normal blood flow.
  • Bamboo – hypoallergenic yarn
  • Compression socks, specifically for certain vascular conditions and may be calf-length and over-the-knee length.

Thickness and length

Socks also come in different lengths, such as thin volume socks for running, medium volume socks for tennis and squash, and thick volume socks for hiking and maximum protection.

Sock length can also vary: long socks, short socks or ankle socks for running, secret socks (very low-cut socks), and medium length socks.

How does diabetes affect your feet?

Diabetes can damage your feet and toes in the same way as it may affect your eyes, blood vessels, and other parts of the body.

Control of the blood glucose levels is most important on a long-term basis, but over time there may be damage to the blood vessels and the nerves throughout the body

This common complication of the foot in diabetes is known as peripheral neuropathy and peripheral artery (vascular) disease (bad circulation). Experts say that up to 80% of limb loss from diabetes is preventable.

Because the feet are high risk in diabetic patients, the feet must be looked after and protected. This is where the correct socks for people with diabetes is important.

Diabetic socks

Normal and special diabetic socks are important for good foot protection and care in the diabetic community. It’s advisable that all people with diabetes wear good quality, preferable special diabetic socks.

In simple terms, a diabetic sock is designed for keeping your feet dry, absorbing and dissipating the sweat, keeping the feet warm, preventing restriction of blood flow, and protecting from rubbing and trauma.

One of the functions is absorbing sweat. Research shows we produce 0,12L of sweat per day from our feet. Socks help to absorb this sweat and draw it to areas where air can evaporate the perspiration.

Thin socks are most commonly worn in the summer months to keep feet cool.

In cold environments, socks made from cotton, wool, bamboo or Merino wool helps warm up cold feet which, in turn, helps decrease the risk of getting chilblains and other lesions. 

Thicker thermal socks can be used for extreme cold environments.  They are commonly worn for skiing, skating, and other winter sports. They provide not only insulation, but also greater padding due to their thickness.

Diabetic socks are often made in a white colour. This makes it easier to notice any bleeding or oozing wounds on the feet.

Diabetic socks are specially designed to help save your feet from amputation by keeping feet dry, decreasing the risk of foot injury, cuts, blisters, infection, dampness, and enhancing blood circulation. They are a key part of foot care, which is an important aspect of diabetes management due to potential damage to the nervous and circulatory systems caused by high blood glucose levels.

Diabetic socks vs compression stockings

Compression stockings are not the same as diabetic socks. Compression stockings are meant to increase constriction so that blood can return more easily to the heart.

Medical-grade compression socks are not appropriate for people with diabetes because they can decrease blood flow to the feet and accelerate damage.

However, if you have swollen feet, talk to your doctor. Some diabetic socks provide a lighter degree of compression that may ease swelling without inhibiting blood flow. True compression socks need to be prescribed by a healthcare professional and properly measured and fitted for the patients’ requirements.

Smart technology

Some diabetic socks have embedded sensors that track foot temperature, moisture and pressure to alert the wearer via an app if, say, an ulcer is forming. They have a coin-size battery located on the exterior of the sock near the ankle. These socks usually last around six months.

Important things to look for in diabetic socks

  • Look at the Drynamix, cotton, wool, Merino wool, bamboo, mohair content in the mix. The higher percentage of these materials, the better the sock.
  • Choose socks that are soft and thick for the protection and cushioning.
  • Look for seamless socks, especially in the toe area.
  • Read the label of the socks when purchasing. The features of the sock and the material composition will be listed. Look specifically for a diabetic type of sock.
  • Buy new socks regularly and get rid of the old and worn away socks. Socks should be thrown away at the first sign of wear and tear, such as holes or rips.
  • Thermoregulating (keeping your feet warm in winter and cool in summer) resulting in dry, healthy, warm and comfortable feet all day long is important.

 What not to do

  • It’s not necessary to sleep with socks on, unless it’s to keep your feet warm.
  • Do not wear toe socks. These socks encase each toe individually like fingers in a glove. You may get irritation in between the toes that could cause skin breakdown or interdigital corns.

 Important diabetic footcare information

  • Gently wash your feet daily, especially in between the toes.
  • Dry your feet well. Concentrate in between your toes.
  • Keep your feet dry to prevent fungal and bacterial infections, especially in between the toes.
  • Powder the feet with a generic powder like baby powder.
  • Wear clean socks every day. Use the special diabetic socks if necessary. Use very soft and thicker socks if you need them to keep your feet warm.
  • Check your feet daily for any wounds, cuts or damage. If you can’t do this then get someone to help you. Look for any small cuts, blisters, or corns that are starting to look bright red, swollen, bloody, oozing pus, developing a green or brown colour, or producing a strong odour.
  • Do not walk around barefoot, especially if you have peripheral neuropathy. If you have neuropathy in your feet and have lost sensation and feeling in your feet, walking around barefoot (especially outside) means you could step on something sharp, cut your foot, and not know it.
  • Wear shoes. Even a thin shoe or ballet-like slippers are better than nothing. Running shoes or tackies also work well to protect feet.
  • Schedule regular foot checks with your podiatrist to examine your feet and to do any treatment that may be necessary.
  • If you have already experienced a foot ulcer, foot inspections and podiatry visits are critical to treating new cuts or ulcers quickly, preventing your risk of amputation.
  • Improve your blood glucose levels if necessary. See your diabetologist, diabetic educator and dietitian regularly.
  • If you suspect an area on your feet isn’t healing properly or is looking a bit unusual, don’t hesitate to visit your healthcare team immediately and get it checked out.


FALKE SOCKS – www.falke.co.za

BALEGA SOCKS – https://balega-socks.implus.com/contact

THE SOCK DOCTOR – www.sockdoctor.co.za

MEDIPOS DIABETIC SOCKS – www.medipod.co.za


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Dennis Rehbock is a podiatrist in private practice in Johannesburg. He has been a part-time lecturer and clinician at the University of Johannesburg Podiatry Department for 37 years. His special interest includes podiatric sports podiatry and the diabetic foot. Visit footdoctor.co.za for more info.

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This article is sponsored by Sock Doctor. The contents and opinions expressed are entirely the medical experts and not influenced by Sock Doctor in any way

Heart attack and stroke – know the symptoms

Did you know heart disease and strokes are the leading cause of death in people living with diabetes? The good news is that there are many things that you can do to control your diabetes, reduce your risks and stay healthy.

How does diabetes affect your heart?

Heart disease and stroke are the leading cause of death in people living with diabetes. The constant high blood glucose causes damage and narrowing of the blood vessels, increased blood triglycerides (a type of fat), decreased levels of “good” HDL cholesterol, high blood pressure and increased risk of a heart attack or stroke.

People living with diabetes are also more prone to the development of atherosclerosis and blood clots. Diabetes also accelerates the damage done by smoking, high blood pressure and high cholesterol.

Diabetes can even affect the heart muscle itself, making it a less efficient pump. As diabetes can affect the nerves to the heart, symptoms of angina may not be felt in the usual way and may be passed off as indigestion or an upset stomach. This leads to delays and difficulties in diagnosing angina and heart attacks.

As you can see, diabetes increases the risk of stroke and heart disease, especially if other risk factors are already present. The risks multiply!

So, prevention is key. Up to 80% of heart disease and strokes that happen before the age of 70 years can be prevented by simply living a healthy lifestyle and treating conditions, such as high blood pressure, high cholesterol and diabetes.

Knowledge is also vital and the best knowledge you can equip yourself with are the signs and symptoms of a heart attack and stroke so that if ever you are in a situation, you are armed with what to do.

Signs and symptoms of a heart attack

Not all people experience the same symptoms when they suffer a heart attack. Sudden chest pain is the most common symptom of a heart attack. In some cases, mostly women or people with diabetes, a heart attack can happen without any chest pain.

Chest pain can also be caused by several other conditions that affect the stomach, chest wall, muscles or lungs. Ambulance staff or a doctor can do the necessary tests to find out if chest pain is caused by a heart attack.

Below are the common symptoms of a heart attack. You may experience only one or several of these symptoms during a heart attack.

  • Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back.
  • Nausea, indigestion, heartburn or abdominal pain.
  • Shortness of breath.
  • Cold sweat.
  • Lightheadedness or sudden dizziness.

If you are in doubt, get checked out.

Signs and symptoms of a stroke

Because stroke is usually not painful, patients may ignore the signs or symptoms and not seek medical attention, in the hope that they will improve. Acute stroke or TIA should be treated as a medical emergency and should be evaluated as soon as possible.

  • Weakness/numbness or limited movement to the affected side.
  • Memory loss/confusion, impaired thinking the loss of concentration.
  • Speech difficulties, (talking or understanding speech).
  • Visual disturbances.
  • Inability to control bowel or urine activities.
  • Loss of balance and difficulties in walking.

FAST is a simple way to remember the signs of a stroke and to seek medical help urgently.

F – Face drooping

A – Arm weakness

S – Speech difficulty

T – Time to call emergency medical services 

FACE: ask the person to show their teeth or smile and see if one side of the face droops or doesn’t move as well as the other side does.

ARMS: ask the person to lift both arms up and keep them up and see if one arm doesn’t move or drifts downward when extended.

SPEECH: ask the person to repeat a short sentence (e.g., “it is a sunny day in Cape Town”) and see if the person uses the correct words without slurring.

TIME: make a careful note of the time of onset of symptoms and call for help urgently if you spot any one of these signs.

For more information go to www.heartfoundation.co.za or find us on Facebook @HeartStrokeSA or on Twitter @SAHeartStroke

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DSA News – Winter 2021

DSA Port Elizabeth news

Denim for Diabetes

Well done to Megan Soanes who promotes the Denim for Diabetes project in Port Elizabeth, she got CompRSA to participate in this project by wearing denim for a day (14 May 2021) to raise much needed funds for the Port Elizabeth branch.

Diabetes Wellness meetings

We are thrilled to report that after more than a year of lockdown we have had two successful Diabetes Wellness meetings so far this year, in April and in May.

They were both held at our main meeting venue in Newton Park. Sadly, the venues for the Malabar and  Springdale meetings are not yet available, but they are most welcome to join us at the main meeting.

April Diabetes Wellness meeting

The people listening to our April speaker, Kevin Stead.

May Diabetes Wellness meeting

Magda Black, a registered dietitian, was the speaker in May.

Camp Diabetable

Our exciting news is that we have a camp for Type 1 children, thanks to the dedication and enthusiasm of Ernest Groenewald and his helpers, Paula Thom and Darren Badenhuizen. They are all young adults with Type 1 diabetes. There is still space available if you are in the Eastern Cape area.

Questions answered: COVID vaccines and diabetes

Dr Paula Diab addresses some of the more common questions and concerns around COVID vaccines in people with diabetes.

Who would have thought a year ago that we would be talking about COVID vaccines already? I graduated in the middle of the South African HIV epidemic (pre-antiretrovirals) and can remember at the time thinking that medication would take a lifetime to develop as HIV required completely new classes of medication. Within only five years of graduating, not only was medication available, but it had become available to all South Africans.

A year ago, I was again wondering how a vaccine could be developed as quickly as would be necessary and on such a large scale. But, the reality is that COVID vaccines are now available.

As a healthcare provider, I was fortunate enough to be one of the first people in South Africa to receive the vaccine and am now grateful that my patients will soon be offered the same.

Why are people with diabetes at risk of COVID?

It’s important to remember that you are not at risk of contracting COVID purely because you have diabetes. It seems that those with uncontrolled diabetes and other co-morbidities (hypertension, obesity, old age) may be at a higher risk than those with controlled diabetes and fewer complications from the disease.

We have also come to realise that diabetes care itself is affected by contracting COVID and therefore we need to try as much as possible to prevent the infection. This is why we are encouraging everyone with diabetes to get vaccinated as soon as possible.

Does getting the vaccine mean I can’t get the virus?

The main objective of the vaccines is to protect you against severe outcomes of COVID, but you may still be able to contract the virus and spread to others. Current evidence shows that you should still wear a mask and practice social distancing even after having the vaccine.

Which vaccine is best?

This question is a little like asking which the best car is to drive when you need to travel hundreds of kilometres and have only Shanks’ pony. Although all vaccines are produced in different countries and with slightly different technology, they are all showing good efficacy and safety. Worldwide, there are currently more than 60 vaccines in various stages of clinical trials.

Currently, there are no trials to show that one vaccine is superior to another or more effective for a particular population group.

Are the vaccines safe?

Although the speed at which the vaccines came to market was unprecedented, each vaccine has completed the standard three phases of clinical trials. These phases take a pharmaceutical product through a small group of people who are very closely monitored (phase 1), to larger groups, matched by ethnicity, age, comorbidities etc, (phase 2) and finally to much larger groups where it is compared to placebo (phase 3). At no stage was safety compromised with the COVID vaccines, only that the administrative process was expedited.

As an example, ethical approval for clinical trials usually takes months for committees to sit but with the COVID vaccines, most of these committees were called to emergency meetings and documentation provided that allowed them to decide within days so that the trial process could go ahead.

What are the side effects?

It’s important to remember that every medication and vaccination has side effects, but we need to rather weigh up the benefit and risk of the treatment being offered.

If you were offered a simple headache tablet that had the side effect of causing hair loss, it’s most likely that you wouldn’t take it. Headaches often tend to go away by themselves and the risk of hair loss would most probably outweigh the benefit of the medication. Yet, every day, people have chemotherapy that induces hair loss because this risk is outweighed by the benefit of placing a cancer into remission or greatly improving quality of life.

Initial side effects from the COVID vaccines are very similar to those of the general flu vaccines: pain at the injection site, general muscle aches, some nausea, and tiredness. These side effects generally indicate that an immune reaction is taking place (which is what you want).

International feedback is indicating that some, but not all, people with diabetes are experiencing slightly elevated blood glucose levels but these can be managed quite simply in conjunction with your diabetes care team.

What is an mRNA vaccine?

There has been a great deal of attention paid to the Pfizer/BioNTech and Moderna vaccines which are mRNA vaccines. This is the first vaccine to be produced with this technology. The truth is the technology had already been developed prior to 2020 but no suitable vector (virus) had been identified to test the vaccine. This was not technology that was developed de novo in 2020.

The usual mechanism of developing immunity is to give a small dose of the virus to which a person is allowed to develop their own immunity. This is the reason that some of the regular childhood vaccinations cause mild illnesses.

An mRNA vaccine uses a piece of the genetic material (the precursor to the illness) to create antibodies. It’s a little like giving the recipe for a cake so you can get out the required bowls, measuring jugs, ingredients etc and have a good idea how to make the cake but you don’t actually make it.

How should I monitor myself after having the vaccine?

It is generally recommended that you monitor your blood glucose levels for the first 24 to 48 hours after receiving the vaccine. Check your levels frequently, stay hydrated and keep in touch with your diabetes care team if you have any concerns. If you are prone to allergic reactions, make sure you have adequate emergency medication should you require it.

When should we expect to get vaccinated?

The optimistic response would be that hopefully by the time this article is printed, that South Africans over the age of 60 and with co-morbidities, such as diabetes, will be able to receive their vaccinations.

Certainly, the aim is that these groups of people should receive their vaccinations as part of phase 2 (May – October 2021) and that the rest of the population will be vaccinated from November 2021 onwards.

What happens if I refuse the vaccine?

Currently, it will not be mandatory for South Africans to be vaccinated. However, the quicker that we achieve herd immunity, the quicker life can return to “normal.” Even if you don’t receive the vaccine, you should still employ safety precautions.

What about children with diabetes?

Currently most vaccines are approved for people over the age of 16. Approving pharmaceuticals for children requires much stricter review and approval but various companies have requested clearance for ages 12-15. It is still thought that young children are at very low-risk of contracting severe COVID infection.

Hopefully, one day, we will be able to look back upon this time and be proud to have been part of this historic and unique event that changed the course of health care as we know it.

References available on request

Dr Paula Diab


Dr Paula Diab is a specialist family physician who enjoys the challenges that diabetes management has to offer. She runs a multi-disciplinary practice in Kloof, KZN, where she works with patients with diabetes and their families to allow them to gain control of their disease rather than being overwhelmed by the complexities and complications often associated with diabetes.

Tending to your life energy through the years

Have you ever considered that there is not a single cell in your body that is as old as your birth certificate says you are? Cells regenerate all through life. So, age is literally just a number.

What is age, actually?

Much more significant for health is celebrating the rhythm of life, having a healthy relationship to your biographical seven-year cycle (1-7; 7-14; 14-21; 21-28, etc), your sleeping and waking patterns, connecting with nature and nurturing your inner core. A healthy balance between your own time and community living is important too.

All of these impact on your energy body. For example, at the end of the first seven years, you lose your milk teeth and also the protection of your mother’s own immune shield (especially if you have been breast-fed). By fourteen, you have a changed body form, with the odd pimple suddenly showing itself and a voice change from an angelic piping to the expression of your emerging individuality.

The changes in the later cycles may not be as obvious physically but there is a shift every seven years as we mature. If we don’t consider the significance of these subtle changes, spiritually and physically, then we just grow old. If we do acknowledge and respond to these subtle changes we grow ‘up’ to where we came from and we can die healthy.1

Can we enhance our immune response system?

When we don’t feel well, we usually say, “Something is wrong with me.” or “What’s wrong with you?” The conventional approach is to reach for pharmaceutical help. One could also recognise this dis-ease as a messenger that something is out of balance. How you view it is entirely up to you.

Although this is your journey, especially in the case of diabetes, most people around you have an opinion on how you could, should or must change your life, even if they don’t tell you to your face. The vibe is palpable; the concern is written in their voices. This is completely understandable on a physical level because those close to you are affected by the way you view and deal with your situation. No one likes to experience their loved one in a coma, or at the mercy of mood swings resulting from fluctuating blood glucose. Besides adhering to your medication prescribed, there are things you can do to enhance your immune system and lower the rate of complications.

Nurturing through nature  

Sue Visser is a well-respected health writer and produces an effective range, Nature Fresh, found in local pharmacies and health shops. I asked her whether she had anything she could say about diabetes management. Turns out that she has a lot to say.

Did you know, for example, that metformin is based on the molecular components of the plant, French Lilac and Goat’s Rue? And, besides being a tried and trusted drug used to treat insulin resistance, it was originally developed to fight the flu in the 1920s?

Even more topical during this time of COVID, is her report on the benefits of metformin which has demonstrated the potential to inhibit the SARS-CoV-2 infection directly. A comparative reduction in the rate of mortality in diabetic patients on metformin with severe SARS-CoV-2 has been observed according to four hospital studies that show lower instances of death in their patients who take metformin.2

A tip Sue offered is to check and treat depleted magnesium levels, especially when diagnosed with diabetes prior to prescribed treatment.

Baobab powder

Sarah Venter worked as a Forestry Scientist for the Department of Forestry in Limpopo. One day while driving through the northern rural areas of Limpopo, where baobabs grow, she noticed that the baobab fruit was just rotting under the trees. This led her to do a PhD study on baobab fruit.

The excitement around her research led her to start a successful and sustainable enterprise, EcoProducts, involving the local villagers. Situated in Limpopo province, it employs up to 50 people in the processing of the fruit and over 800 helpers for harvesting. Together they create BaoActive, a pure baobab powder which is gluten free, suitable for vegans, and has been certified Halal and Kosher.

Baobab powder is naturally rich in vitamin C, vital for the support of the immune system, boosting defence against disease and infection.3 It has both high soluble and insoluble dietary fibre content. Soluble dietary fibres stimulate the growth of intestinal microflora allowing the more effective absorption of nutrients from food. The insoluble fibre provides the roughage necessary for the movement of food through the gastrointestinal tract. Being rich in polyphenols, baobab powder has a stabilising effect on blood glucose, especially when consuming high-starch foods, such as bread and pap.4 An exciting research paper is rewarding reading: “The polyphenol-rich baobab fruit reduces starch digestion and glycaemic response in humans.”

Bon Voyage!

It’s the persistent pursuit of small changes in lifestyle that leads to surprising and significant results. And this is the goal of Agents for Change. We all know what lies at the end of our road; let us arrive healthy and positive and looking forward to the inevitable next step.


  1. William Bryant – The veiled pulse of Time
  2. http://naturefresh.co.za/metaformin-offers-protection-for-diabetics/
  3. https://www.baoactive.co.za

Please contact Noy Pullen if you would like more information: [email protected] or 072 258 7132.

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Empathy in your diabetes care: a luxury or a necessity?

Daniel Sher dives into the science of empathy to show why empathy is a healthcare necessity, rather than a luxury.

As people with diabetes, most of us have experienced leaving the doctor feeling unheard, despondent, fearful, anxious or misunderstood. If we’re lucky enough to have a doctor who really cares, though, we may leave the consult feeling hopeful, heard, supported and considered. Through empathy, our doctors are setting us up for success in more ways than one.

What is empathy?

It is the ability to put yourself in the shoes of another and see things from their perspective. Ultimately, empathy involves a healthy, authentic connection between two people. Empathy comes easier to some than others, but it is a skill which, ultimately, can be learned and refined.

While some think of empathy as a vague and ‘fluffy’ concept, science has explored this ability fairly rigorously. We know, for example, that people who lack empathy tend to have reduced functioning in a specific part of the brain (the right supramarginal gyrus) which helps us to gauge the emotional state of others. We also know that empathy has real and significant implications for a person’s health, as we’ll discuss in more detail below. But first:

What does a doctor’s empathy look like?

There’s no doubt that some doctors’ empathy skills are stronger than others. The following are possible indicators that your healthcare professional is doing a good job on the empathy front.

  • You’re engaged in collaborative decision making about your treatment, rather than being told what to do.
  • You feel heard during the session.
  • You’re left feeling genuinely cared for, rather than told-off.
  • Your doctor explores the reasons for your difficulties, rather than simply pointing out where you’re going wrong.
  • Your doctor asks open-ended questions and really listens when you respond.
  • You feel that your concerns have been acknowledged, rather than brushed aside.


What stops a doctor (or any other person) from practicing empathy? If a person is anxious, sad, exhausted or over-stressed, this can stop one from being able to access the parts of the brain that help us to empathise with others.

For those who know how gruelling medical school can be, therefore, it may come as no surprise that medical training is known to lower empathy. It’s important for us to be empathic with our doctors in this regard. However, it’s also important that our doctors take responsibility for managing their workload and mental health properly, so that they can continue to fulfil the Hippocratic Oath by providing empathic care.

Keep in mind that in South Africa, state healthcare services are often under a great degree of pressure. Doctors with huge caseloads and ongoing exposure to trauma are less likely to be able to muster empathy than those who are not exposed to such conditions.

Does empathy really matter?

In short, yes. The science quite clearly tells us that empathy matters when it comes to diabetes care. More specifically, the research shows that empathy is more than just a vague and fuzzy feeling that is perhaps nice to have. Rather, empathy from your doctor may have a direct impact on your health. Let’s look at what some of the research has shown:

  • A study found that patients who have empathic physicians are more likely to follow treatment recommendations, including glucose testing, diet, exercise and medications.
  • The same study also found that patients who have empathic doctors tend to have a higher quality of life.
  • In this 2004 paper, it was shown that empathic doctors are better able to help their patients stick to proper self-care routines. Interestingly, the research showed that empathy ratings were, in fact, more important than the doctors’ medical expertise.
  • These researchers found that patients with empathic doctors tend to have lower HbA1C levels.
  • Amazingly, this 2019 study found that patients who have very empathic doctors are up to 50% less likely to die of heart-related issues.
  • Finally, this study found that empathic doctors help their patients to avoid admissions for diabetic ketoacidosis.

So, luxury or necessity? 

For many of us, empathy is little more than an afterthought. We feel lucky if our doctor leaves us feeling heard; but we don’t really feel that we have a right to expect empathy from our healthcare team. The science, however, suggests that empathy is far more than just a luxury. Rather, having an empathic doctor is a necessity and something to which we, as diabetic patients, have a right.


  1. Dambha-Miller, H., Feldman, A. L., Kinmonth, A. L., & Griffin, S. J. (2019). Association between primary care practitioner empathy and risk of cardiovascular events and all-cause mortality among patients with type 2 diabetes: A population-based prospective cohort study. The Annals of Family Medicine, 17(4), 311-318. 
  2. Del Canale, S., Louis, D. Z., Maio, V., Wang, X., Rossi, G., Hojat, M., & Gonnella, J. S. (2012). The relationship between physician empathy and disease complications: an empirical study of primary care physicians and their diabetic patients in Parma, Italy. Academic medicine, 87(9), 1243-1249.
  3. Eltaher, S. M., Rashid, M. A., Mahdy, A. W., & Lotfy, A. M. M. (2020). Physicians’ Empathy and Its Effect on Adherence to Treatment of Diabetic Patients in Al-Qassim Region, Saudi Arabia. Annals of Tropical Medicine and Health, 23, 231-638.
  4. Hojat, M., Louis, D. Z., Markham, F. W., Wender, R., Rabinowitz, C., & Gonnella, J. S. (2011). Physicians’ empathy and clinical outcomes for diabetic patients. Academic Medicine, 86(3), 359-364.
  5. Kim, S. S., Kaplowitz, S., & Johnston, M. V. (2004). The Effects of Physician Empathy on Patient Satisfaction and Compliance. Evaluation & the Health Professions, 27(3), 237–251


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital in Cape Town where he works with Type 1 and Type 2 diabetes to help them thrive. Visit danielshertherapy.com

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