Two auto-immune diseases, two healthy children


Not even two auto-immune disease – Type 1 diabetes and Graves’ disease – stopped Tara-Lee De Wit from starting her family. She shares this journey with us.


Tara-Lee De Wit (28) lives in Hopefield, Western Cape with her husband and two children, Madison (6) and Kayden (4 months).


Auto-immune disease 1: Type 1 diabetes

In October 2007, at the age of 18, Tara-Lee would walk in to work with two bottles of juice, a bottle of water, a whole-wheat sandwich and fruit. However, the contents of this lunchbox would never sate her appetite. The scale shocked her with the fact that she had lost 6kg. “Considering how my calorie intake had increased over the past two weeks, I knew something was wrong,” she says.

What followed was a five-day stay in hospital and a diagnosis of Type 1 diabetes. Here, she was taught how to inject her stomach and thighs with insulin, and the importance of drinking water to flush ketones out of her system if she experienced a hyperglycaemic episode. “I was dreadfully shocked. No one in my family had diabetes. Let alone Type 1. But as I learnt, it is not hereditary. Thinking about it now, it seems scary, but in the moment, you do what you must do. You have no choice,” explains Tara-Lee.

Obviously, the teenager was overwhelmed but took her diagnosis in her stride due to her being a naturally disciplined person. “I learnt and researched as much as I could about my condition. Diabetes would not own me; I was adamant about that,” she adds.

Auto-immune disease 2: Graves’ disease

At 25-years-old, then a mother of one, was plagued with an abundance of symptoms: heart palpitations, heart rate constantly above 100bpm, constantly anxious, slight tremors in her hands, and then a goitre (swelling in the neck due to the enlargement of the thyroid gland). It was diagnosed as Graves’ disease, where the thyroid gland produces too much thyroid hormone (hyperthyroidism).

“During my research after my diabetes diagnosis, I read that when you’re diagnosed with an auto-immune condition, it is likely you can have more than one. However, I was still quite stunned. Once again, I read up as much about Graves’ disease and the thyroid as I could. Interestingly enough, both diseases I have are the rare ones. Hyperthyroidism affects up to 5% of people between the ages of 20 – 40 years old. Whereas hypothyroidism – where the body operates at a much slower rate, slow heartbeat, lacklustre, no energy, more prone to depression – is much more prevalent. Just like Type 1 only accounts for 10% of all diabetes, and is diagnosed mostly in children and young adults.”

Treatment

Currently, the 28-year-old takes Actrapid and Protaphane, injecting four times a day (Basal-bolus regime). The amount of insulin she takes is dependent on whether she is exercising, sick, and what she eats. “It allows me to change it accordingly to my lifestyle which is great. I am in control,” Tara-Lee says. For her thyroid, she takes 2,5mg of Carbimazole. Her thyroid is at optimal levels now.

Conflict of auto-immune diseases

If Tara-Lee’s thyroid hormone levels are high, then it interferes with her blood glucose control. But during this time, if it occurs, she takes extra insulin, until the thyroid medication starts working. “It takes about two weeks until you see a difference in thyroid levels,” she explains.

Pregnancy 1

Despite being a scared 22-year-old with Type 1 diabetes, the young mother had a very good pregnancy. “I knew I was doing everything I had to, to ensure the health of my baby remains at optimal levels. I had a consistent 6% HbA1c, and when Madison was born, my HbA1c was 5,4%. Madison was a bit bigger than normal, but babies born to diabetic mothers are known to be bigger when born. After a five-day hospital stay, Madison and I could go home,” she says.

Pregnancy 2

Tara-Lee had her second child, Kayden, this year July. The pregnancy was planned. Before conception, she worked with the endocrine unit at Tygerberg Hospital to ensure her HbA1c and thyroid levels were exactly where they should be. This took six months, then the married couple got the go ahead. Two months later, Tara-Lee was pregnant.

Describing this pregnancy, Tara-Lee says, “Despite a high blood pressure scare, all went well thankfully. Kayden was just growing exponentially and a decision was made to take him out via C-section at 37-weeks’ gestation. My big boy shocked all the doctors when he came out at a whopping 5,1kg! I was told he would have some lung immaturity (wet lungs), but we had no choice. He was on oxygen for a couple of days, and after all checks were done we went home after 11 days in hospital.”

You do what you have to do

With both pregnancies, Tara-Lee had to travel 300km every two weeks to the hospital. She did this for nine months, sometimes every week. She had much more foetal monitoring scans than someone who doesn’t have a high-risk pregnancy, and her HbA1c and thyroid levels were checked every 4-6 weeks. Commenting on this, Tara-Lee says, “You push through… you do what you have to. The team at the hospital was amazing; they helped me complete my family: two healthy babies even though I have two auto-immune conditions.”

10 years of being a diabetic

When Tara-Lee was asked how she feels looking back at her diagnosis 10 years ago, she responds, “I do not give much thought to the fact that I am diabetic. It is part of who I am. I always have my glucose meter with me, a roll of sweets in my bag, in the car, in my pocket…for that emergency hypo. I constantly carry my small bag with my insulin pens around with me.”

“But, in the beginning…in all honestly, the first thing I was concerned about was pregnancy. I knew it would probably be a huge undertaking, but was aware that pregnancy and diabetes can happen. Dr Google gives numerous horror stories. I remember searching online and in book stores for a story of a young South African woman with Type 1 diabetes, and her successful pregnancies. But I didn’t find any. This is what motivated me to share my story…for women in the same position I was…they need to hear the positive stories.”

Knowledge is power

“I am fully aware of what my body is susceptible to due to these two conditions I have: possible deteriorating eyesight, more prone to infections, take longer to recover when sick, kidney function must remain optimal etc. However, I take care of my body. This is what everyone should be doing anyway though.”

She goes on to say, “Diabetes is nothing to be afraid of. Knowledge is power. To this day, if someone finds out I have diabetes, they immediately say, ‘Oh, you are so thin, so which one do you have then?’, or ‘You don’t look sick!’ I hate hearing this. Yes, I do not look sick at all. I can do anything and be anything I want to be. Diabetes does not restrict me in any way.”

Exercise

The mother of two walks as much as she can, teaches hip-hop dancing to toddlers. She started cycling off-road, which she hopes to intensify soon. “I look for any excuse to remain active, even though I have an office job. Exercise releases the good endorphins. It is so important!”

Diet

“I eat whole wheat low-GI bread and the low-fat version of everything. Twice a day I drink a green smoothie, and make salads in summer. Three fruits a day is my goal, and I supplement with Provitas and cheese or peanut butter. However, I am not a saint –  I enjoy my father-in-law’s lovely Sunday roasts! I just remove the skin from the chicken,” Tara-lee explains.

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

Healthy and easy ways to make smoothies for people living with diabetes

Brought to you by: FUTURELIFE®


Smoothies are one of those foods that have stayed popular and remained on the food trend list for the last few years. Everywhere you look; restaurants, recipe books, food blogs and Pinterest are filled with the most delicious smoothie recipes and a simple google search on smoothies can pull through pages and pages of articles and recipes, but needless to say, looking through all this information can be a pretty daunting task. For those of you who don’t know anything about smoothies…you are in luck, here is all the information you need to know about making a nutritious smoothie.


WHAT ARE SMOOTHIES?

A smoothie is a blended drink made from a combination of fruits and/or vegetables; a liquid such as milk, a milk alternative, yogurt or juice and ice.1 Smoothies can vary in thickness depending on the ratio of solid to liquid ingredients used.

WHY ARE SMOOTHIES A GREAT ADDITION TO YOUR DAY?

As smoothies contain a combination of foods and are a great way to boost your nutrition in one meal. They often contain beneficial vitamins, minerals, antioxidants, fibre as well as healthy fats and protein. Smoothies are versatile, and if made correctly they can be had as a meal, snack or healthy treat.

There are endless combinations of ingredients that you can use to make smoothies, therefore it’s difficult to get bored. Smoothies are also quick and easy to prepare. Just put all the ingredients into a blender and ‘voila’ you have a nutrient dense meal.

ARE SMOOTHIES SAFE FOR INDIVIDUALS LIVING WITH DIABETES?

Living with diabetes doesn’t mean you need to deny yourself all the foods you love, but it is still important to ensure that you make healthier food choices. As smoothies contain many ingredients, they can often be high in sugar, carbohydrates and calories which can cause havoc on blood sugar levels. Therefore, it’s important to choose your ingredients carefully and keep an eye on how much you drink at a time.

HOW TO MAKE A ‘DIABETIC-FRIENDLY’ SMOOTHIE

1. Choose your produce

Most smoothie recipes call for the addition of a selection of fruits. Fruits are high in vitamins, minerals, fibre, antioxidants and natural sugars. Any seasonal fruit of your choice can be used but make sure include fruits of different colours. Examples include all berries, apples, pear, melon, nectarine, citrus, kiwi and plums etc. Watch your portion of the following fruits as they contain more sugar per portion e.g. banana’s, grapes, figs, paw paw, melon and dried fruit.

If you are going to include other carbohydrate sources in your smoothie, such as dairy or a cereal product e.g. FUTURELIFE® or oats, it is suggested you only include 1/2 – 1 fruit portion per smoothie.

One fruit portion = 1 tennis ball size fruit OR 2 golf ball size fruit OR ½ cup
People often forget about adding vegetables to smoothies. Vegetables also contain fewer carbohydrates than fruit therefore are helpful in keeping the total carbohydrate of the smoothie down. Including vegetables in your smoothie is a quick and convenient way to include more vegetables into your day. Any of the green vegetables such as kale, spinach, broccoli, cucumber and avocado are great additions to any smoothie as they contain little carbohydrates. Be careful of starchy vegetables such as carrots or beetroot. Some recipes also call for cooked vegetables like sweet potato or legumes that contribute to fibre content, texture and taste.

One vegetable portion = 1 cup raw vegetables OR ½ cup cooked
Natural sugars, found in fruits and starchy vegetables, also cause spikes in your blood sugar levels if too much is eaten at once. Remember to count the fruit and starchy vegetables you blend into your smoothies as part of your daily fruit allowance. This will ensure you don’t overdo it on carbohydrates.

2. Add your liquid

There are many choices when it comes to liquids, many people just add water or ice. Including plain, unsweetened dairy such yoghurt or milk not only contributes calcium and vitamin D which is important for bone health but also increases the protein content. This helps to lower the Glycaemic index (GI) of the whole smoothie (refer to article on GI & GL),2 which helps to prevent spikes in blood sugar levels.2,3 Bear in mind that dairy also contains carbohydrates, therefore contributing to the total carbohydrate content of the smoothie.

For dairy free options include a non-sweetened milk alternative such as soy, almond, rice, hemp, or a little bit of coconut milk. Other recipes also call for fruit juice, however for people living with diabetes, fruit juice isn’t recommended as it contains natural sugars but no fibre. Remember these smoothies contain multiple ingredients that contain carbohydrates, fruit juice will push the carbohydrate content up quickly.

3. Boost nutrition
Protein & Fat
Including a source of protein and fat in your smoothie is helpful as they both slow the rate at which the meal leaves the stomach. This slows down the absorption of the sugars into your blood which prevents spikes in blood sugar levels.

  • Ways to boost the protein content would be to add a protein powder such as whey and /or casein which is milk based or a plant based protein powder include hemp, soy, brown rice, and pea.
  • Include the following healthy fats in your smoothie: 1 small handful of nuts, 1 – 2 Tablespoons of seeds, ½ small avocado (gives your smoothie a creamy texture), 1 tablespoon of sugar free nut butter and 1 teaspoon of seed oils e.g. coconut, flaxseed, macadamia or olive.

Other tips:

  • Whole grains can also be a useful addition to the smoothie as they contribute texture and boost the nutritionals by adding vitamins, minerals, fibre, and protein and are low GI. Oats or oat bran are a great option. Remember to watch portions as they will contribute to the carbohydrate content
  • Don’t add extra sweeteners; remember fruits and dairy contain natural sugars already.
  • Remember to consider the carbohydrate content of the total smoothie. This should be no more than 1 – 3 carbohydrate exchanges depending on if it’s a meal or snack.

WHERE DOES FUTURELIFE® FIT IN?
FUTURELIFE® products are a great addition to any smoothie as they contain nutrients that are useful when looking at the steps for making diabetic friendly recipes above. They are high in protein, fibre, healthy fats and omega-3. Many of our products are also enriched with vitamins and minerals; contain the prebiotic inulin and MODUCARE® which supports the immune system. Our products are also quick and easy to prepare, just add water or milk.

FUTURELIFE® Smart food™, FUTURELIFE® HIGH PROTEIN Smart food™ and ZERO Smart food™ are the recommended products to add to any smoothie. While all are high in protein and fibre, low GI and nutrient dense, FUTURELIFE® HIGH PROTEIN Smart food™ has the highest protein content of 30 g per 100g. It contains SmartProtein3D which is a combination of soy, casein and whey protein, and has the lowest carbohydrate content and GI of all our products. FUTURELIFE® ZERO Smart food™ is free of cane sugar and contains Smart Sweetness, a combination of Stevia, Erythritol and Sucralose. All 3 offering great benefits despite your preferences.


How to make a diabetic friendly smoothie:

ONE

Choose your produce. Include both fruit and vegetables and stick to portions

One fruit portion = 1 tennis ball size fruit OR 2 golf ball size fruit OR ½ cup

One vegetable portion = 1 cup raw vegetables OR ½ cup cooked

TWO

Add your liquid e.g. water, milk, yoghurt or dairy free option such as unsweetened soy, almond or coconut milk

THREE

Boost the nutritionals with a source of protein and fat

FOUR

Consider the carbohydrate content of the total smoothie


There you have it, see how simple it is to make your own smoothie. Remember by following these principles above you can adapt any smoothie recipe into one that is suitable for people living with diabetes. Included below are some easy recipes containing FUTURELIFE® products for those living with diabetes. Consult with your dietitian or diabetic nurse educator if you have any questions. For more delicious smoothie recipes, nutritional advice, health tips, Diabetes meal plans and more, visit www.futurelife.co.za


Try our healthy and easy recipes!

FUTURELIFE® Mixed Berries and Mint Crush

Ingredients 1/3 cup mixed frozen berries 125 ml plain fat free / low fat yoghurt 125 ml water 40 g or 4 Tbsp. FUTURELIFE® Smart

FUTURELIFE® HIGH PROTEIN Mocha Smoothie

Ingredients ½ cup of coffee, already prepared ½ cup low-fat or fat-free yoghurt (vanilla) 1 handful of ice 50 g (5 heaped Tbsp.) of FUTURELIFE®

Workplace wellness – making the workplace a healthy, happy space

Corporate Wellness Week is observed in the first week of July (1-7). With this in mind, Paula Pienaar explains why workplace wellness is of vital importance.

What is corporate wellness?

Corporate, employee or workplace wellness refers to the physical and mental well-being and health of employees, their work environment and workplace culture. Understanding the significance of this concept begins by addressing the health needs of our working population.

State of the nation’s health

Recent data from Statistics SA show that 56% of all deaths annually are attributed to chronic diseases, such as heart disease, cancer, diabetes and stroke. In fact, Type 2 diabetes mellitus is now the second most common cause of death in South Africa (5,4%), after tuberculosis (7,2%)1. The prevention and management of such chronic diseases can be largely accomplished by managing associated health risk factors which include hypertension, high blood sugar levels, high cholesterol, excess body weight and lifestyle behaviours, such as smoking, physical inactivity, poor dietary habits and poor sleep health. One estimate is that eliminating these health risk behaviours would make it possible to prevent 80% of heart disease, stroke, and Type 2 diabetes mellitus, and even 40% of cancers2.

Using the workplace to improve the nation’s health

Recent economic statistics show that 44% of South Africans are employed3 and on average, South Africans who work full-time spend more than one-third of their day, five days a week, at their workplace. It is therefore not surprising that the workplace provides an opportune setting through which a large part of the population can be helped through workplace wellness programmes. Employers have a responsibility to provide a safe, hazard-free workplace for their employees and also the opportunity to foster a happy, productive working environment by promoting a healthy lifestyle.

Workplace Wellness programmes (WWPs)

Healthy employees are more productive and have the lowest cost to organisations. WWPs therefore aim to prevent the development of chronic diseases and support employees with existing chronic medical conditions. Another way in which employees can be supported is by creating a work environment that encourages healthy lifestyle behaviours, such as having quality short breaks away from the desk, physical activity, good nutrition and no smoking. Successful, effective WWPs therefore have significant benefits to the organisation and to employees.

Workplace wellness is beneficial to:

The Organisation

The Employee

Reduces productivity loss. Reduces risk for premature death.
Reduces risk for short-term disability. Reduces risk for cardiovascular disease, diabetes, cancers, back pain, and high cholesterol.
Enhances mood and job satisfaction. Results in greater job satisfaction.
Enhances work performance. May increase annual income.
Reduces healthcare spending. Lowers debt.
Lowers employee turnover rates. Lowers long-term unemployment.

Workplace wellness – the key to a healthy, happy and productive workforce

Workplace wellness is among the most vital investments that a company can make. Businesses that start WWPs aren’t only investing in the physical wellness, safety, and mental health of their employees, but are also taking preventive measures by creating a healthier environment. A recent scientific review concluded that well-designed, comprehensive WWPs have the potential to improve heart health and to reduce mortality and disability resulting from cardiovascular disease and stroke4.

5 evidence-based strategies that have shown to work in successful WWPs:

  1. Wellness screening days (height, weight, waist circumference and finger prick blood tests).
  2. Healthy lifestyle programmes (e.g. smoking cessation, weight loss, fatigue management, and diabetes programmes).
  3. Covering or minimising co-payment of lifestyle-related health programmes.
  4. Onsite exercise facilities and informative health talks.
  5. Fully covered flu vaccinations.

Making workplace wellness enjoyable

Participation in workplace wellness initiatives may often be poor. However, research has shown that by involving employees in the roll-out of such programmes through interest-based surveys and good communication strategies, companies can play a significant role in changing employees’ attitudes to work from a dreary obligation to an exciting health-enhancing part of their day.

Strategies that organisations can take to improve 3 pillars of performance – nutrition, physical activity and adequate rest:

  1. Nutrition
    1. Review the catering menu and vending machines to gently introduce healthier options.
    2. Coordinate a ‘healthy snack of the month’ club.
  2. Physical activity
    1. Arrange for bicycle racks and provide ‘bike to work’ promotional materials.
    2. Make the area around the office building conducive to walks and try to move your meetings from the boardroom to walking paths (walking meetings).
  3. Sleep and fatigue
    1. Invite a sleep health professional to a ‘lunch and learn’ session.
    2. Create a workplace with adequate natural lighting and low noise levels.

For more information, please visit eohworkplacehealth.co.za

MEET OUR EXPERT - Paula R. Pienaar

Paula R. Pienaar
Paula R. Pienaar (BSc (Med)(Hons) Exercise Science (Biokinetics)), MSc (Med) Exercise Science) is the scientific advisor to EOH Workplace Health and Wellness, and a PhD candidate at the University of Cape Town. Her scientific research relates to sleep health and managing daytime fatigue to improve workplace productivity and lower the risk of chronic disease. Her thesis will identify the link between sleep and cardiometabolic diseases (Type 2 diabetes and cardiovascular disease) in South African employees. She aims to design a tailored sleep and fatigue management workplace health intervention to improve employee health risk profiles and enhance work productivity. Contact her at paula.pienaar@eoh.co.za

References:

  1. Statistics South Africa, Mortality and causes of death in South Africa, 2015: Findings from death notification. 2017: Pretoria:SSA.
  2. Lloyd-Jones DM, Hong Y, Labarthe D, et al. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation. 2010;121(4): 586-613
  3. https://tradingeconomics.com/south-africa/employment-rate
  4. Fonarow GC, Calitz C, Arena R, et al. Workplace wellness recognition for optimizing workplace health: a presidential advisory from the American Heart Association. Circulation. 2015;131(20): e480-e497.

Staying healthy together

When starting your fitness journey, it can be challenging at first. Sheana Abrahams suggests getting a training buddy – partner, family member or friend – to help make it less of a burden. Training with someone will make exercise fun and gives you the support you need, and allows both of you to hold each other accountable for every training session. Sheana shares the benefits of exercise and provides tips on how to support each other and how to stay on this fitness journey together.

What are the benefits of exercise?

Where to start? Before you start any exercise, make sure you have spoken to your doctor and that he/she has cleared you for exercise and set out clear guidelines. If there are any other complications, or certain limitations have been set by your doctor, you should consider obtaining a personalised exercise program prescribed by a health professional, e.g. a biokineticist, to make sure that you’re doing the right exercise for your type of diabetes and at the right intensity level.

Let’s look at what some of the benefits are:

  • Better control of your diabetes and blood glucose levels: when you exercise, your muscles use glucose for energy. That being said, it is important to constantly check your blood sugar levels when you exercise. Physical activity may affect your blood sugar levels both during and after exercise, so make sure you check it regularly.
  • It can help avoid long-term complications: by exercising, you are in turn controlling your blood glucose levels, which is important to help prevent long-term complications such as kidney disease, nerve pain and heart problems.

Other benefits of exercise are:

  • Helps lower blood pressure
  • Better control of weight
  • Stronger bones
  • Stronger and leaner muscles
  • Exercise gives you more energy
  • Helps improve your mood
  • Makes you sleep better
  • Helps with stress management
  • Helps prevent diabetes in family members by lowering their risk factors.

What exercise can you do?

There are three types of exercises that you should do: aerobic; strength/resistance training; and stretching. Your aim should be to have a good balance of all three1.

Examples of aerobic exercises are:

  • Walking
  • Jogging/running
  • Tennis
  • Swimming
  • Dancing
  • Cycling, etc.

The American College of Sports Medicine (ACSM) guidelines say that you should aim to get at least 30 minutes of aerobic exercise most days of the week. Remember, this does not have to be done in one go, you can split the 30 minutes up throughout the day, for example you can do 10 minutes in the morning, 10 minutes in the afternoon, and 10 minutes in the evening. As you get fitter, you can gradually build up to doing exercise for a continuous 30 minutes.

Be creative with your exercise; go for a walk in the park, or after dinner get the whole family to walk together, put the music on and dance, walk with a friend, take the dog for a walk, or go for a nice jog near the beach. The more fun exercise is, the more you’ll stick to it. Find activities that you really love and enjoy, and ask your friend, partner or family to do the exercises with you. This will help keep you motivated.

Strength training

Once you have started doing your aerobic training and you’re managing to fit in 30 minutes most days of the week, chat to your doctor about adding strength training to your exercise regime.

Simple strength training on at least two days of the week is important in Type 2 diabetes as it helps to control the blood sugar levels and improves the action of the body’s own insulin2. Strength training builds lean muscle, and it also helps to maintain strong healthy bones.

Strength training doesn’t mean that you need to lift weights, you can use your own body weight to build up strength. Using your own body weight, you can do exercises such as squats, push-ups, lunges, crunches or sit-ups.

When you’re starting a strength training program, make sure that it is prescribed specifically for you. Always seek advice from your doctor, biokineticist or personal trainer who has experience in working with people who have diabetes. It’s important for you to start with the right exercises and the right intensity as well as being taught how to do the exercise correctly. Doing strength training for 20-30 minutes two or three times a week is sufficient1.

Flexibility training

Flexibility training can help prevent pain, stiffness, and injury of muscles and joints1. Stretching before and after training reduces muscle tenderness and relaxes your muscles2. Yoga is a great activity to do to help increase your flexibility.

Exercise safety

  • Remember to start slowly, especially if you have not exercised before.
  • Check your blood sugar before and after exercise until you’re aware of how your body responds to exercise4.
  • Do a nice warm up before training and a cool down after training.
  • Remember to stay hydrated and drink plenty of water before, during and after exercise4.
  • Be prepared for any episodes of low blood sugar. Always have something sweet with you that can increase your blood sugar level4.
  • Always carry a cell phone with you when exercising in case of an emergency4.
  • Do not exercise in extremely hot or cold temperatures.
  • Wear proper shoes and socks to protect your feet when doing any physical activity4.

Remember to be conscious of your body, if you become short of breath, dizzy or light-headed, stop exercising. Seek advice from your doctor if you continue to have any of the above symptoms or feelings or experience any other unusual problems4.

What can you do as a partner, family member or friend?

  • Talk to your partner, family member or friend who has diabetes about seeing the doctor before starting an exercise program. This will allow him/her to know their exercise limits and from there you can both set realistic goals and choose the right exercises for the type of diabetes.
  • Suggest going for walks a few days in the evening after work.
  • Instead of going out and getting takeaways, take a nice walk together or do a fun activity and then make a healthy meal.
  • Sit down and work on your training plan together, set your goals, and decide on the exercises that both of you can do. Make it a team effort.
  • Encourage your friend, partner or family member who has diabetes to do his/her blood checks before, during and after exercise, and to keep an exercise journal and write down all training sessions and blood glucose readings.
  • Encourage each other to make exercise a daily habit, and choose fun activities to do together that you both enjoy.
  • Get educated about diabetes, know the signs and symptoms of low blood sugar and learn what to do in these situations.
  • Constantly acknowledge your partner, friend or family who has diabetes, and let them know how proud you are of them for keeping up with their exercise regime, and remind them how this is an important part of managing their diabetes3.

Any chronic illness can have a profound impact on the family member, partner or friend. Looking at ways to stay active and healthy can be a fun and rewarding journey that you can all take together.

MEET OUR EXPERT - Sheana Abrahams

Sheana Abrahams studied a BSc. Sport and Exercise Science and then completed a BSc. (Honours) Biokinetics. Based in Cape Town, she the Head of Health and Wellness at GetSmarter, and frequently presents the fitness segment on the Expresso Show on SABC 3.

Maintaining a healthy sex life

Newly diagnosed diabetes patients may have many questions at first, but, “How will this chronic illness affect my sex life?” is probably not one of them. However, diabetes and the medications used to treat it can cause sexual challenges for men and women, but with some education and a little extra planning, there’s no reason for diabetes to be a downer in the bedroom.

It’s important to be aware of these possible sexual changes, and to discuss any sexual malfunctions with your doctor no matter how embarrassing you may find the topic.

Women’s sexual health

Most commonly, women who have diabetes will experience a lower sex drive compared to women without the condition.

This can be for several reasons:

  • Blood glucose level changes can cause irritability or a lack of energy.
  • Depression and anxiety associated with diabetes can lower a desire for sex.
  • Anti-depressive medications can lower sex drive.
  • Autonomic neuropathy can lead to vaginal dryness and painful sex.

In some cases, nerve damage in diabetic women can make it more difficult for a woman to experience an orgasm. Sex can also be uncomfortable and unpleasant when a woman has a yeast infection or experiences vaginal itching.

These sexual difficulties are not a normal part of aging and can be addressed if you broach the topic with your doctor. They may suggest the following options to maintain a healthy sexual appetite:

  • Monitor your blood glucose levels closely before having sex to increase energy and reduce irritability.
  • Seek medication for depression or anxiety.
  • If anti-depressive medicines are causing your low sex drive, speak to your doctor about trying a different medicine, or discontinuing the medication and seek counselling instead.
  • Use water-based lubricant to combat vaginal dryness and practice Kegel exercises to relax vaginal muscles.
  • Avoid drugs that may cause painful yeast infections.

Men’s sexual health

Diabetes can also cause sexual complications in men; most notably, erectile dysfunction and retrograde ejaculation. Those with erectile dysfunction cannot get or maintain an erection. In men with retrograde ejaculation, semen empties into the bladder, rather than out of the tip of the penis. In both cases, diabetes-related autonomic neuropathy is likely the cause. This type of nerve damage often occurs when a person maintains poor control over their glucose levels.

In the case of erectile dysfunction, when the autonomic nerves are damaged, they can no longer communicate arousal from the brain to the penis. Similarly, damaged autonomic nerves may stop a sphincter in the bladder from opening, stopping semen to exit the penis. Erectile dysfunction can be embarrassing and makes the act of sex physically impossible. Men with retrograde ejaculation will likely experience infertility.

Additionally, some uncircumcised men who take certain drugs may also notice a high frequency of genital bacterial infections. While neither condition is, painful or causes bodily harm, both can cause problems in the bedroom.

Fortunately, both erectile dysfunction and retrograde ejaculation have solutions. To treat erectile dysfunction, men may consider trying:

  • Oral prescriptions, such as Viagra.
  • Injections of prostaglandins into the penis.
  • Vacuum pumps to draw blood to the penis.
  • Surgical implants.
  • Counselling to reduce anxiety about sexual performance.

To treat retrograde ejaculation, men may consider trying:

  • Meeting with a urologist for a more specific diagnosis of the condition.
  • Medication that strengthens the bladder sphincter muscles.
  • Fertility treatments, such as extracting semen from the urine to use in artificial insemination.
References:
American Diabetes Association. (2013, June 7). Autonomic Neuropathy. Retrieved from http://www.diabetes.org/living-with diabetes/complications/neuropathy/autonomic-neuropathy.html.

American Diabetes Association. (2013, August 1). Sexual Health. Retrieved from http://www.diabetes.org/living-with-diabetes/treatment-and-care/women/sexual-health.html

Auteri, S. (2014, March). How Chronic Illness Can Affect Sexual Function. Retrieved from https://www.aasect.org/how-chronic-illness-can-affect-sexual-function

The National Institute of Diabetes and Digestive and Kidney Diseases. (2008, December). Diabetes & Sexual & Urologic Problems. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/sexual-urologic-problems

Nyirjesy, P. (2013, May). Genital mycotic infections in patients with diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23748505

MEET OUR EXPERT – Taylor Griffith

Taylor Griffith2Taylor Griffith is an award-winning journalist with a background in newspaper, magazine and digital writing. She earned her degree from the University of Maryland’s Philip Merrill College of Journalism. She regularly contributes to drugwatch.com, along with other publications.


Healthy eating – a family affair

A healthy meal plan isn’t just for people with diabetes. In fact, the dietary guidelines recommended for people with diabetes are the same as those recommended for the rest of the population. That means your family doesn’t need to prepare separate meals for you at home – they can simply adopt your healthy habits. Follow these 10 tips to build a balanced and healthy meal plan for your whole family.

  1. Enjoy a variety of foods.

Not one food can deliver all the necessary nutrients for you and your family, so you should make sure that your family eats different types of food.

  1. Make starchy foods part of most meals.

A small portion of good quality carbohydrates helps to give the body energy. Choose high-fibre starchy foods – like high-fibre breakfast cereals, whole grain bread and wholewheat pasta – over more refined versions for sustained energy to help your family through the work or school day.

  1. Eat dried beans, split peas, lentils and soya regularly.

Beans and legumes are good sources of protein, fibre and B vitamins, and they also help to improve blood glucose control. Aim to include beans and legumes in your family’s menu at least twice a week.

  1. Eat plenty of vegetables and fruit every day.

Vegetables and fruit contain loads of different nutrients, like fibre, vitamins and minerals. Your family should eat at least five portions of vegetables and fruit daily to make sure they get a variety of nutrients needed for health.

  1. Have milk, maas or yoghurt every day.

Encourage your family to enjoy at least three servings of dairy foods per day to ensure they develop strong, healthy teeth and bones. Aim to choose versions with less added sugar where possible.

  1. Drink lots of clean safe water.

Water is the best way for your family to stay hydrated and should be their first choice when choosing a beverage. It is the cheapest yet best drink of all. Start your children on water when they are young and it will remain a good habit for the rest of their lives.

  1. Use salt and food high in salt sparingly.

Eating too much salt increases your risk of high blood pressure (hypertension) and health conditions in the long term. Let your family enjoy the natural taste of foods by not adding salt to meals and avoiding salty ingredients in your cooking, such as stock cubes and soup powders.

  1. Use sugar and food and drinks high in sugar sparingly.

Limit foods with added sugar, like cookies, sweets, chocolates and sugar-sweetened drinks. Keep sugary foods as ‘special occasion’ treats, and practice portion control when you do enjoy them.

  1. Fish, chicken, lean meat and eggs can be eaten daily.

Protein helps to provide the body with strength and structure, while repairing damage and promoting growth. Including protein in your meals also helps to improve blood glucose control. Oily fish is also a great source of omega-3 fatty acids which helps to protect against heart disease.

  1. Choose good quality fats.

Beware of eating excess saturated and trans fats. When you and your family use fats, choose unsaturated sources like olive and canola oil, oily fish, tub margarines, avocado, peanut butter and nuts.

Pick n Pay Health Hotline

Did you know that Pick n Pay employs a registered dietitian to provide free food and nutrition-related advice to the public? Whether looking for guidelines on managing your condition, weight loss tips, healthy eating tips for kids, how to manage food allergies, how to interpret food labels or any other food-related query you have always wanted answered, our registered dietitian is just a phone call away.

Contact the Pick n Pay Health Hotline on 0800 11 22 88 or email healthhotline@pnp.co.za to start your nutrition conversation.

MEET OUR EXPERT - Leanne Kiezer

Registered Dietitian BSc Diet, PgD Diet UKZN, MSc Nutrition NWU. Leanne joined Pick n Pay as the resident dietitian in May 2014. She is the voice behind the Pick n Pay Health Hotline, providing advice to customers on a range of nutrition and health-related topics. She also provides nutrition input as part of the Pick n Pay food development team, and ensures that all communication is in line with the most recent advances in nutrition science and research.

Is butter healthy?

If you have diabetes, you have an increased risk of developing cardiovascular disease. To reduce this risk, it is essential that you optimise your nutrition as part of a healthy lifestyle. Trying to understand the effects of dietary fats on your heart and health is not easy, and it still remains a topic of confusion and, in some instances, fierce debate. Read more…