Rita van Wetten shares how her and her husband, Toine, have persisted the glass-is-half-full-attitude in both of their diabetes journeys.

Tonie (80) and Rita van Wetten (67) live in Ballito, KwaZulu-Natal and have been married for 47 years. They have one daughter and an adopted grandson. Rita has Type 1 diabetes and Toine has Type 2 diabetes.

Rita’s diagnosis

Rita was diagnosed with Type 1 diabetes in 1970 and thinking back she recalls how things have changed, for the better of course. “My first syringe looked like an icing decorator and it was extremely stressful to inject myself. In those years, a person with diabetes couldn’t check his/her blood glucose like we do nowadays. You had to go for blood tests at the lab, or on visiting my physician, he would take my urine sample, put it in a test tube and light a burner, he would then put a tablet in the urine and hold the test tube over the burner. Then he would compare the result with a strip on the tablet’s bottle and most of the time my glucose level would be shockingly high. The urine glucose could be an hour or more out in comparison to a blood test.”

“When we could test our own blood glucose around the 1990s, you had to prick your finger with what looked like a scalpel blade. Scary, and needless to say to get a proper drop of blood for the test was extremely stressful. I think my readings were always high as just battling to prick with that lancet made me perspire, stress and curse every time. It was horrible! Insulin changed over the decades from pig-based insulin to human-culture based insulin.”

Rita admits in the first four years of her diagnosis, she couldn’t accept it. “I was in complete denial and cheated and lied to everybody and myself for those four years. This changed once I got married and the biggest turning point was when I was invited to a diabetes meeting at the old Hillbrow hospital, but unbeknown to me this was a lecture for medical students. The words were one thing, but the graphic and horrific slides showing an ulcerating leg, foot, and vagina, with three quarters ‘eaten away’ jerked any complacency out of me.”

“During the lecture, there was also a discussion about the pregnancy complications for a woman with diabetes, and her unborn child. Toine and I so wanted at least one child so that is when while driving home I decided, no more transgressing!”

Brittle diabetic

In the first years of Rita’s diagnosis, it was a struggle to stabilise her glucose levels, not only by herself but by doctors too. “I remember soon after I was diagnosed, I was admitted to hospital to try and stabilise my glucose, and also during my pregnancy I was in hospital for three months. My gynae eventually said, ‘We will never be able to get your glucose right, go home and try your utmost at home.’ I would be 12 mmol/L and within 30 minutes I could be in a hypoglycaemic coma, and it wouldn’t be because of over-injecting. This happened often and I was then deemed a brittle diabetic.”

Brittle diabetes is a term used to describe Type 1 diabetes that is particularly difficult to control. If you have brittle diabetes, you are likely to experience frequent, dramatic swings in blood glucose levels and are at risk of dangerous periods of hypoglycaemia and hyperglycaemia.

Rita adds, “I have never had a hyperglycaemic coma but about 500 hypo comas (where I was out for the count and needed help, either from family, friends or paramedics or doctors). That is apart from  thousands of lows in my 50-years with diabetes. In the early years of my life with diabetes, I had bad spells of high glucose and very often had ketoacidosis.”

Toine’s diagnosis

Toine was diagnosed with Type 2 diabetes after an armed robbery in 2005. Rita explains, “However, he is also unfortunately genetically predisposed due to a family history going back generations.”  Toine currently takes Jardiance and Galvus Met as well as cholesterol medication and Rita uses Tresiba (long-acting insulin) and Humalog (short-acting insulin) and Glucophage.

Managing their diabetes together

Despite the turbulent road Rita has had with her glucose control, she is happy to say she has no secondary complications caused from diabetes. She attributes this to managing her diabetes as best as she can.

“I have no secondary health problems due to diabetes. This I feel is due to a number of factors: after the wake-up call of the diabetes meeting, Toine and I incorporated a healthy lifestyle with regard to eating habits and keeping fit. Smoking and drinking were out. I detest smoking and I have never taken to drink. Regarding our eating plan, we eat very little white carbohydrates (bread, rice, potatoes). However, that doesn’t mean that we occasionally don’t cheat, but when we do we relish and love it and enjoy it thoroughly and thereafter back to the straight and narrow next meal. I carbo count, our dietitian has helped me to work out to a fine art what to inject for what I am going to eat. This injection depends entirely on what my reading is before we eat.”

A game changer

“Since glucometers came into fashion, my control improved a lot. Before I was on Freestyle Libre, I used to test up to 20 times a day because I’m not able to distinguish between high or low glucose symptoms. However, the Freestyle Libre has made my life a lot easier the past three years, actually it has changed my life completely. And Toine’s life as well. He can check my readings any time, whether I am asleep or busy reading or whatever I am busy with.”

Advice for families

Rita’s advice for family with a newly diagnosed member is, “Cook and serve healthy and nourishing meals to everyone in the family. In other words, as a family, decide how this diabetes disruptor is going to be handled and tackled by the family. It’s not only a problem for the person with diabetes.”

Her reasoning for this is her own experience, “When I was just diagnosed, it was a shock to me and my family. It felt like a death sentence. The admonitions and finger wagging of the doctor, no sugar, no desserts etc, only chicken and salads from now on demolished my savoury and sweet tooth staples. While the rest of the family ate delicious meals, I had to/pretended that my piece of chicken and salad was nice. I felt alienated (A driver of my denialism?). Once the family was asleep, I would creep into the pantry and help myself to tasty leftovers. I became a food thief par excellence.”

Glass half full attitude

Rita also attributes positivity to her and Toine’s good management of diabetes. “We keep friends with a positive outlook on life as we are very positive. I believe that having the glass half full personality is important in life. We laugh a lot, at, with and about ourselves (thankfully nobody has to listen to our warped sense of humour). Furthermore, we have immense respect for one another and we touch and cuddle often and show and tell our immense love for each other.”

“We do a lot of things together but we also give each other room to do our own thing. I’m an extrovert and Toine is an introvert. It works well for us. I have always kept myself busy with hobbies over the years like pottery, sculpting, weaving, painting and dancing (which I still do now) and I belong to a writers club. Toine reads a lot and does woodwork; he makes frames for my art. We do crosswords and quizzes and play games and also card games. Last but not the least we are Christians and our faith is of utmost importance in our lives and it keeps us on our knees and grateful, joyful, thankful, happy and our hearts filled with love.”

When asked if they feel they are aging or upgrading, Rita responds, “Mentally, we feel very young. Physically it gets harder and harder to keep fit and before COVID we used to walk 5 plus kilometres daily on the boardwalk without a problem. With lockdown, it went out the window and down the tube. We are trying to get back but it is hard. The mind is willing and instructs; but the muscles say, who are you talking to?”

Surendra and Manjhula Daya, the co-ordinators for the Malabar Diabetes Wellness Group, tell us about both having diabetes and managing it together.

Surendra (71) and Manjhula Daya (71) live in Malabar, Port Elizabeth. They have been married for 46 years and have two adult children and two grandsons. Surendra has Type 2 diabetes and Manjhula has Type 2 diabetes.

Manjhula was diagnosed first, in 2000. She remained positive as she knew diabetes is controllable and in order to live a full life, one needs to accept this. She has used insulin (Basaglar and Humalog) since her diagnosis.

Surendra was diagnosed in 2008. He too accepted the condition, despite having high blood pressure and heart problems. His belief is that one must not be upset with the sickness they have, they just need to be positive that they will overcome and survive. He was prescribed Glucophage XR 500 and still takes it today.

The Dayas became members of DSA in September 2009 and Surendra became the co-ordinator of the Malabar Diabetes Wellness Group, which had been in recess for a while; in 2012 when it was re-launched on Valentine’s Day.

“Throughout our lives, my wife and I knew we had to be positive and support each other no matter what, and this is what we did when we found out we had diabetes. We became aware of what we were eating, especially during the Diwali festival. The wife prepares all the delicious sweetmeats, but we control our eating habits during this time.  Every winter, we get our flu vaccines. and we are waiting to get our COVID vaccines Even though we are aging in years, we feel we are upgrading in life,” Surendra says.