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.