The journey to positive living with diabetes
“But it’s perfectly possible to lead a healthy, fulfilling and active life with the right healthcare and family support, medication and personal attitude,” explains Dr Ntsiki Molefe-Osman, Diabetes Medical Advisor at Lilly South Africa.
Diabetes comes in two types – Type 1 and Type 2.
- If you have Type 1 diabetes, your body is unable to produce sufficient insulin of its own in order to maintain healthy blood sugar levels in the body. It usually begins in childhood or adolescence and is caused by a faulty autoimmune response that causes the body to destroy the pancreatic cells that produce insulin, which in turn leads to an insulin deficiency. People with type 1 diabetes must take insulin as it is vital to staying healthy and achieving the most consistently normal sugar levels, and quality of life. There’s no cure for type 1 diabetes although researchers are working on preventing the disease as well as the further destructive progression of the disease in people who are newly diagnosed.
- Type 2 diabetes is far more common and according to the International Diabetes Federation (IDF), there were 2.28 million diagnosed cases of diabetes in South Africa in 2015¹. In the case of type 2 diabetes, insulin is produced, but the body’s cells do not respond to it correctly. Instead, the body becomes resistant to insulin. It is most often, but not always, associated with obesity, poor diet, physical inactivity, advancing age, family history of diabetes, ethnicity and high blood glucose during pregnancy. It can go undiagnosed for years. Due to the progressive nature of the disease, most type 2 cases will eventually need insulin to be added to their treatment. However, many cases of type 2 diabetes can be prevented by making simple changes in our everyday lives and knowing the risks.
Understand the symptoms – they may not be as harmless as you think
Sometimes people overlook the warning signs of diabetes because they do not experience symptoms, or the symptoms seem harmless. It is important to talk with a health care provider if you have noticed:
- unusual weight loss,
- frequent urination,
- tingling or numbness in your hands or feet,
- a persistent feeling of hunger or thirst,
- drowsiness, nausea or blurred vision.
Management of diabetes is crucial for your future health
“If diabetes is diagnosed – whether Type 1 or Type 2 – it’s very important to manage your blood sugar levels according to the guidelines provided by your doctor or healthcare provider. The huge emphasis on strict control and disease management if you’re living with diabetes is with very good reason. Diabetes is an exceptionally challenging disease to live with and manage, requiring the support of specialist doctors, and a huge amount of discipline on the part of the patient in managing the demanding diet, lifestyle and treatment regimen,” explains Dr Molefe-Osman.
There are a number of health challenges that come with living with diabetes including²:
- Diabetes can lead to eye disease (retinopathy), which can damage vision and even cause blindness.
- Poorly controlled blood glucose and high blood pressure can lead to damage of the nerves throughout the body (neuropathy). This damage can lead to problems with digestion, urination, erectile dysfunction in men and other complications. Among the most commonly affected areas are the extremities, in particular the feet, where nerve damage can lead to pain, tingling, and loss of feeling. Loss of feeling is particularly important because it can allow injuries to go unnoticed, leading to serious infections and possible amputations.
- Kidney disease (nephropathy) is far more common in people with diabetes, a leading cause of chronic kidney disease.
- People living with diabetes have a much higher risk of cardiovascular disease – angina, heart attack, stroke, peripheral artery disease, and congestive heart failure.
- Diabetes can cause complications and health problems that worsen symptoms of depression, leading to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain.
Poor management of diabetes today has significant health repercussions for later on in life – from kidney failure, heart failure, blindness, nerve damage and as a result, loss of limbs. How well you manage your diabetes today, will influence the quality of life you can expect to live later in life.
Insulin treatment is not the enemy – poor sugar control is
Many patients are overwhelmed by the prospect of having to go onto insulin treatment. It is important to know that it is not a failure if you need insulin treatment as diabetes is a progressive disease, so in most cases all diabetics will eventually need insulin. Good control of blood sugar levels is the ultimate goal, and effective insulin treatment will help prevent other serious issues like heart disease, stroke, nerve damage, organ damage, eye problems or in extreme cases, premature death.
Insulin is a hormone that’s made by the pancreas and its purpose is to help the body move glucose into cells for energy. When your pancreas can’t produce enough insulin or fails to function properly, blood sugar (glucose) levels can rise — leading to diabetes. If you are diagnosed with diabetes, you may need insulin treatment to help control your blood sugar level³.
Know your myths and facts⁴:
- Being on insulin will not disrupt your daily routine.
- Insulin does not cause complications such as blindness. Along with other medications it helps to reduce complications by controlling your blood sugar level.
- Insulin is not an addictive drug!
- Starting insulin does not mean you are failing to take care of your diabetes. For many people with type 2 diabetes, the body gradually produces less and less of its own insulin. Eventually, oral medications may not be enough to keep blood sugar levels norms. Using insulin to keep a healthy level is the responsible thing to do for your own health.
“The best approach is to be methodical in your planning, and to work out a daily programme that keeps you on track and becomes part of your routine. Your healthcare provider or diabetes educator is also a very important source of information and experience, so don’t be afraid to engage with them about your concerns, no matter how minor you may think they are,” says Dr Molefe-Osman. “The fact is that with proper management, you can overcome the challenges that turn your diabetic journey into a success story. Know the value of building a support system around you because diabetes requires healthcare providers, daily attention and commitment – and often involves your whole family.”
Know your body
Everyone reacts differently to low blood sugar (hypoglycaemia), so it is important to understand and recognise your own symptoms. Some of the visible signs and feelings could include shakiness, anxiety, rapid pulse, irritability, tingling fingers or lips, headache, sweating, blurred vision, hunger, dizziness and fatigue or weakness. It is important to discuss low sugar events and treatment actions with your doctor⁵.
The Rule of 15
There are five important steps to treat low blood sugar⁶:
Step1 If your blood sugar is less than 70mg/dL take 15 grams of glucose or simple carbs⁹.
Step 2 Recheck your blood sugar after 15 minutes, if possible.
Step 3 If you still feel the symptoms of low blood sugar, repeat step 1.
Step 4 Once you return to normal, eat a small snack if your next planned small meal or snack is more than an hour away.
Step 5 If you continue to experience signs of low blood sugar – contact your doctor or emergency health services immediately.
15 grams of carbs = any of the following⁶
- 4 glucose tablets (follow package instructions).
- 1 gel tube (follow package instructions).
- 2 tablespoons of raisins or 1 tablespoon of honey or syrup.
- ½ a cup of juice or non-diet soda or 1 cup of non-fat 1% milk.
- 3 – 5 hardboiled sweets, jellybeans or gumdrops.
Track your symptoms
When managing long-term health conditions, you may find it helpful to keep track of any symptoms you experience such as pain, fatigue, insomnia or nausea). What makes them worse? What makes them better? How do medications, foods, activities, people, and stresses affect you? You can also keep track of numbers that affect your symptoms, like blood pressure or blood sugar readings. Bring your logs to appointments and share them with your healthcare provider and with your family. Consider asking your family for their thoughts about your log and what they have noticed about your symptoms.
Above all be healthy, active and look after your heart. It doesn’t have to be a complicated routine. Even a small increase in daily physical activity can make a big difference. While some risk factors for diabetes such as age, ethnicity and family history can’t be changed, many other risk factors such as managing your weight, eating healthy foods in the right quantities and exercising regularly can be managed.
According to Diabetes South Africa there are various aspects to good diabetes management including⁷:
- Education – Knowing about diabetes is an essential first step. All people with diabetes need to understand their condition in order to make healthy lifestyle choices and manage their diabetes well.
- Healthy eating – There is no such thing as a ‘diabetic diet’, only a healthy way of eating, which is recommended for everyone. However, what, when and how much you eat plays an important role in regulating how well your body manages blood glucose levels. It’s a good idea to visit a registered dietician who can help you work out a meal plan that is suitable for your lifestyle.
- Exercise – Regular exercise helps your body lower blood glucose levels, promotes weight loss, reduces stress and enhances overall fitness.
- Weight management – Maintaining a healthy weight is especially important in the control of type 2 diabetes.
- Medication – People with type 1 diabetes require daily insulin injections to survive. There are various types of insulin available in South Africa. Type 2 diabetes is controlled through exercise and meal planning and may require diabetes tablets and\or insulin to assist the body in making or using insulin more effectively. Talk to your doctor about the best treatment option for you, as well as the all-important cost considerations of different treatments.
- Lifestyle management – Learning to reduce stress levels in daily living can help people manage their blood glucose levels. Smoking is particularly dangerous for people with diabetes.
“As a major contributor towards diabetes care for over 93 years, Lilly works with healthcare providers to help people overcome the daily challenges of living with this chronic condition. Your doctor is your best resource for information about living with diabetes. However, while your healthcare team will advise and support you, how well your diabetes is managed depends on you. Use the resources available to empower yourself to improve your metabolic control, increase fitness levels and manage weight loss and other cardiovascular disease risk factors, which in turn will improve your sense of well-being and quality of life,” concludes Dr Molefe-Osman.
To learn more about Lilly, please visit at www.lillydiabetes.co.za
About World Diabetes Day (WDD)
WDD is celebrated annually on 14 November. WDD was created in 1991 by IDF and the World Health Organisation in response to growing concerns about the escalating health threat posed by diabetes.
- 1 – https://www.idf.org/our-network/regions-members/africa/members/25-south-africa
- 2 – https://www.idf.org/about-diabetes/what-is-diabetes.html
- 3 – https://www.lillydiabetes.co.za/en/site/why-insulin/what-is-insulin.html
- 4 – https://www.lillydiabetes.co.za/en/site/why-insulin/myths-facts.html
- 5 – https://www.lillydiabetes.co.za/en/site/hypoglycemia/how-to-identify-hypoglycemia.html
- 6 – https://www.lillydiabetes.co.za/en/site/hypoglycemia/how-to-treat-hypoglycemia.html
- 7 – http://www.diabetessa.org.za/are-you-at-risk/
Get It Magazine (Ballito/Umhlanga) – July 2018