Sweet Life Magazine issue 13

Issue 13

Autumn 2015

LIFE CAN BE SWEET, WITH DIABETES

Diabetes in the golden years

Also

Climbing

Kilimanjaro with diabetes

PLUS: The future of diabetic technology

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- easy exercise for everyone - delicious breakfast ideas - expert interviews - And more!

Free!

Take one now

www.sweetlifemag.co.za

2015/03/09 11:07 PM

Don’t let your life be ruled by diabetes.

Use the power of your smartphone and the web to manage your diabetes so that you can get connected and get living.

• Automatically send test results to loved ones.

• Transfer your blood glucose results wirelessly to the mobile app.

• Get mobile and online reports of your blood glucose patterns.

• Calculate how much insulin to take at mealtimes with the clinically proven Accu-Chek Bolus Advisor.¹ • Share your diabetes data online with your healthcare professional, parent or caregiver.

Experience what’s possible.

For more information contact your Healthcare Professional

To see which smartphones are compatible with the Accu-Chek Connect system, scan this barcode or go to www.accu-chek.co.za/dmapp

1. Ziegler R, Cavan DA, Cranston I, et al. Use of an Insulin Bolus Advisor Improves Glycemic Control In Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control: First results from the ABACUS trial. Diabetes Care. 2013;36:3613-3619.

ACCU-CHEK, ACCU-CHEK CONNECT and ACCU-CHEK PERFORMA CONNECT are trademarks of Roche. © 2014 Roche Diagnostics. © 2014 Roche Diagnostics.

Toll free: 080-Diabetes (Dial 080-34-22-38-37) www.accu-chekconnect.co.za / www.accu-chek.co.za Ref: ACUST 141201b

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This is our Autumn issue, and we’ll be checking in with you each season this year. We’ll be here for Winter (June), Spring (September) and Summer (November) too...

This year, we’re focussing on the different life stages of diabetes: pregnancy, children, being diabetic in the workplace, and living with diabetes as you get older. Seeing as this is our Autumn issue, we’re starting with diabetes in the golden years, and there’s no better example of how to live a happy, healthy life with the condition than our cover star, Neil Rae, who just climbed Mount Kilimanjaro in Tanzania - after living with diabetes for 50 years!

If climbing a mountain seems a bit too adventurous for you, don’t worry - we’ve also got some great everyday exercises that anyone can do, no matter how old. And, as always, delicious diabetic-friendly recipes: this issue we tackle breakfast in seven different ways.

Finally, I am very excited about our feature on the future of diabetes technology - there are so many exciting developments just around the corner.

And speaking of tech, be sure to check out our new look website at www.sweetlifemag.co.za and let us know what you think.

Here’s to a fantastic 2015, with diabetes! Until next time,

EDITOR Bridget McNulty

ART DIRECTOR Mark Peddle

PUBLISHER Claire Barnardo

ADVERTISING SALES TFWcc: Tessa Fenton-Wells

CONTRIBUTORS Carine Visagie, Cindy Tilney, Claudine Lee, Genevieve Jardine, Jeanne Berg, Jenny Russell, Joel Dave, Kate Kruger, Luisa Farelo, Neil Rae, Sarah Hall, Wayne Derman, Wayne May.

Welcome

Hello, and welcome to Sweet Life 2015!

ADVERTISING ENQUIRIES Box 52301, Kenilworth 7745.

Tel: 021 761 2840.

Fax: 021 761 0442.

Cell: 082 320 0014.

Email: tessa@tfwcc.net

EDITORIAL ENQUIRIES PO Box 12651, Mill St, 8010.

Email: info@sweetlifemag.co.za

COPYRIGHT Published by The Editors Publishing House CC. Copyright The Editors Publishing House CC. All rights reserved.

Reproduction in whole or part is prohibited without prior permission of the Editor.

COMPETITION RULES Winners will be randomly selected and notified by telephone or email. Prizes are not transferable and cannot be exchanged for cash. The judge’s decision is final and no correspondence will be entered into.

Bridget McNulty, Editor Diabetic South Africans

PS: Want to make sure you get your free copy of Sweet Life?

Check out page 4 for details.

sweet_life_mag

The views and opinions expressed in this magazine are those of the contributors and not necessarily those of Sweet Life. Always consult a specialist before making any changes to your diet or medicine.

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Exciting news!

Sweet Life is now available at all Dis-Chem stores nationwide!

Pick up your FREE copy of Sweet Life from any Dis-Chem store in South Africa, or from your local support group or pharmacy.

SWEET LIFE AVAILABLE AT ANY DIS-CHEM!

Find your nearest Dis-Chem store:

www.sweetlifemag.co.za/dischem

Local pharmacies and clinics: Want to get Sweet Life in your area? Let us know where your local clinic or pharmacy is, and how to get hold of them, and we’ll send them free copies of Sweet Life. Email us on hello@sweetlifemag.co.za

Community

You can also read Sweet Life online at: www.sweetlifemag.co.za/magazine

Meet our diabetic experts: Sweet Life has a fantastic Panel of Experts who are all leaders in the field of diabetes. They give us advice on everything we publish so that you can be sure you’re only getting the very best information to help you live a happy, healthy life with diabetes.

Here are the wonderful experts on our panel: ENDOCRINOLOGISTS:

Dr. Zaheer Bayat

MBBCh (Wits), FCP(SA), Cert Endo is a specialist physician and specialist endocrinologist working in Gauteng. He is the chairman of SEMDSA: the Society for Endocrinology, Metabolism and Diabetes of South Africa.

Dr. Joel Dave

MBChB PhD FCP Cert Endocrinology is a Senior Specialist in the Division of Diabetic Medicine and Endocrinology at the University of Cape Town and Groote Schuur Hospital and in private practice in Cape Town.

PROFESSORS

Timothy Noakes

MBChB, MD, DSc, FACSM, (hon) FFSEM (UK) is a Professor in the Discovery Health Chair of Exercise and Sports Science at the University of Cape Town. He is also cofounder with Morné du Plessis of the Sports Science Institute SA.

Wayne Derman

MBChB BSc (Med) (Hons) PhD is the Director of the Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of SA, where he is also Professor of Sport Science and Sports Medicine.

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Ajita Ratanjee is

a registered dietician and the founder of Easy Health Wellness in Moreleta Park. Her special interest is ICU nutrition and diabetes.

Cheryl Meyer is a

registered dietician and member of the ADSA* who is passionate about diabetes and works in private practice in Bryanston.

Genevieve Jardine

is a dietician based in Durban who is registered with ADSA* and specialises in diseases of lifestyle, including diabetes.

DOCTOR

DIABETES EDUCATORS

Dr. Claudine Lee

Jeannie Berg is

is a family doctor (GP) with a passion for diabetes. She is based in Hilton, KwaZulu/ Natal and also runs an insulin pump centre.

the Chairperson of DESSA: the Diabetes Education Society of South Africa, and a registered pharmacist and diabetic educator.

SUPPORT GROUP EXPERT Jenny Russell is

Meet

Jenny Page 11.

Branch Manager of DSA Durban and is passionate about educating diabetics on how to lead a healthy lifestyle. She also holds the Community portfolio on the DESSA KZN committee.

PODIATRISTS

Andy Blecher is a podiatrist in Cape Town and currently runs the Western Cape Diabetic Foot Clinic with a team of other specialists.

Faaiza Paruk holds

a Bsc Dietetics (Hons) from the University of the Western Cape and is a member of ADSA*.

She specialises in diseases of lifestyle. *ADSA = Association for Dietetics South Africa.

Kate Bristow is

a qualified nursing sister and certified diabetes educator who runs a Centre for Diabetes in Pietermaritzburg, KwaZulu/Natal.

Community

DIETICIANS:

OPHTHALMOLOGIST: Dr. Dale Harrison is an ophthalmologist in private practice in Cape Town, and a sessional consultant at Groote Schuur Hospital.

His motto is simple: Get your eyes checked annually.

BIOKINETICISTS

Anette Thompson

M Tech Podiatry (UJ) and B Tech Podiatry (SA) is currently Chairperson of the Footwear Committee of the SA Podiatry Assoc.

Sarah Hall is a registered biokineticist BSc (Med)(HONS) in Exercise Science (Biokinetics) UCT who works for Wellness in Motion in Parkmore.

Ilona Padayachee

is a biokineticist in private practice in Port Elizabeth. She studied HMS (Human Movement Science) Hons Biokinetics at NMMU.

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DIABECINN ORIGINAL - the nature-based solution

Diabecinn™ Original is a water-based cinnamon extract (ZN112) for people with type 2 diabetes.

Diabecinn Original contains a water-based cinnamon extract (ZN112) proven to be highly effective for diabetics.

•

• • • •

Whole ground cinnamon has been shown to reduce fasting blood sugar levels in humans by up to 29%, triglycerides by up to 30%, LDL cholesterol by up to 27 % and total cholesterol by up to 26%1.

Clinically proven to support healthy glucose metabolism and normal blood sugar levels2,3.

Diabecinn Original may help reduce blood sugar levels, triglycerides, LDL cholesterol and total cholesterol in patients with Adult Type 2 Diabetes1,2 May be used with anti-diabetic diets or medication Free from sugar, lactose, gluten coumarin and contains no added preservatives.

Availability Diabecinn™ is available at health shops, independent pharmacies, Dis-Chem, Clicks, Pick n Pay, Medi-Rite and Springbok Pharmacy.

For more information call +27 11 516 1700.

Find us on Facebook.com - Search for “Diabecinn”

References: 1. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with Type 2 diabetes. Diabetes Care. 2003 Dec;26(12):3215-8: 2. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus Type 2.

Eur J Clin Invest 2006; 36 (5): 340 -344 3. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with Type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009 Sept – Oct

S0

Each Diabecinn capsule contains 112mg water-based cinnamon extract (ZN112) (equivalent to approx. 1232mg dried, whole ground cinnamon)

D21.13 others.

Combination Western Herbal This medicine has not been evaluated by the Medicines Control Council. This medicine is not intended for diagnose, treat, cure or prevent any disease.

Part of Litha Healthcare Group Limited

Reg No: 1994/008717/07

LP952 02/2015

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Partner’s Corner This is your space…

“I

feel like my husband thinks that if I don’t see him cheating on his diet, it doesn’t count. I don’t want to be a nag, but I know he isn’t eating right… How do you suggest I encourage him to eat better?” Cheryl Lee.

You need to get your husband to take responsibility for his condition and accept the importance of eating correctly. After all: it is his health at stake here.

Perhaps you could help him figure out a meal plan that looks at his likes and dislikes, eating habits and schedule, and any other health issues that may affect the way he eats. Try and come up with a meal plan that’s realistic – and one he may actually stick to. That said, it’s always important to be sensitive when advising someone about their

eating habits. Change is hard for everyone, especially older adults who’ve been doing what they do for a long time.

Communication is the only way that you are going to resolve this issue.

Do it in a gentle way and if he does not hear what you are saying, be as honest as you can and tell him exactly how you feel.

Help him set small, achievable goals. Do this as a couple and focus on what is important. You know he doesn’t want you to be disappointed in him and your opinion is therefore important. This gives you the opportunity to help him. Maybe if you communicate to him how hard it is for you see him hiding his cheating, he might be more open with you and make everything a lot easier for both of you.

Good luck!

Ask the expert: Jeanne Berg, Diabetes Educator “It is always important to be sensitive when advising someone about their eating habits.”

Partners

Dear Cheryl, I have no magic advice for you, but I feel the pain of your situation. As a caring partner, you feel worried about how his eating habits are affecting his diabetes. From his side, he is obviously trying to please you by eating correctly in front of you (but cheating on the side).

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Ask the expert: Genevieve Jardine

Sundowner snacks

Ask the Dietician

From our community:

‘M

y wife and I love having friends over for sundowners but never know what drinks to offer and what snacks to serve so that I can actually enjoy myself too. Any advice?’

Riyaaz Benjamin.

Luckily, there is a way to enjoy (guilt-free) sundowners…

It just takes a little planning. Let’s take a look at the when, what and where of it.

When?

The main problem with sundowners lies with the timing. As the name suggests, they usually occur long after lunch and just before supper. This means that you may arrive hungry and tired with low blood sugar levels: a recipe for overeating, drinking (sugary) alcohol on an empty stomach, and filling up on unhealthy snack food.

After sundowners, you may then go for supper, which means even more food and alcohol.

Healthy snack options include: Lean proteins:

nuts, lean biltong and grilled strips of chicken or beef.

Fresh vegetables:

cucumber strips, baby carrots, baby tomatoes and celery sticks, served with a low fat cottage cheese, avo or salsa dip.

The key? Sundowners are best handled when prepared. Make sure you have an afternoon snack just before arriving (preferably one that contains protein to help stabilise blood sugar levels). Upfront, decide to either have the snacks as a replacement dinner (only a good idea if there are healthy snack options) or hold back and leave room for a light supper.

What?

What is being dished up? The good news is that sundowner snacks are usually savoury and not sweet. The bad news is that savoury snacks (like chips and cream dip, sausage rolls and salty peanuts) are often high in starch and fat. Try to choose the healthiest options on the table, and don’t forget to dish up a plate rather than snacking so that you know exactly how much you eat.

Sundowners are also synonymous with cocktails (not the right choice of drink for anyone with diabetes!)

When it comes to alcohol, good

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options are light beer, a wine spritzer made with Sprite Zero or soda water, or single spirit tots with diet mixers. Sparkling water with ice, lemon and cucumber is a refreshing drink if you’re not in the mood for alcohol.

Where?

The last thing to consider is where the sundowners are being held. If you’re hosting or going to a friend’s house, you can simply bring along what you would prefer to eat and drink. Restaurants can be more challenging, but easily overcome with a bit of forward planning. Call the restaurant beforehand and make sure that there are snacks or drinks on hand that you can enjoy. Most restaurants are more than willing to help – if not, at least you know and can plan for the evening.

Sundowners are best handled when prepared.

Ask the Dietician

Top tip

Having diabetes doesn’t mean you can’t enjoy a cold drink and a delicious snack as the sun goes down, it just means you need to plan a little bit more to enjoy it!

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10 fast facts about diabetes in the golden years Keeping your diabetes in check as you get older is not only possible, but important. Here’s what you need to remember.

Healthy Living

7.3% =

the average HbA1c in the elderly population in SA: within national guidelines.

What’s yours?

Always keep a glucagon pen on hand for hypo emergencies (and make sure you’ve told someone close to you how to use it).

5

It’s a good idea for any diabetics over 65 years old to have a pneumonia vaccine shot. An annual flu shot is also beneficial..

Diet is vital: be sure to eat as balanced a diet as possible. Not eating the right kind of food or not eating often enough can result in low blood sugar.

Drinking plenty of water is also important.

It’s important to have regular blood pressure and cholesterol tests, and annual kidney, eye, teeth and feet check-ups.

3

Hypos (low

blood sugar) are a risk, especially in Type 2 diabetics who are on SUs (sulphonylureas).

A severe hypo can result in a coma, so it’s important to know how to treat it.

10

Studies show that older diabetics are more compliant than teenagers, the newly diagnosed, and even pregnant diabetics.

7

Keep active as it helps with mobility, balance, strength, mental wellbeing and insulin sensitivity.

Be prepared and always have at least three days of supplies on hand for testing and treating your diabetes.

Controlling Type 2 diabetes with Glucophage or Galvus can have a life-changing effect.

Ask the expert: Dr Claudine Lee, GP “Most of my elderly patients seem to have ‘got it’ by the time the twilight years dawn. They really do take care of themselves, report any changes and actively manage their diabetes.”

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Sweet Life is lucky to have an amazing Panel of Experts giving us advice to share with you each issue.

Meet Jenny Russell, our Support Group Expert.

How are you involved with diabetes?

I am Branch Manager of Diabetes SA Durban, and hold the Community portfolio on the Diabetes Education Society of SA (DESSA) KZN Committee.

What advice would you give to older diabetics who are struggling with the condition?

Don’t be too hard on yourself, or try to manage your condition on your own. Contact a Diabetes SA branch near you: we can help with lifestyle advice, and put you in contact with the right medical experts in your area.

Why do you think support groups are so important for diabetics?

Most diabetics feel very alone and different to their family and friends. They are often given incorrect and conflicting advice on living with diabetes, but a support group exposes them to health professionals who give them relevant information. Members also get to socialise with other diabetics who are having the same daily challenges they are.

Do you have any stories to share about the power of diabetic support groups?

• One lady who has been diabetic for 28 years said she did not start understanding her condition until she came to a support group.

• A man who came to one of our talks on eye care went to see an ophthalmologist and had emergency laser treatment that saved his sight.

• Many underprivileged diabetics have been given glucometers and strips to monitor their blood sugar levels.

• We have had great carb counting meetings where we put out about 40 plates, each with one 15g carb portion. The reaction when members see what makes up one portion is such fun to watch, and there is lots of laughter and discussion.

Meet the Expert

Jenny Russell

What makes your life sweet?

Aaaah… That’s easy. Being able to make a difference to even one person’s life every single day!

Meet the rest of our experts at www.sweetlifemag.co.za/about-us

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Climbing

Kilimanjaro s e t e b a i d h t wi

It’s the highest mountain in Africa, but that didn’t stop Neil Rae – a Type 1 diabetic for 50 years – from wanting to climb it. We chat to Neil, 63, about his preparation, the climb itself, and life with diabetes.

How long have you been diabetic?

I was diagnosed on the 13th December 1964: in December last year it was 50 years. I’ve seen a lot of changes for diabetics in my time – there’s a lot more we can eat, the technology to monitor blood sugar levels is a lot more advanced and the insulin pen sets are much more convenient.

We’ve come a long way since the gas cylinder with a tin cup that I used to sterilise my glass syringes when I was at university!

set a goal for my diabetes: to climb Kilimanjaro when I’d lived with it for 50 years.

About 18 months ago I contacted Novo Nordisk, the people who manufacture my insulin, to ask if they’d like to partner with me. They were very excited to join the challenge. As you can see it’s been a long-term goal of mine… I’ve always loved mountains, and this is the highest mountain in Africa and the highest freestanding mountain in the world so it seemed an obvious choice.

What made you decide to climb Kilimanjaro?

I grew up in Lesotho and I’ve always had a love for mountains. I don’t know how many decades ago, I said to myself I wanted to

What did you do to prepare?

I’ve always been a relatively fit person, at school and varsity I played all the sports I could, and I do a lot of walking with my wife Shaye, in and around the streets of

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Inspiring

Johannesburg and in the Drakensberg. We stepped it up a bit over the last few months – Novo Nordisk notified me in September last year that they would definitely help sponsor the trip so that’s when we picked up our training. I was walking between 30 and 40km a week, and over weekends doing long walks in Westcliff – they have a flight of 222 stairs built into the rock face, and with a heavy rucksack on your back it’s good training! I did the climb with my doctor, Dr Bruce Ilsely, and David Broomfield from Novo Nordisk, so as a team we were well-prepared.

ing up and up and up all the time. It was tricky to balance that amount of exercise with the food supplied by the people who organised the walk – we didn’t take any food with us.

Normally my sugar is very well controlled, so the plan was to do very regular checks of my blood sugar levels, see what we were going to be given to eat and then decide how much insulin to take. It turned out that I didn’t eat very much: I became nauseous quite early on, once we were over 3500m. I didn’t take insulin for a period of about 48 hours and my sugar remained between 10 and 16mmol/l the whole time, which is what my doctor wanted because we were on our feet all day and constantly walking. We had to move very slowly to acclimatize. My biggest challenge was the fact that the glucometer I was using, which was specifically for high altitudes, didn’t work very well, so Dr Bruce had to do manual checks for me.

How did you keep your insulin at a stable temperature while climbing?

That was quite a challenge because at the bottom of the mountain, in the town of Moshi where we stayed before we started the walk, the temperatures were between 35 and 40˚C and then it obviously kept getting colder the higher we went.

How did you know what to eat and drink while climbing, and how to balance your blood sugar?

Balancing blood sugar was obviously going to be a challenge - spending between 7 and 8 hours a day climb13

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The hardest parts for me were the ascents and descents, because you had to climb up mountains and then down into valleys every day.

Inspiring

I used an insulin insulation package that David gave me from Novo Nordisk, which was very helpful: it kept the insulin cool and also prevented it from freezing. There was no problem with my insulin at all – it never froze.

What was the hardest part of the climb?

The hardest parts for me were the ascents and descents because you had to climb up mountains and then down into valleys, and there was a lot of very rocky pathways – walking from rock to rock. Some days we went up and down two or three times in a day. We left Moshi on the Monday and we summited on the Thursday night/Friday morning.

Unfortunately I wasn’t able to make the summit – I got up to about 5000m and my altitude sickness was so bad that Dr Bruce said to me, “If you carry on, you’re going to die”.

Once I got back down to the base camp at 4600m, then I was fine: it wasn’t diabetes related at all.

What surprised you about the Kilimanjaro experience?

What surprised me was the number

of people that were climbing, people from all over the world – everywhere other than Africa. It was interesting to listen and talk to them about their experiences.

What advice would you offer to diabetics who are struggling?

In my opinion, every diabetic who’s struggling has got to develop a lifestyle routine: get up in the morning, check your blood sugar, decide how much insulin you need and what you’re going to eat for the day.

You have to have a definite lifestyle routine, and stick to it every day.

Discipline is so important to a diabetic. If you don’t have the routine and don’t have the discipline, you’re not going to live with it for 50 years!

You have to take charge of your life and be tough – tough on yourself, because it’s in your best interests.

That’s how I’ve lived with diabetes for 50 years.

What makes your life sweet?

I’m very fortunate: I’m married to a lovely lady and I have two daughters and four grandchildren now. My family, my life and everything in it makes my life very sweet.

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Of the estimated 382 million people with diabetes3

About 50% are diagnosed1,2

Of whom about 50% receive care1,2

Of whom about 50% achieve treatment targets1,2

Of whom about 50% achieve desired outcomes1,2

DIABETES

DIAGNOSED RECEIVE CARE

ACHIEVE TREATMENT TARGETS

ACHIEVE DESIRED OUTCOMES

Actual rates of diagnosis, treatment, targets and outcomes vary in different countries.

the one rule we have to change Diabetes affects 382 million people worldwide.3 According to the ‘rule of halves’, only half of them have been diagnosed and only about half of those diagnosed receive professional care. Of the people receiving care, only about half achieve their treatment targets and of those, only about half live a life free from diabetes-related complications.1,2 Through our Changing Diabetes® partnerships and programmes, we are working with communities around the world to break this rule by increasing diabetes awareness and improving access to care and treatment options.

Learn more about how we are changing diabetes at www.novonordisk.com

References: 1. Hart JT. Rule of halves: implications of increasing diagnosis and reducing dropout for future workload and prescribing costs in primary care. British Journal of General Practice 1992; 42:116–119.

2. Smith WCS et al. Control of blood pressure in Scotland: the rule of halves. Br Med J 1990;300:981–983.

3. International Diabetes Federation. IDF Diabetes Atlas, Sixth edition. 2013. Online version of IDF Diabetes Atlas: Available from www.idf.org/diabetesatlas. Accessed January 2014.

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Amara de Abreeu, Type 1 Diabetes, South Africa

Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. 345 Rivonia Boulevard, 2nd Floor, Building A, Rivonia, 2128. Tel: (011) 202 0500 Fax: (011) 807 7989 www.novonordisk.co.za CD RLC 0215 3881 0316

ADVERTORIAL

Demystifying insulin It’s the life-changing drug for so many diabetics – both Type 1 and Type 2 – but what exactly is it, how does it work, and why is it such an emotional injection? Here’s a 360˚ view of insulin.

What is insulin?

Insulin is a hormone made in the pancreas.

Insulin is the blood sugar balancing hormone: it ensures your blood sugar doesn’t get too high (known as hyperglycaemia) or too low (known as hypoglycaemia).1

Understanding normal insulin secretion In a person without diabetes, the pancreas releases insulin throughout the day to keep the blood glucose values within a certain range. When meals are eaten, more insulin is secreted by the pancreas to deal with the sugar load of the meal.2

How does it work?

All the cells in your body need sugar for energy, but the sugar from the food you eat can’t pass directly into the cells. Every time you eat, your blood sugar level starts rising.

This sends a message to the beta cells in your

pancreas to release insulin into the blood.

The insulin signals the cells to absorb the sugar from the blood and use this sugar for energy: it unlocks the cell and allows the sugar to pass into it.1 When you have more sugar in the body than is needed, insulin helps to store this sugar in your liver – to be released when it is needed.

The higher the blood sugar, the more insulin is secreted by the pancreas.1 In people with diabetes, the body either doesn’t produce enough insulin or the cells do not respond to the insulin that is produced. Type 1 diabetics can’t make any insulin because their beta cells are damaged or destroyed, that’s why they need insulin injections. Type 2 diabetics don’t respond to the insulin in their system or they are resistant to it.1 People with Type 2 may first be treated with oral medications, along with diet and exercise.

However, because this is a progressive condition, they may also require insulin to get to glycaemic control and remain controlled.1 There are various insulin preparations currently available in South Africa. They differ in the times that they take to start working after injection (onset of action), the time of maximum peak effect, the times that they continue to have an effect (duration of action) and whether they are human insulins or analogue insulins.

Human insulins are laboratory made insulins (you would think come from humans, but don’t). Analogue insulins are also made in a lab – but are modified to affect how quickly or slowly they act.3

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ADVERTORIAL

Why is there so much emotion around it?

Many Type 2 diabetics feel that moving on to insulin injections means that they have ‘failed’ in some way: that if they had been ‘better’ diabetics they would not have needed to take injections. But this is simply not true.4 “Injecting is just another kind of treatment,” explains diabetes educator Jeanne Berg, “and it’s inevitable as the pancreas stops making insulin in the long run.” Just because a Type 2 diabetic has to take insulin injections doesn’t mean there has been any failure on their part.

“Injecting insulin is just replacing the exact hormone your body needs. No more, no less,” says Jeanne. As for the fear associated with injecting, the much shorter needles available today ensure the injections are no longer painful.5 For Type 1 diabetics – especially those who have lived through adolescence with diabetes – injecting insulin can become an emotional part of every meal. Some diabetic teenagers feel as if their parents actually control their diabetes, and use injecting (or, more specifically, not injecting) as an act of rebellion.

Unfortunately the only person this rebellion hurts is the person with diabetes, as high blood sugar over a long period of time results in long-term damage to the body.6 But even those who aren’t rebelling against anyone can have an emotional time with their injections. “I remember when I was first diagnosed, at 25,” explains Sweet Life editor and Type 1 diabetic Bridget McNulty. “I thought that if I took less insulin it meant I was being a better diabetic. It was difficult not to think of it as a diet: I would still eat the same amount, but I thought that if I didn’t take the full amount of insulin it didn’t count… It makes no sense at all, but it was definitely tied to what I was eating every day.” And perhaps this is where the secret to the emotions around insulin lie: injecting for every meal is so closely tied to food, and what we eat, and how we feel about that.

The good news?

Once you understand what insulin is and how it works, you can remove any emotion from the act of injecting, and focus on better things: like living a healthy, happy life with diabetes.

Ask the expert: Jeanne Berg, Diabetes Educator “Insulin is just the next step in the journey of treating diabetes. Whether you take tablets or inject, you are treating the same condition. Taking insulin is simply replacing the same hormone that the body is lacking.”

BROUGHT TO YOU BY: REFERENCES 1. http://www.endocrineweb.com/conditions/type-1-diabetes/what-insulin. Accessed 24th February 2015 2. Polonsky KS et al. Twenty-Four-Hour Profiles and Pulsatile Patterns of Insulin Secretion in Normal and Obese Subjects. Journal of Clinical Investigation. Volume 81, February 1988. Pg 442-443 3 http://www.diabetes.org/diabetes-basics/myths. Accessed 24th February 2015 4. www.diabetes.co.uk/ Types of Insulin. Accessed: 24th February 2015 5. www.bd.com. BD Ultra-Fine™ Nano: World’s Smallest Pen Needle: Shorter Needles Deliver Added Benefits. Accessed 27th February 2015 6. Schreiner RN et al. Management Strategies for the Adolscent Lifestyle. Diabetes Spectrum, Volume 13, Number 2, 2000, pg 83

SLM13_Sanofi_AD.indd 3

2015/03/09 3:54 PM

ADVERTORIAL

Insider info: caring for your feet We ask Sister Kate Kruger, one of Recharge Your Feet’s foot nurses, to share some of the things she wishes all diabetics knew about their feet.

1 It’s important for diabetics to realize that their feet are very important: when your feet hurt, your whole body suffers.

2 As we get older, walking and being active naturally slows down. In order for walking to remain natural, the feet must be healthy and circulation must be stimulated.

3 Keeping the legs and feet elevated can improve circulation.

4 Crossing the legs while sitting can damage circulation.

5 Keeping the skin on the feet and legs clean and healthy is essential, particularly the skin in between the toes.

It’s important to dry the skin very well, as damp skin in between the toes will invite infections.

6 Moisturising the skin is also vital so that the skin doesn’t dry out and crack. When the skin’s natural barrier is

damaged it is easy for toxins and bacteria to enter the tissue and cause infection.

7 Injuries that aren’t treated can lead to infection and tissue damage, which can lead to gangrene and even amputation.

8 A podiatrist can be very helpful if there is any nerve damage and to test the blood flow to and from the feet. If the veins are not carrying blood away from the feet, the blood can pool and congeal, which causes discoloration and can lead to ulcers if not treated.

9 Any blemishes or changes in skin colour should be reported to a health care worker immediately.

10

Checking the feet and legs every day is a must!

Don’t forget!

• Check your blood sugar before and after a meal to establish whether your diet is working • Drink 6 to 8 glasses of water a day • Get regular exercise: walking and foot exercises • Have regular HbA1C blood tests every 3 to 6 months to get average blood sugar readings

Get more helpful advice online at www.rechargeyourlife.co.za or email Sister Kate directly to discuss foot care and general diabetic problems: footnurse@rechargeyourlife.co.za

SLM13_Recharge.indd 1

2015/03/09 11:38 PM

“Having diabetes doesn’t make me different. But having my Dis-Chem Clinic on my side makes all the difference.”

Diabetes Type 2 sufferer

When I was diagnosed with diabetes,

I thought my whole life would change for

the worst, and I’d never be ‘normal’ again!

However, thanks to my Dis-Chem

Clinic Sister, I realised that with the

right diet and lifestyle changes,

a suitable exercise programme,

regular blood glucose monitoring and medication management, diabetes doesn’t rule my life.

I do.

If you suffer from diabetes,

talk to your Dis-Chem

Clinic Sister: seriously, when you know there’s someone

who can (and will) help you

get on with life, you just feel

differently about the whole thing.

In a good way!

Clinic Call Centre 0861 117 427 Customer Careline 0860 347 243 careline@dischem.co.za www.dischem.co.za

GO Advertsing 72549

“Remember, having diabetes doesn’t make you any different.”

“It’s the specialised diabetes training that makes our Dis-Chem Nursing Practitioners different.”

Lizeth Kruger Head of Clinics

Dis-Chem’s commitment to providing the highest standards of diabetic care goes

beyond offering prescription medication

and monitoring aids, vitamins, supplements and condition-specific foodstuffs at our famously affordable prices: now, the nursing practitioners who run our Dis-Chem Clinics all undergo

extensive training in this highly specialised field.

So, in every one of our 84 branches nationwide, you’ll find a qualified

professional who can advise you on all aspects of diabetes, including: • HbA1c screening

• Regular monitoring and treatment adjustment

• Medication and

condition management

• Nutrition, exercise, lifestyle

“But having professional help to manage it makes a big difference.”

Diabetes breakthroughs From the artificial pancreas to new ways of testing blood sugar and more, we take a look at the future for those with diabetes.

WORDS: CARINE VISAGIE

Diabetes is a rollercoaster ride of blood sugar ups and downs, and tight control can be hard work. But there’s good news: while some researchers are working on a cure, others are making life easier for those with diabetes right now.

monitoring is going to be very helpful in patients that have difficulty controlling their blood glucose levels, as it will provide a 24-hour 360-degree view of their diabetes control.” Dr Joel Dave, Endocrinologist

We bring you a roundup of the top new technologies available.

Ask the expert: “I’m looking forward to the Abbott Flash Monitor, as it will stay on for 14 days and doesn’t require calibrating with a second machine.” Dr Wayne May, Endocrinologist

1

Glucose-monitoring devices

Continuous glucose monitoring (CGM) devices are soon going to take blood sugar control to another level.

With the help of tiny electrodes stuck beneath the skin, CGM devices allow for real-time glucose readings throughout the day. The results are sent wirelessly to a monitor you can clip onto your belt and access on the go, and some devices can even send results to your doctor. Normal finger prick testing is still required (for a double check and to calibrate the CGM sensor), but you can rest assured that a CGM device will alert you if your sugar spikes or drops below your limits.

Examples include the Flash Glucose Monitoring System (Abbott) and the Guardian REAL-Time Continuous Glucose Monitoring System (Medtronic).

Ask the expert: “24-hour glucose

2

Insulin pumps

Insulin pumps keep getting smarter: some of the latest ones sync with CGM devices, while others are incredibly accurate at giving just the right insulin dose at the right time.

One example is the touch-screen Tandem t:slim insulin pump, which shows the date, time, how much insulin is ‘on board’ (seeing this before you bolus can help you avoid stacking your insulin*), duration of insulin action, and the amount of insulin in the reservoir. It looks like a smartphone and data is easily transferrable via a USB

* What is insulin stacking?

Injecting a second dose too soon after a first, without taking into account the insulin already in your system. This can result in low blood sugar.

24

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2015/03/09 3:59 PM

Another insulin pump to watch is the MiniMed530G by Medtronic – the first pump to shut off when blood sugar goes below a predetermined level.

What about now?

Smartphone apps for diabetes If the future of diabetes tech seems too far away, keep an eye out for apps that can help you deal with diabetes right now, on your smartphone. We like: GLUCOSE BUDDY: to track blood sugar readings, insulin doses, carb intake, exercise, blood pressure and weight.

Ask the expert: “Although an insulin pump isn’t the ideal way of administering insulin for everyone, many diabetics find a pump improves their diabetes control and quality of life. Since the addition of CGM, the use of this technology has improved even more, especially in children and patients with very erratic blood sugar.” Dr Joel Dave, Endocrinologist

3

Bionic pancreas

Bionic (artificial) pancreas systems are the next big thing in diabetes management. These systems, the first of which is still being tested, combine the latest CGM tech with the most advanced insulin pump tech and add a sophisticated computer programme to simulate the function of the pancreas.

DIABETIC CONNECT: helping you tap into trusted advice, friends, support and tips.

But be warned:

Many international apps use mg/dL, the US blood glucose standard, instead of mmol/l.

“I

’m yet to find a diabetes app that works for me,” says Laura Newnham, a Sweet Life reader with Type 1 diabetes. “So far, the apps I’ve downloaded don’t record blood glucose in mmol/l. I would definitely use an app if I could find a good one: it would be helpful to have reminders to test, especially on busy days at the office.”

The system constantly checks blood sugar levels by means of a CGM, and responds automatically by administering either insulin (to lower blood sugar) or glucagon (to raise blood sugar quickly) via two separate pumps. The system hooks up to a programme on your smartphone that makes decisions every few minutes, pancreas has been the ‘holy grail’ for telling the pumps via Bluetooth how diabetes care for many years. The much hormone to deliver. system has been vastly improved and early studies are showing great The bionic pancreas should be promise. In the near future it will available in the next 5 years. be a life-changing addition to the diabetes care of many patients.”

Ask the expert: “The artificial Dr Joel Dave, Endocrinologist

Special Feature

port. Plus, it can deliver insulin in very small doses.

25

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2015/03/09 3:59 PM

The daily sweat Getting active every day can feel like a bit too much to ask for… Which is why we’ve asked the experts to give us easy ways to keep fit – no matter how old you are!

Work It Out

WORDS: CINDY TILNEY

3 top tips for people with diabetes:

1

Don’t begin exercising if your blood sugar is either too high or too low (over 16 or below 4.8).

2

If you are using insulin, always take something sweet with you when you exercise, in case of hypoglycaemia (low blood sugar).

3

Avoid injecting into any of your large muscle groups just before exercising.

26

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2015/03/10 12:07 AM

We all know exercise is good for us, but exercising to the max – especially in later life – can be too much of a good thing. It’s essential not to stress the body by exercising too hard, says Professor Wayne Derman, the Director of the U-Turn Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of South Africa. “When planning an exercise routine, it’s important to consider any medical condition you might have, as well as any medication you’re taking and how it may affect you while exercising,” says Prof. Derman.

Older age also comes with a bigger chance of aches and pains because of problems like osteoarthritis and rheumatoid arthritis – if these names ring a bell, it’s a good idea to be more careful about the kind of exercise you choose, and to consult a medical professional (a biokineticist, physiotherapist or sports physician) when planning an exercise routine. Be sure to check if any medications you are on will interfere with this routine, reminds Prof. Derman.

Be informed “It’s essential to go for a health check and orthopaedic assessment before starting any exercise programme,” says biokineticist, Sarah Hall.

Get checked for: • • • • • •

Cardiac weakness Any existing injuries High blood pressure Ischaemia (restriction in blood supply) Uncontrolled diabetes Also be aware that falls are more likely if your balance isn’t what it used to be.

So what should you do?

It’s important to include all of these steps in an optimal exercise programme, as they all have different functions, say Derman and Hall. These include: 1. The warm-up: This involves stretching and preparing your body for exercise.

2. Flexibility training/stretching: This focuses on increasing the range of motion of the joints and stretching the body to release tension in the major muscle groups – calves, quads, glutes, hamstrings, back, chest and arms.

3. The aerobic phase: Involves movement of the large muscle groups to increase the heart rate. It can be walking, jogging, cycling, aqua aerobics or rowing, for example.

4. Muscle strength resistance training: Using elastic bands or circuit training to make muscles stronger. This is particularly important for people with diabetes, as it can help the muscles involved in the absorption of insulin to become more sensitive, which helps blood sugar control.

5. Stability training: Exercises like plank position that help balance and core stability.

6. The cool down: This involves stretching and relaxation to allow the heart rate to go back to normal and the body to return to a resting state.

Remember: The goal is to exercise 20 to 30 minutes on most days of the week.

Warning signs: The right kind of exercise has benefits for every chronic condition, says Prof.

Derman. But watch out for: • Feeling breathless to the point that you can’t talk when exercising.

• Any pain.

• “The saying ‘no pain no gain’ is not true,” he says. “Your body should be in a state of relative comfort while exercising.”

“The goal is to begin with the basics and work consistently at increasing both load and intensity slowly.” Sarah Hall, Biokineticist

27

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2015/03/10 12:07 AM

Ask the expert: Sarah Hall, Biokineticist

What kind of exercise is best for older people with diabetes?

Warm-up: 5-10 minute brisk walk Stretch: Standing calf and quad stretch, chest, shoulder and bicep stretch, lying down hamstring stretch and cat stretch for the back Aerobic: Step for 2 minutes

Muscle strength: Like bicep curls, wall push-ups and abdominal crunches (sit-ups) Aerobic: Walk or jog on the spot for 2 minutes Stability: Plank position Cool down: Repeat stretches

Work It Out

“It’s never too old to start exercising. People in their 90s undergo 90% of the adaptation that a 30-year-old does, simply by following a regular basic exercise routine.”

Prof. Wayne Derman

Smart snacks for exercise • 30 mins exercise: Not usually

•

• 60 to 90 mins: A small carb

50g carb = 1 wholewheat sandwich with protein + 1 fruit, or 50g FUTURELIFE Smart Food + 250ml fat free milk.

necessary to snack

snack 1 hour before you exercise.

15g carb = a slice of bread or ½ a FUTURELIFE High Energy Bar or 1 small fruit.*

More than 90 mins: A bigger carb snack.

* Check your blood sugar before you exercise: if it is more than 10mmol/l you won’t need a snack.

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2015/03/10 12:07 AM

ADVERTORIAL

Gero... taste it and enjoy it!

What makes Gero yoghurt different?

• It’s fat free and sugar free: sweetened with non-nutritive sweetener (no aspartame).

• It contains various strains of probiotic micro-organisms.

• Gero has a low GI: it is slowly absorbed and does not spike blood sugar levels.

• It is good for diabetics, those on a diet and those who choose a healthy lifestyle.

• It contains the nutrients required to maintain a healthy body.

www.gero.co.za

12 FANTASTIC WAYS TO ENJOY GERO:

• Gero is good for the whole family.

1. As a delicious dessert 2. As a dessert sauce 3. As an ingredient in sorbets and ice-cream 4. For breakfast, with cereal 5. As a to-go meal 6. As an ingredient in smoothies and drinks 7. As part of a tasty salad

dressing 8. As an ingredient in sauces 9. As a meat marinade 10. As a creamy ingredient in baked dishes 11. To replace cream in cream soups, dips, etc.

12. To replace sour cream over baked potatoes

Choose your favourite flavour: • Plain Gero has a mild taste and no added sweetener.

• Fruit yoghurts are made with real fruit: goji berry, strawberry and exotic berries.

• Flavoured yoghurts are made with flavourings: strawberry, vanilla and cranberry.

Available in 100g, 175g and 1kg tubs.

SLM13_Gero_AD.indd 1

2015/03/01 10:11 PM

PRINT.pdf

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2015/02/16

12:10:19 PM

Breakfast: sorted Here's how to make the most important meal of the day the most delicious meal too. Whether you want breakfast onthe-go, quick and easy, a lazy weekend option or a treat, we've got it all. We also gave three readers' breakfasts a diabetic-friendly facelift. Yum! PHOTOS: MARK PEDDLE FOOD EDITOR: LUISA FARELO ASSISTANT: MEGAN DANIELS

Inspired by you

24

SLM13_Food.indd 1

Look out for our healthy tips from Pick n Pay's dietician, Leanne Tee, to make these dishes even better for you!

31

2015/03/09 10:25 PM

Apple and Cinnamon Crumble Muffins protein

846kJ

5g

Makes: 12

fat

carb

8g 29g

fibre

sodium

3g

50mg

per muffin

energy

2 apples, grated 1 cup low-fat plain yoghurt 1 egg ¼ cup vegetable oil 1 cup flour 1½ cups wholewheat flour 1t baking powder 1t bicarbonate of soda

1t cinnamon Pinch of salt 1T brown sugar

Method:

then fold in the grated apples.

To make the crumble topping: Place sugar, flour and cinnamon into a small bowl.

Using your fingers, rub in the butter until it resembles breadcrumbs.

Pour muffin mix into a lined muffin tin and top each muffin with a little crumble.

Bake in oven for about 25-30 minutes or until golden brown and cooked through.

Topping: 2T butter 2T brown sugar 4T flour ½t cinnamon

Preheat oven to 180˚C. In a glass bowl, whisk together the yoghurt, egg and oil until just combined and set aside.

In a separate bowl, place the two flours, baking powder, bicarb, cinnamon, salt and sugar and mix lightly to distribute all ingredients.

Add the wet ingredients and mix until just combined,

Top tip:

Use canola oil instead of sunflower oil for cooking and baking, as it has a higher monounsaturated (healthy) fat content.

Inspired by you

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

24 32

SLM13_Food.indd 2

2015/03/09 10:25 PM

Vanilla Quinoa Porridge protein

fat

carb

fibre

sodium

1324kJ

15g

9g 46g

6g

173mg

per portion

energy

Try this!

Serves: 2 ½ cup rinsed quinoa 1¼ cups low-fat milk ½t vanilla essence Pinch of salt

READER'S BREAKFAST Zulpha Salie Ackerdien's "Oats with milk and 1t sugar."

1t brown sugar Handful of toasted pumpkin seeds

Method: Place the quinoa, milk, vanilla, salt and brown sugar into a saucepan and cook (covered) over a gentle heat for about 15 minutes or until quinoa is tender and liquid is absorbed.

Remove from heat and spoon into bowls.

Pour over a little extra warm milk and top with toasted pumpkin seeds and some sliced pear just before serving.

Top tip:

Quinoa is a high-fibre cooked starch which can be included as part of a diabetic diet. Try it in sweet and savoury dishes.

25 33

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Method:

Vegetarian Open Omelette protein

1340kJ

21g

fat

carb

fibre

sodium

24g 9g

2g

507mg

Serves: 2 Vegetable oil, for frying 1 spring onion, sliced ½ yellow pepper, thinly sliced Handful of cherry tomatoes, halved 2 handfuls baby spinach

5 eggs 2T low-fat milk Salt and freshly ground pepper 1T low-fat milk 50g low-fat feta cheese

per portion

energy

Heat a large non-stick frying pan with a little oil and gently cook the peppers and cherry tomatoes for a couple of minutes over a moderate heat until just blistered and slightly softened.

Add the spring onions and spinach and cook for about 30 seconds or until spinach has just wilted. Season and set aside.

Crack eggs into a glass bowl, add the milk and whisk together using a fork.

Heat the same pan with a little more oil and when hot, add the whisked eggs.

Reduce flame to a medium heat and gently cook the omelette by drawing a wooden spoon across the eggs so that they cook quicker and evenly.

Once the eggs are almost cooked, scatter the spinach, peppers and tomato mix across the base of the omelette and crumble over a little feta cheese.

Allow the omelette to cook completely over a very gentle heat and once ready, carefully tip out onto a plate and serve immediately.

Top tip:

Research now says you can eat an egg a day! If you are eating more than one, use two egg whites to replace one of the eggs. Egg whites are cholesterol free.

Inspired by you

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

34

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2015/03/09 10:25 PM

Spiced Apple Breakfast Bake protein

1587kJ

12g

Serves: 4

fat

carb

fibre

sodium

17g 51g

8g

57mg

1 egg 2T brown sugar ½ cup low-fat milk 1T vegetable oil 50g raw pecan nuts, roughly chopped (optional) 1t ground cinnamon ½t ground nutmeg ¾ cup oats ¼ cup oat bran 2 apples, peeled and roughly chopped

per portion

energy

Method: Preheat oven to 180°C. Crack egg into a bowl and beat in sugar until light and fluffy.

Add milk and oil and mix until combined.

Set aside.

Place pecan nuts, cinnamon, oats and oat bran into a separate bowl and mix together lightly. Stir into the wet ingredients.

Place chopped apples into a small square baking dish and pour the oats mixture over them.

Bake in oven for 20-25 minutes or until lightly golden brown.

Serve warm with a spoonful of low-fat yoghurt and fresh nectarine wedges.

Top tip:

Oat bran is a wonderful source of soluble fibre, which helps to control blood sugar and blood cholesterol levels.

35

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2015/03/09 10:25 PM

Bircher Muesli protein

1967kJ

20g

Serves: 4

fat

carb

fibre

sodium

17g 66g

11g

62mg

1½ cups oats 1 cup low-fat milk ½ cup low-fat yoghurt ¼ cup mixed seeds, toasted 50g flaked almonds, toasted 2 apples, grated Squeeze of lemon juice Granadilla, to serve

per portion

energy

Try this!

Method:

READER'S BREAKFAST Aileen Hattingh's "All Bran flakes, low fat milk, chopped up apple."

Place oats into a bowl and pour over the milk.

Leave to soak for a few hours or preferably overnight.

Stir in the yoghurt, mixed seeds, toasted almonds, grated apple and lemon juice.

Serve spoonfuls of Bircher Muesli into individual serving bowls and top each with a teaspoon of extra yoghurt, a few extra nuts and a little granadilla.

Top tip:

Make sure the seeds and nuts you use in this recipe are raw and unsalted - that means they will be lower in fat and sodium.

Inspired by you

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

36

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2015/03/09 10:25 PM

Ham and Egg Cups protein

572kJ

10g

fat

carb

fibre

sodium

10g 3g

0g

371mg

per cup

energy

Makes: 12 12 slices of ham 12 eggs Salt and freshly ground pepper 2 courgettes, shaved into ribbons (using a vegetable peeler) 2 spring onions, finely sliced

Method: Preheat oven to 180ËšC. Grease muffin tray and line each cup with a slice or two of ham.

Place two courgette ribbons (or a few cherry tomatoes) into the ham cup and crack an egg on top.

Season with a little salt and pepper.

Top each egg with a few sliced spring onions and bake in oven for about 15 minutes or until eggs are cooked through.

Remove from oven and serve immediately.

Top tip:

Pair your ham and egg cup with a slice of low GI, wholewheat toast for a balanced meal.

27 37

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2015/03/09 10:25 PM

Homemade Health Seed Bread protein

716kJ

8g

fat

carb

fibre

sodium

8g 19g

3g

29mg

Makes: 1 loaf

per slice

energy

Try this!

READER'S BREAKFAST Maureen Hawker's "Two slices of toast with cheese."

¼ cup oat bran 1 cup brown bread flour 1 cup white bread flour ½ cup oats 1½ cups mixed seeds, crushed 1T vegetable oil 1t bicarbonate of soda ½t salt 1 egg 1½ cups low-fat milk

Method: Preheat oven to 200°C. Place all dry ingredients into a bowl and set aside.

Whisk together the egg, milk and oil until combined and add to the flour mix.

Mix well until combined and pour into a lightly greased bread loaf tin. Bake in oven for 50 minutes or until bread is golden brown.

Remove from oven and allow to cool in tin.

Serve fresh or toasted with avocado, low-fat chunky cottage cheese and a pinch of chilli flakes for a delicious breakfast.

Top tip:

A loaf of bread usually yields 12 to 16 slices. Measure up to ensure that your serving isn't too big.

Health hotline

Inspired by you

0800 11 22 88 healthhotline@pnp.co.za

38 28

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2015/03/09 10:25 PM

Do you know how much salt you’re eating every day? Here are some great tips to reduce salt intake.

Salt has always flavoured our food, but modern day processed and convenience foods have increased our salt intake. The World Health Organisation suggests less than 5g of salt (or 2000mg sodium) per day: in SA, we’re closer to 9g!

Our National Department of Health has published regulations to decrease the amount of sodium in processed foods. Here are some other ways you can reduce sodium in your diet every day: • Focus on using fresh foods over processed foods wherever possible.

• If you prefer salty tastes, cut back on your salt gradually. A preference for salty taste is learned over time, so it will take some time for your palate to adapt to enjoying less salty foods.

• Taste your food before you add salt, as it may not need it.

Did you know?

Having a high sodium intake can increase your blood pressure, which is a major risk factor for heart disease, stroke, kidney disease and other conditions.

• If you have already added salty spices or a stock cube to your meal, you may not need to add extra salt.

• Instead of using salt, flavour your food with herbs and unsalted spices like lemon juice, vinegar, Italian herbs, parsley, rosemary, curry powder, paprika, pepper, garlic, ginger, chilli and onions.

Check the amount of salt in processed foods by reading the product label. Use this table as a guide to tell which foods are high, moderate and low in salt or sodium:

Sodium (Salt)

Per 100g

Low

Moderate

High

120mg or less

120-600mg

600mg or more

Eat more often

Eat sometimes

Avoid or limit

Salt Awareness

16 – 22 March is Salt Awareness Week!

REMEMBER TO LOOK AT THE NUTRITION INFORMATION PER 100G OF FOOD, NOT PER SERVING.

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietician, Leanne Tee, to provide food and nutrition-related advice to the public.

For your nutrition and healthrelated queries, contact Leanne >> healthhotline@pnp.co.za >> Toll free on 0800 11 22 88

SLM13_Food.indd 9

Brought to you by

39

2015/03/09 10:25 PM

Just Diagnosed

Always have your medication handy. No matter where you are or what you’re doing.

Diabetic diet: there is no specific ‘diabetic diet’, but all diabetics should eat lots of fresh fruit and vegetables, plenty of wholegrains, lean proteins, and as little sugar and refined / fried / fatty / junk food as possible.

Everything in moderation!

Blood sugar (or blood glucose): aim for balance – not too low (hypoglycemia), not too high (hyperglycemia).

The golden number for blood sugar readings is 7.0.

Gestational diabetes occurs when a woman has high blood sugar levels during pregnancy.

Like Type 2 diabetes, it can often be controlled with diet and exercise.

Juice is a great pick-me-up for a low. Try to carry a small juice box or some sweets on you at all times, just in case.

Ketones are acids that build up in the blood and urine when your body doesn’t have enough insulin. They can lead to a serious condition called ketoacidosis and from there to diabetic coma. If you’re in good control, you don’t have to worry about ketones.

Carbohydrate counting lets people with diabetes eat a varied diet.

Each carbohydrate (which includes dairy and fruit as well as starch and sugars) has a specific value that can be counted to determine how much insulin to take.

Exercise every day, for at least half an hour. It doesn’t have to be difficult – just a walk around the block will do.

Family history plays a big role in diabetes, particularly Type 2 diabetes. Your genes determine whether or not you are at risk for diabetes.

HbA1c tests are important to have, every 3 to 6 months. They give you one number for the past 3 months that will tell you how good (on average) your blood sugar control has been.

Insulin needs to be kept cool – keep spares in the fridge. Insulin can last for 30 days at room temperature, but any longer than that is not ideal.

Lifestyle plays a big role in Type 2 diabetes.

Changing the way you eat, how you exercise and your daily stress levels can make a big difference to how well you feel every day.

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Meal plans are very helpful when you are first diagnosed because they give you an idea of how you should be eating. Ask your dietician for a meal plan, or simply use the recipes in this magazine.

Never allow yourself to feel like a patient. You’re going to be diabetic for the rest of your life – but if you look after yourself, it will be a long and happy life.

Positive attitude: you’ll feel better if you have a positive attitude towards diabetes. Getting depressed or angry won’t make it go away.

Quitting is not an option with a chronic condition. Just take it one day at a time, have a support group, and give yourself credit for trying.

Unless you take control of your diabetes, it will take control of you. Don’t let it become the defining point of your life.

Regular checkups with your doctor are a must. You can’t afford to ignore any kind of illness, wound or infection.

Vegetables are a diabetic’s best friend. Make sure you eat fresh veggies and some fruit, every single day.

Wholegrains should be a big part of your diet. They’ll keep you and your heart healthy.

Obvious symptoms of diabetes include: constant thirst, needing to urinate all the time, constant hunger, extreme tiredness and blurry vision.

An A to Z of all you need to know if you’ve just been diagnosed with diabetes:

Support is so important for people with diabetes.

Make sure you have a team of people who can help you deal with the condition, and join a support group or the Sweet Life community so that you’re not alone.

Types of diabetes: Type 1, usually diagnosed in young people and treated with insulin injections immediately; Type 2, known as a lifestyle disease because those at risk are often overweight and don’t eat a healthy diet; and gestational diabetes, which occurs in pregnancy. eXtra care should be taken any time you feel unwell. Don’t push yourself if you don’t feel 100%.

You are the most important part of your diabetes care programme.

Treat yourself well!

Zzzz… Make sure you get enough sleep.

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Wrinkles merely mark where smiles have been.

Mark Twain

2015/03/09 3:35 PM

Discreet bolus delivery, and still stepping out in style.

The Accu-Chek Combo system. For discreet bolus delivery without touching the pump. ®

• By wireless two-way communication between the pump and meter • Supporting tighter control of post-prandial blood glucose values 1,2 • Sensitive occlusion detection provides additional safety 3 Operating your pump remotely with the meter means you don’t have to touch your pump to bolus or check the screen once it’s placed under clothes.

Experience what’s pos possible.

For more information contact your Healthcare Professional 1H.Zisser et al. Clinical performance of three bolus calculators in subjects with type 1 diabetes mellitus: A head-to-head comparison.

Poster presented at the 46th EASD Meeting, Stockholm Sep.2010.

2A.McDaniel et al. Differences in management of post-prandial hyperglycaemia by automated bolus calculators is due to distinct insulin on board algorithm.

Poster presented at the 2nd international conference on Advanced Technologies & Treatments for Diabetes, Athens, Greece Feb. 2009. A237. ³”Andreas Buhr et el. Time delay to occlusion detection of insulin infusion pumps. Poster presented at the 5th International Conference on Advanced Technologies and Treatments for Diabetes Barcelona, Spain, February 2012”

Roche Products (Pty) Ltd Diagnostic Division PO Box 1927, Randburg Toll free: 080-Diabetes (Dial 080-34-22-38-37) www.accu-chek.co.za / www.diabetes.co.za Ref: COMB 140124

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