LesDaChef – living with diabetes

Five months ago, Lesego Semenya, aka LesDaChef, was diagnosed with Type 1 diabetes. We caught up with the 36-year-old chef to see if his love for food has changed.


Lesego Semenya (36) stays in Meredale, JHB south, Gauteng.

Who is LesDaChef?

I’m a former process engineer. I used to wear a tie and suit every day for six years before the madness hit me. After I quit the corporate scene I travelled around SA for a year. Once I got tired of that I enrolled at Prue Leith Chef’s Academy in June 2009. I studied towards a Grande Diploma in Food and Wine (basically I’m a chef with an expensive signed cardboard that says I am).

Whilst at the academy, I entered a World Cup Pie Designing competition run by the British High Commission. I won; the prize was a trip to London to cook in one of the best restaurants in the UK, Corrigans Mayfair.

I’ve cooked for TV shows, for celebrities, for politicians and high profile people. I’ve worked in restaurants, game lodges, as a private chef and in catering.

Tell us more about your diagnosis

I was diagnosed with Type 1 diabetes in April 2018, a few days after my birthday. My symptoms included fatigue, excessive craving of frozen food items, unquenchable thirst, running to the loo uncontrollably, struggling with sleep and sunken eyes.

I went to the pharmacy to get a vitamin B shot, thinking it was just tiredness from work. The pharmacist on duty told me to first do a blood glucose test.

After a few tests, the nurse at the pharmacy immediately told me to head to hospital. I was admitted for two weeks.

In your blog, you speak about not even knowing what type of diabetes your father had. Please explain.

Even though we knew my dad was diabetic, we kids didn’t know the type he had or what it meant. (He has Type 1 diabetes). As kids, you don’t really see any symptoms of diabetes in your parents. Especially, if they look after themselves well. Without obvious symptoms, we assumed it was a simple thing. We just knew the diet we had at home was different from our friends and relatives but we just thought it was because our father was a health freak. My dad didn’t really go into the details of what his diabetes was about.

Usually Type 1 is diagnosed in childhood. How did the doctors explain your diagnosis in adulthood?

Type 1 can happen at any stage of a person’s life. Internationally, doctors still don’t know what triggers it. My dad only got diagnosed with Type 1 in his 30s as well, like myself.

Are you aware of Type 1.5 diabetes?

No, I’ve only ever heard of Type 1 and Type 2.

What is Type 1.5 diabetes?

Type 1 diabetes diagnosed in adults over 30 may be Latent Autoimmune Diabetes in Adults (LADA), sometimes known as Type 1.5 diabetes. LADA is sometimes referred to as Type 1.5 diabetes. This is not an official term but it does illustrate the fact that LADA is a form of Type 1 diabetes that shares some characteristics with Type 2 diabetes. As a form of Type 1 diabetes, LADA is an autoimmune disease in which the body’s immune system attacks and kills off insulin producing cells. The reasons why LADA can often be mistaken for Type 2 diabetes is it develops over a longer period of time than Type 1 diabetes in children or younger adults. Whereas Type 1 diabetes in children tends to develop quickly, sometimes within the space of days, LADA develops more slowly, sometimes over a period of years. The slower onset of diabetes symptoms being presented in people over 35 years may lead a GP to initially diagnose a case of LADA as Type 2 diabetes. (Source: www.diabetes.co.uk)  Look out for our summer issue where we cover Type 1.5 in much more detail.

What insulin are you on?

The insulin I’m on at the moment is Insuman Comb 30/70. I also take Amlodipine (for high blood pressure) and Simvastatin (for high cholestrol).

You bought a Contour Plus glucose monitor? Explain why?

I was given a machine by the hospital, one made by On Call. I used it for the first 30 days after my diagnosis. Though, finding test strips for the machine became a problem. I then purchased a Contour Plus machine. It’s smaller and slicker then the standard machines out there and the strips are available at most pharmacies. It syncs with my phone and has a brilliant app that helps track your nutrient intake, your exercise routine and your sugar levels. This helps in keeping track of what foods spike your sugar levels and how you react to different things. It saves all the data to the cloud so even if you lose your phone your data is always available.

How have you been managing since your diagnosis?

My daily readings have been consistent and steady. There has been one high spike and one extremely low but these were linked to being busy with work and not being vigilant with my water intake and not eating regular small portions. Other than that, I’ve been coping well.

I’ve also slowed down my routine. I have stopped working on Mondays. I schedule my work and my life with more focus on working smart rather than working hard.

Do you find testing and injecting a hassle?

Not really. When I’m catering an outside event, or know I’ll be away from my house for the whole day, I take my insulin pen and test machine along. It’s a quick process and it’s become part of life now. I also am not shy about it. All my friends know and I take my shot and test in front of them…and explain what it’s all about if it’s the first time they see it.

How has your diet changed?

  • I avoid all white maize. So, no mealie meal for me.
  • I avoid processed sugar. Although, I do still taste desserts and cakes now and then but it will only be a teaspoon-sized taste.
  • If I drink alcohol, it’s only spirits or red wine only drink with one or two glasses max and always followed up by a bottle of water. I avoid any ciders, beers or cocktails.
  • Three times a day, I have fruit and never all at once. I avoid bananas, grapes and dried fruits. The less ripe the fruit the better.
  • I drink about three litres of water a day.
  • When I can, I source low-GI breads, -rice, -biscuits and -spices.
  • I only eat sugar-free and fat-free yoghurt.
  • Every morning I try have Mabele, if not then I have oats. The fibre and low-GI quality of these two cereals is good for diabetes control.
  • I watch the amount of salt I consume. Pre-mixed spice blends, like BBQ spice, are a no-no.
  • Condiments and overly oily food are also a no.
  • I don’t eat processed meats like sausages, sandwich ham, etc.
  • I have a love/hate relationship with sweeteners. I’ve yet to find one that doesn’t have an after taste. During my research, I’ve learned a few of these sweeteners aren’t good for you. So, I stay clear.

List the foods that you’ve found spike your blood sugar

  • Very sweet/low fibre fruit, such as strawberries, bananas and watermelon.
  • Popcorn and white starches, like crackers, chips, white bread and white rice.

Since getting diabetes, has it changed your mind-set of making food?

It has changed my mind about needles! Before, I was freaked out by needles and blood. Now I don’t even flinch at them. When I wake up each morning I drink water, prick my finger, do a blood glucose level test and then inject my insulin before having breakfast. It’s a daily routine, it must happen. If I skip breakfast, my sugar levels will plummet to critical levels.

I’ve had to get my mind into the concept of having regular meals throughout the day. Even when I’m not hungry I still eat a fruit or snack (a spoon of peanut butter or crackers). It has also affected how long I stay out if I go out. I can’t have dinner too late at night.

Something I’ve tried to explain over and over to deaf ears is that I’m a chef and the food I post on social media is work and not my lunch. Then people tag me in green, unappetising health-freak posts! I understand it comes from a good place but the information overload is real and sometimes some of the facts on these health-freak sites are incorrect. 

Have you been inspired to make tasty diabetic dishes?

Yes. I’ve always been health conscious in terms of the type of produce I use. Fresh and seasonal has always been a mantra for me but now I’ve become even more vigilant about ingredients and products I use.

I have been playing around with diabetic friendly recipes and dishes. More to keep myself away from the usual bland and boring stuff people normally associate with diabetic-friendly diets. I’ve been asked to put together a diabetes focused cookbook, which will focus on African taste.

Are you the designated cook in your household?

I live alone so I have no choice but when my girlfriend is around, we take turns.

What’s next on the table?

Currently, I do private events and functions. I also own a culinary business that does monthly classes and monthly chef’s table. Soon, I will be releasing my own product range. My first cookbook is coming out in October and there is a TV show in the pipeline for later this year.

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


FUTURELIFE® ZERO Smart food™ with berries and nuts

Ingredients

  • 4 Tbsp. (40g) FUTURELIFE® ZERO Smart food™
  • 100 ml cup warm water
  • ¼ cup warm milk (optional)
  • 1 Tbsp. dried berries e.g. goji berries
  • 1 Tbsp. chopped nuts e.g. almond

Method

  1. Cover the FUTURELIFE® ZERO Smart food™ with warm water, mix until combined.
  2. Sprinkle over raisins and nuts.
  3. Add milk (optional).

For more information on the product used in this recipe visit: http://futurelife.co.za/product/futurelife-zero-smart-food/


FUTURELIFE® Smart Bread™ pudding with spinach and mushrooms

Ingredients

  • 4 slices FUTURELIFE® Smart Bread
  • 1 cup mushrooms, sliced
  • 2 cups low-fat milk
  • ½ cup gruyère cheese, grated
  • ¼ cup parmesan cheese, grated
  • 1 bunch spinach, stemmed and washed thoroughly in two changes of water (more if necessary)
  • 1 tablespoon extra-virgin olive oil
  • 1 teaspoon fresh thyme leaves, coarsely chopped
  • 1 – 2 garlic cloves (optional)
  • Salt and freshly ground pepper
  • 4 eggs
  • Spray’n Cook

Method

  1. Bring a medium or large pot of water to boil, salt generously and add the spinach.
  2. Cook 2 to 3 minutes, until tender but still colourful.
  3. Transfer to a bowl of cold water, then drain and squeeze out excess water. Chop coarsely and set aside.
  4. If using garlic, cut one of the garlic cloves in half and rub the slices of FUTURELIFE®Smart Breadwith the cut side. Then mince all the garlic. Cut the FUTURELIFE®Smart Bread into 2cm squares.
  5. Heat the oil over medium-high heat in a heavy, wide skillet and add the mushrooms. Cook, stirring often, until they begin to soften, and add the thyme, garlic and salt and pepper to taste. Continue to cook for another minute or two, until the mushrooms are tender and fragrant. Stir in the spinach, toss together and remove from the heat.
  6. Preheat the oven to 180°C. Spray’n Cook a large oven-proof dish, soufflé dish or gratin. In a large bowl, combine the FUTURELIFE®Smart Bread cubes, the mushrooms and spinach, and the two cheeses and toss together. Transfer to the prepared baking dish.
  7. Beat together the eggs and milk. Add salt to taste and a few twists of the pepper mill, and pour over the FUTURELIFE®Smart Bread Let sit for 5 to 10 minutes before baking so that the FUTURELIFE® Smart Bread can absorb some of the liquid.
  8. Place in the oven and bake 40 to 50 minutes, until puffed and browned. Remove from the oven and serve hot or warm.

For more information on the product used in this recipe visit: http://futurelife.co.za/product-type/bread/


Teenagers with diabetes tackling puberty

Rosemary Flynn helps us comprehend what children with diabetes encounter when they transition through puberty.


When children become teenagers, they go through a huge transition. They rapidly develop in all areas of their lives: physically, sexually, emotionally, mentally, and socially. As if that is not enough to negotiate, teenagers with diabetes have extra challenges to face during their puberty years.

Early puberty

In early puberty, insulin works together with growth hormones to enable normal growth. When the growth hormones get going, insulin resistance increases. So, it’s important for those with diabetes to ensure they have enough insulin to allow growth to proceed as normal.

With diabetes, the insulin levels depend on how well the teen manages their diabetes. Sufficient insulin is the key to reaching their normal final height. They also gain weight as their body grows into a more adult body. With self-image being of great importance to them at this stage, the rapid weight gain often makes them feel very self-conscious. One of the most important tasks of adolescence it to accept these dramatic physical changes as normal and develop a positive body image.

Sexuality

Teenagers develop a keen interest in the opposite sex during this time. Many teenagers become sexually active, and for the teen with diabetes, this presents extra risk. For girls, there is the risk of an unwanted pregnancy even if they take precautions. In all pregnancies, women have to keep their blood glucose levels as normal as possible before, during and after the pregnancy. This ensures the baby is protected from birth defects. Unplanned pregnancy puts the baby at high risk. For both boys and girls, information about their sexuality and advice about contraception should be given well before they need it.

Responsibility

Another development of adolescence is that they are able to start taking responsibility for their lives and their diabetes. Teaching children and adolescents to take up this responsibility is a parental task. If teenagers are never asked to be responsible, they will have a tremendous battle to take up the challenge of managing their own diabetes. They will always expect others to be responsible or alternately, they will neglect it. The teen will have to consciously make a choice to  take on the responsibility of diabetes. Some are resistant to this transition and may take longer to do so.” 

Changes in the brain

During puberty the brain is going through impressive intellectual changes. Knowledge increases in leaps and bounds and teenagers are able to absorb much more information. They can imagine ideas which are actual possibilities, and use these to reason with and solve real problems. Their ability to pay attention and concentrate increases a great deal and they can remember much more than before. All this development means they are ready to make a transition from a dependent child to a responsible teenager.

It is worthwhile for teens to remember that poor control of diabetes can have a negative effect on the developing brain and prevent it from developing fully. Maintaining good control will protect their intelligence and allow it to develop to its full potential.

Attitude

The teenager’s attitude towards their diabetes can be influenced by how they perceive the illness. If they see it as a life-threatening disease over which they have no control, they will have a sense of hopelessness. They will always feel like a victim and have a very negative attitude towards their diabetes.

If they understand that diabetes can be controlled and believe they can learn to manage it effectively, they can develop a positive attitude and feel empowered to participate in all the activities that other teens do. They then believe and see that they can also do well at school.

Social life

Teenagers’ social lives become very important to them. The idea of being different from their peers is very threatening. Especially in early adolescence when they are finding their place in social groups.

They may struggle to be open about their diabetes and try to conceal the testing and injecting from their peers. This may mean that they miss injections or eat whatever the others are eating, even if it has a bad effect on their blood glucose levels. Sadly, the resulting poor control can mean missing lots of school, or being hospitalised due to diabetic ketoacidosis. In turn, this removes them from their social environment, or when it leads to poor growth it reduces their self-image.

The quest for social acceptance may lead them to try risky behaviours, like smoking, drinking alcohol and having unprotected sex. Somehow, they have to find a balance between having a good time socially and remaining responsible for their diabetes care.

Many teens have successfully negotiated their puberty years and have developed a maturity which exceeds that of their peers. With lots of support and encouragement, they can all succeed if they can get their minds around the challenges they face.

Rosemary Flynn

MEET OUR EXPERT


Rosemary Flynn is a clinical psychologist at the Centre for Diabetes in Johannesburg. She has worked with children, families and adults with diabetes for 24 years, enabling them to overcome their anxieties about their condition and to deal with the difficult events in their lives.


FUTURELIFE® Smart Bread™ casserole muffins with ham and cheddar cheese

Ingredients

  • 3 – 4 slices FUTURELIFE® Smart Bread™
  • 8 eggs
  • 1 cup cheddar cheese, grated
  • 1 cup low fat milk
  • 3 – 4 slices deli ham
  • 2 teaspoons ground mustard
  • ½ teaspoon ground pepper
  • Dried parsley

Method

  1. Preheat oven to 200°C. Grease muffin tins well.
  2. Tear the bread into small pieces and place FUTURELIFE® Smart Bread™ pieces evenly in muffin tins until they come about ⅔ of the way up the tin.
  3. Sprinkle ham pieces and grated cheese evenly in each tin.
  4. Whisk together eggs, milk, ground mustard, and pepper.
  5. Pour egg mixture evenly in each muffin tin.
  6. Sprinkle a little dried Parsley on the top of each one.
  7. Bake for 15-20 minutes or until golden brown on top and cooked through the middle.

For more information on the product used in this recipe visit: http://futurelife.co.za/product-type/bread/


Travelling with a child with diabetes


Travelling, whether it’s on a train, plane or by car, with children always takes planning and preparation. The more so when travelling with your child who has Type 1 diabetes. Consider these factors when travelling.


Travelling must:medical alert bracelet

Firstly, when travelling, your child should be wearing some form of indication that he or she has Type 1 diabetes. A medic alert bracelet, or even a letter from the doctor may suffice.

General travelling tips

  • Before departure, it is important to make sure that the country or region to which you are travelling has medical services nearby. Find out where the closest hospital is and if they treat paediatric diabetic cases.

  • Keep contact information for emergencies (e.g. pump helpline) as well as a prescription of supplies or a copy thereof on hand.

  • Ensure your travel insurance covers the emergency treatment of diabetic-related issues.

  • It is essential to keep a travel (cooler) bag with your child’s diabetic supplies handy. Ensure you pack more than enough insulin to cover the days of your trip and possible fluctuating glucose levels; a glucose meter and extra batteries for both the meter and pump; capped lancets; appropriate snacks; and glucagon.

  • Always carry easy meals or snacks for unforeseen delays and unanticipated glucose levels.

  • Remember heat and excitement can cause fluctuating blood glucose levels. Carry plenty of water and suitable snacks to address these fluctuating levels.

  • If your child is on a pump, consider taking a spare pump along, or if this is unavailable ensure you have a spare prescription or supply of insulin pens, including short-acting and long-acting insulin.

  • Glucose control may be affected due to changes in your child’s normal routine. Therefore check glucose levels more frequently. As a result, more strips will be used – make provision for this. Don’t forget to make provision for ketone testing strips.

  • Ideally, split the supplies into two bags. If possible, give one bag to a travelling companion in case some luggage gets lost.

Flying and diabetes

These days airline security measures are very strict regarding the possession of diabetes supplies. The regulations require that all diabetic supplies are transported in original pharmacy packaging with prescription labels preferably intact.

In addition, you may need to prove that the syringes and lancing devices are specifically for your child’s diabetes care. The brand of the lancets and blood glucose meter must also match each other. It’s important that the strips have not expired.

When travelling within the country, enquire prior to the flight whether a meal is provided or not. Provision can therefore be made when this information is obtained. Taking your own meal may, however, be better accepted by your child.

When flying outside of your home country, it is recommended that you find out that specific country’s requirements when travelling with diabetes supplies. Also, learn phrases in the local language that may help address a crisis situation e.g. ‘Please help, my son/daughter has diabetes’; ‘Please give me something sweet’; and ‘Please call a doctor’.

For those children wearing an insulin pump, inform the screener that your child is wearing a pump. The pump should not be scanned by the X-ray machine along with all the other items. Therefore request a hand wand screen.

If you’re flying, don’t put any of your supplies in your checked-in luggage as the temperature in the hold can drop to freezing. Instead, keep everything with you in your hand luggage.

Altitudes and temperature

Check your child’s glucose meter manufacturing information regarding the altitude and temperature ranges that the meter may have altered accuracy. Keep meters close to the body for optimum temperature operation.

It is important to keep your child’s insulin supplies at the correct temperature. In a hot climate, it is a good idea to request a room with a fridge, or to bring your cold bag or Frio bag. Frio bags are activated by cold water and are reusable every 48 hours; but are only available online.

In cold climates, insulin should not freeze. In freezing conditions, keep your child’s insulin or pen injector in an inner pocket of your clothing or bag.  Examine the insulin for crystals and discard the insulin if any are found.

Adjusting insulin doses

You may find you need to vary insulin doses for very active holidays or holidays in unfamiliar climates. If your child is swimming for extended periods, test his/her blood glucose level regularly. Especially in the evening due to the occurrence of low blood glucose level after periods of prolonged exercise.

Insulin absorption is more rapid in hot climates so be careful for post-meal lows, which may be followed by a spike. If you’re on a pump, the dual or square wave function may be very useful in these situations.

Don’t allow the fluctuating glucose levels to get your child or family down. Do what you know and manage each situation best you can.

Avoid holiday tummy bugs

  • Ensure to avoid tap water. Ideally, your child should not swallow the water even when brushing teeth.
  • Avoid ice cubes in unclean environments because they’re generally made from tap water.
  • Be cautious of milky, creamy and mayonnaise products or produce.
  • Be cautious of diluted juices e.g. a concentrate mixed with water as this water may be from a tap. Rather choose water from a bottle.
  • Be vigilant when feeding your child from buffet tables – food items have probably been washed using tap water.
  • Avoid shellfish, for example sushi, salads and raw food.
  • Carry plenty of bottled water, especially during hot weather, or if high blood sugars are being experiences and if your child is doing extra activities, to ensure they stay hydrated.

In summary, check your child’s blood sugar often, make smart adjustments based on their levels, and keep a positive attitude in the face of challenges when travelling with diabetes.

MEET OUR EXPERT

Donna van Zyl is a private practicing dietitian for Nutritional Solutions, Bloemfontein. She is growing in the field of paediatrics and plays a key role in individualising nutritional therapy for Type 1 diabetics. She has a special interest in optimising health, managing chronic lifestyle related diseases, and sports nutrition. She lectures part-time at the University of the Free State, which she enjoys thoroughly.

Frequently asked questions when diagnosed with diabetes


When diagnosed with diabetes, you will have a plethora of questions. Diabetic Nurse Educator, Christine Manga, shares the top 10 frequently asked questions.


A whirlwind of emotions is dealt with when receiving a diabetes diagnosis. Because of this, the first consultation post diagnosis barely touches on treatment per se. This is due to the fact that patients have an overwhelming need to get answers that are pertinent to them. There is definitely a trend to the questions that are asked regularly. I consider the following questions to be frequently asked questions (FAQs).

1. Is my diagnosis correct?

For a diabetes diagnosis to be made, a minimum of two blood glucose tests need to be done. It is recommended that the same test is used, but on two separate days. A fasting blood glucose reading of ≥7 mmol/l, a random blood glucose level of ≥11 mmol/l, or a two hour post glucose ingestion reading of ≥ 11 mmol/l is required for diabetes to be confirmed. One HbA1c level of ≥6,5% would also be sufficient to make the diagnosis of diabetes. If these tests have been done, then the diagnosis is most likely correct.

2. Is Type 2 diabetes reversible or is there a cure?

No and no. It can, however, be managed that it goes into ‘remission’ or gets significantly better. This is more likely to happen in the early stages of the disease. This can be achieved by being physically active and losing excessive amounts of weight by dietary means or bariatric surgery. Even with this weight loss, some people will not go into remission. Unfortunately, aging, the natural progression of Type 2 diabetes, and weight regain will cause the diabetes to return in most people.

3. Did I get diabetes from eating too much sugar?

No. However, a high consumption of fatty and sugary foods can cause weight gain. This extra weight could lead to insulin resistance which usually precedes Type 2 diabetes.

There are some people who do not carry extra weight and yet go on to develop diabetes. In these individuals, genetics may play a significant role. If you have a parent or sibling with Type 2 diabetes, you have an increased risk of developing diabetes yourself.

4. What do I do now that I have been diagnosed with diabetes?

It is important to make positive lifestyle changes. Being active is important. The World Health Organisation recommends 150 minutes of activity a week. Following a balanced, nutritional eating plan is imperative in managing your diabetes. A dietitian can assist you with this, as it is best if it is individualised.

Adhering to the medication regimen, prescribed by your medical practitioner, will also form part of the lifestyle changes. An annual screening by a podiatrist and ophthalmologist are also advised.

5. What should my glucose readings be?

There are international guidelines set out for glucose targets. These targets may need to be adjusted according to your individual needs. Your practitioner would assist you with deciding on a target. By achieving these targets, it may delay the onset of diabetes complications.

The targets set out for the general population with diabetes are:

  • fasting blood glucose 4,0-7,0mmol/l
  • post prandial (MEAL) blood glucose of <10,0mmol/l

Avoiding hypoglycaemia whilst reaching these targets may be challenging.

6. I don’t want to inject, but do I need to take insulin?

Some patients may live for many years using only oral medication to manage their condition. Research indicates that the earlier diabetes is diagnosed and treated, it may delay the need to use insulin.

On the other hand, some patients experience a much quicker progression of their diabetes. This could result in the need to use insulin early on in the condition. Most people living in excess of fifteen years with diabetes will require insulin.

An indication that you may need insulin is when your glucose readings and HbA1c start to increase. Your medical practitioner will discuss with you – if and when it is necessary to commence insulin.

Once on insulin, you will usually use it for the rest of your life. If the correct injection technique, site rotation and needle replacement is practised, injecting of insulin will not be too uncomfortable.

7. Now that I take insulin, do I have Type 1 diabetes?

No. Type 2 diabetes can’t turn into Type 1 diabetes. They have different causes. Type 1 diabetes is an autoimmune disease – the body completely destroys the insulin producing cells so that no insulin can be produced. People with Type 1 diabetes need to start taking insulin at diagnosis. Type 1 usually occurs in childhood and is much less common than Type 2 diabetes.

With Type 2 diabetes, the body does still produce insulin, however, the body can be resistant to it. Over time the body will produce less insulin, at this stage you will need to start to replace insulin by means of injections. You will still have Type 2 diabetes.

8. Will I gain weight with insulin?

Possibly yes. When you are not using insulin, your levels of glucose in the blood stream are high. Some of this glucose is lost in the urine. Once you commence insulin, the cells in the body absorb this glucose from the blood, to be used as energy. If you are consuming extra glucose, the body will now store it as fat. Portion control and being active are important ways to combat the potential weight gain.

9. Can I share a glucometer with my family/partner?

Preferably not. Firstly, for infection control, it is important that each person who is pricking their finger should use their own needle. This will prevent blood borne diseases spreading.

Secondly, when your practitioner downloads the glucometer to evaluate your control, it will not be a true reflection. Your averages will be skewed and the profile of your readings will be inaccurate. This could lead to incorrect management choices. If you do have to share a meter with someone, let your practitioner know.

10. Can I drink alcohol?

Yes. Taken in moderation it is okay to consume alcohol. One drink a day for women and two drinks a day for men. Taking alcohol with certain medication and/or insulin can increase your risk of hypoglycaemia. Discuss this with your diabetes practitioner.

No doubt, there will be many other questions; direct them to your healthcare provider who will give you the correct information.

MEET OUR EXPERT

eating time budget
Christine Manga (Post Grad Dip Diabetes and Msc Diabetes) is a professional nurse and a diabetes nurse educator. She has worked with Dr Angela Murphy at CDE Centre, Sunward Park since 2012.

FUTURELIFE® Smart food™ with Strawberries and a yoghurt topping

Ingredients

  • 50 g or ½ cup FUTURELIFE® Smart food™
  • 125ml of warm water or low fat milk (or more to get your preferred consistency)
  • 1 – 2 tbsp. low fat plain yoghurt
  • 1 – 2 sliced strawberries
  • 1 tsp of shaved coconut flakes (optional)

Method

  1. Add your FUTURELIFE® Smart food™ and milk to a bowl and mix well.
  2. Top with yoghurt, sliced strawberries and coconut shavings.

For more information on the product used in this recipe visit: http://futurelife.co.za/product/futurelife-high-energy-smart-food/


Dry eye associated with diabetes

Eye Care Awareness Month runs from 21 September to 18 October. In light of this, Dr Chrissie Cockinos explains why dry eye is so common in people living with diabetes.


Diabetes has a number of associated eye conditions: ocular muscle palsies, blepharitis, dry eye, corneal ulceration, changes in refraction, early cataracts and retinal disease.

Sadly, diabetes is becoming more common than ever before. The World Health Organisation (WHO) predicts that there will be 370 million diabetes patients by the year 2030. This is double the number of people living with diabetes registered in 2000.

Why is dry eye common in diabetes patients?

Some studies report dry eye in more than 50% of diabetic patients. People with dry experience discomfort, grittiness, sensitivity to light, redness and a foreign body sensation of the eyes. Sometimes vision becomes blurry. One of the most common causes of dry eye disease is blepharitis (infection and/or inflammation of the eyelids). This is very common in diabetic patients.

Causes of dry eye in people living with diabetes

Hyperglycaemia and insulin resistance can result in neuropathy. The corneal nerves can be affected by long-term diabetes and this may, via the trigeminal nerve and facial nerves, affect the way the lacrimal gland produces tears. This may result in dry eye.

Neurotrophic (insensitive) corneas often result from diabetes. This nerve damage interrupts normal tear development pathways.

Insulin also has a role in tear production.

Inflammation releases certain chemicals, called cytokines, in the body. These chemicals can also damage tear producing cells in the conjunctiva and lacrimal gland.

Sequelae of dry eye

Apart from the frustration of suffering from dry eye, people living with diabetes have a higher incidence of corneal ulceration. This is due to the lack of protection to the eye by a normal tear film, increased blepharitis incidence (a source of bacteria) and insensitivity of the cornea.

Treating your dry eye

  • Topical treatment
  1. Eyelid hygiene to clear blepharitis. A good eyelid cleanser, preferably with tea tree is advisable.
  2. Topical lubricant eye drops and lubricant ointments at night.
  3. Visit your eye doctor annually.
  4. The inflammation of your eyes may require additional treatment and extra measures with cortisone eye drops or ointments.
  5. You may even require lacrimal plugs to be inserted.
  • General
  1. Check your HbA1c and blood pressure regularly via your doctor.
  2. Follow a good diet consisting of protein, vegetables, especially leafy greens, and oily fish like salmon and mackerel.
  3. Exercise regularly. Walk 20 minutes daily.
  4. Take Omega 3 supplements.

MEET OUR EXPERT - Dr Chrissie Cockinos

Dr Chrissie Cockinos (B.Sc (Hons) MBChB (Pret) MMed (Ophth) (Wits)) is an ophthalmologist in Sandton, Gauteng. She completed a masters dissertation in corneal ulceration. She has a special interest in laser eye surgery; cataract microincision, using monofocal and multifocal intraocular lenses; medical retina (diabetes and macular degeneration); surgical retina (retinal detachment and macula surgery) and glaucoma.

Mini chicken kebabs with a quick peanut sauce

Serves 4

Ingredients

  • 4 chicken breast fillets, chopped into bite-sized pieces
  • 60 ml freshly squeezed lemon juice
  • 1 dash of salt and milled pepper
  • 6 wooden skewers, soaked

Sauce

  • 125 ml coconut milk
  • 60 ml smooth sugar-free peanut butter
  • 30 ml red curry paste
  • 45 ml soy sauce

Method

  1. Thread 3 – 4 cubes of chicken onto the top end of each skewer.
  2. Grill, braai or cook in a smoking hot pan until done.
  3. Heat sauce ingredients together and stir until smooth.
  4. Cool sauce and pour over chicken skewers, ready to be packed for lunch.

 


Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88.