Fortunately, there is plenty of information and support available to assist you in managing the condition. Penny Haw asked for help from the experts in compiling a toolkit.
1. Inform yourself, empower yourself. Diabetes is the shortened name for diabetes mellitus, the condition in which the pancreas does not produce insulin or enough insulin (Type 1 diabetes), or your body is unable to use insulin effectively to move glucose into the cells that require it (Type 2 diabetes). But what does that mean for you?
The first step in diabetes self-care is to learn as much as you can about your condition (without feeling overwhelmed), so you can treat it effectively, and live as happily and healthily as possible. A good understanding will empower you to make the right choices about your health.
There are several free sources of information about diabetes available in South Africa, and it’s worthwhile reading as much as you can. But the best information is that which you receive one-on-one initially from your doctor and, thereafter, from a diabetes educator or other specialist healthcare worker. This interaction will focus specifically on your condition and the treatment thereof, within the context of your general health and lifestyle.
You might also consider joining a diabetes support group in your area. Important to note, too, is that support is valuable not only to someone with diabetes, but also to their family and friends. So, where possible, include your loved ones in meetings with healthcare practitioners and support groups. There are also several specialist diabetes magazines available, both in print and online, which offer excellent information. These include Diabetes Lifestyle (published by the Centre for Diabetes and Endocrinology (CDE)) and Diabetes Focus (produced by Diabetes South Africa (DSA)).
2. Brace yourself. If you have Type 1 diabetes, always carry sugary sweets or drinks with you. Wear a MedicAlert or Mediband bracelet with the appropriate information, such as “Diabetes. Give sugar if confused”, written on it.
3. Getting to grips with glucose. Managing diabetes means ensuring there is not too much or too little glucose in your blood. Glucose gets into your blood from the food you eat, particularly carbohydrates. This means you have to watch what, when and how much you eat, and you need to exercise regularly. You might also have to take tablets or have insulin injections. Your health practitioner will prescribe the appropriate treatment and teach you how to monitor your glucose levels. The important thing is to know when to test and how to act on the results.
4. Eat right. Because food is what puts glucose in your blood, what, when and how much you eat are crucial to your health. You need to eat the right proportions of different types of food. The age-old story applies: it’s all about moderation and balance. Space more or less consistently sized meals evenly throughout the day. It’s preferable to eat small quantities regularly rather than a few large meals, and always eat protein with carbohydrates. Not all carbohydrates are bad, but refined carbohydrates (such as white bread, white rice and pasta) “dump” large amounts of glucose into your blood. Wholegrain and low-GI (glycaemic index) carbohydrates in small portions enter the bloodstream slowly and have less of an impact on blood glucose levels. If possible, eat at the same times each day. Use salt and sugar sparingly, and eat small amounts of fat. Drink plenty of water, keep alcohol consumption low, and avoid sweetened drinks, fast food, cakes and sweets, and refined carbohydrates.
5. Get moving. Physical activity helps to control diabetes, and has many other health benefits, such as lowering cholesterol, improving blood pressure, reducing stress and anxiety, and enhancing general wellbeing. Exercise is one of the three pillars of diabetes management, the other two being diet and medication. Try to exercise at least three times a week, for 30 minutes each time.
6. Be vigilant about medication. Take medication as prescribed. Do not stop unless your doctor tells you to. If you take tablets, take them with meals at the same time every day, and make sure you always have enough medication. If you need insulin injections, learn how to test your glucose levels, manipulate doses and inject yourself skilfully to make injections as pain-free as possible. Your doctor, nurse or clinic sister will be able to help you with this. Pay close attention to information about taking and storing your medication.
7. Test and keep records. Measuring, monitoring and recording your glucose levels can expedite effective diabetes management. Not all people with diabetes have early-warning signs of hypoglycaemia (low blood sugar), which is why it is important to regularly check your blood glucose levels. Keep a record of your test results to take with you when you next visit your doctor or clinic.
8. Get to know the signs. Once you know you have diabetes, it becomes easier to recognise your body’s warning signals indicating you have too much or too little glucose in your blood. For high blood glucose levels, signs include going to the toilet more often than usual, feeling tired and weak, experiencing great thirst, and/or not seeing well. When you experience any of these, it could mean you are not eating healthily, exercising and/or taking your medicine as prescribed. If you are indeed doing all of these things, you need to return to your doctor or clinic for advice.
9. Be extra-alert for low blood glucose. If you take diabetes tablets or insulin and you begin sweating; feel confused, faint, weak, shaky, nervous, irritable or even drunk; and/or your heart begins pounding and your arms and hands feel numb, these could be signs you have too little glucose in your blood and are suffering hypoglycaemia. Eat a sweet or have a sweet drink immediately, followed by a sandwich.
10. Take special care of your feet, eyes and mouth. Small injuries incurred by people with diabetes can easily become infected, which is why it is important to take special care of your feet. Because diabetes can reduce the flow of blood to your feet, they need additional attention. Check your feet for wounds every day. Clean and dry them – particularly between the toes – and use lotion to keep feet soft, but don’t put it between your toes. Keep your toenails trimmed in a neat, safe way. Do not walk barefoot. Wear comfortable, well-fitting shoes. Check the insides of shoes carefully for foreign objects before putting them on. High blood sugar can affect your eyesight. Have your eyes tested annually – even if they seem fine. Brush your teeth twice daily, visit your dentist regularly, and don’t forget to remind him or her that you have diabetes.
Where to find help
- Centre for Diabetes and Endocrinology (CDE), 011 712 6000, www.cdediabetes.co.za
- Diabetes South Africa, 086 111 3913, 021 425 4440, www.diabetessa.org.za