Dealing with diabetes
Getting to grips with a ‘silent disease’
The festive season is often a time for overindulging in food and drink but South Africans would be well advised to ensure healthy eating features high on their list of New Year resolutions.
Lifestyle diseases – from obesity to heart disease – are on the increase. All forms of diabetes also require close attention to diet.
According to the International Diabetes Federation (IDF), diabetes afflicted more than 1.8 million people in South Africa in 2017 and is on the rise among young people.
Not everybody recognises the warning signs, particularly when they present in youngsters. They include excessive thirst, frequent urination, a lack of energy, blurred vision, slow healing wounds and numbness in hands, feet or both.
The IDF recently released the results of an online study, conducted via a survey, in which 7,000 participants between the ages of 18 and 65 of various races from six different countries, including South Africa, took part.
As many as 74% of respondents said despite having a family member with diabetes, they would have trouble recognising the signs in their children while 40% said they could not spot the signs at all.
For registered dietician Jessica Oosthuizen, a spokeswoman for the Association for Dietetics in South Africa (Adsa), her severe weight loss was the first clue.
Diagnosed with type 1 diabetes at the age of 13, Oosthuizen said she had all the typical symptoms. A competitive swimmer at the time in her first year of high school, Oosthuizen said the weight loss was easy to notice because she lost 8kg in the space of 12 days.
“I was very lean – I didn’t have any weight to lose, so it was very obvious. I remember drinking about three litres of liquid just when I was at school. That excluded what I drank when I was training,” she said.
Diabetes was diagnosed and her family reacted with shock.
“Even though patients and family members should get a good explanation of what diabetes is and how it can be managed, the amount of information may be overwhelming and often little is taken in initially.”
According to the Diabetes South Africa website, there are three main types of diabetes.
Type 1 diabetes occurs when the pancreas stops producing insulin. It’s common in young people under the age of 30 including young children and infants. This type usually starts suddenly and dramatically.
People with type 1 have to inject themselves with insulin in order to survive, as well as ensuring a balanced diet and exercise programme.
With type 2 diabetes, the insulin produced by the pancreas is either insufficient or does not work properly.
People diagnosed with type 2 are typically aged 40 and above, are overweight and do little exercise.
Its onset is gradual and hard to detect, making it the most dangerous as high blood glucose levels over a long period can lead to blindness, heart attack, stroke, kidney failure, impotence and amputation.
Treatment for type 2 is usually drug free, with weight management used to reduce glucose levels. A correct eating plan and exercise plan play an important role.
The third type, gestational diabetes, is a temporary condition which occurs during pregnancy. It usually places both the mother and baby at increased risk of developing diabetes in the future.
East London-based Dr Daya Appavoo said diagnosis usually involved urine and blood tests.
Young or old, type 1 or type 2, what diabetes does is bring about lifestyle changes, Oosthuizen pointed out.
While the treatment regimens do differ, both kinds of diabetes demand discipline, constant planning and control.
“The patient and the family need to understand a number of things including how the medication works, how many carbohydrates they can consume and how often.”
Oosthuizen said the main focus should be to ensure optimal blood sugar control based on the type and amount of carbohydrates consumed.
She said people living with diabetes should focus on choosing whole, unprocessed, high fibre carbohydrates such as rolled oats, brown rice, barley, quinoa, legumes and sweet potatoes. Processed carbohydrates such as corn flakes, white bread, pasta, pizza and wraps should be avoided as these were likely to cause a blood glucose spike. She added: “Children with diabetes should focus on following healthy eating principles including a variety of foods from all the food groups.
“Carbohydrates are the main nutrient that affect blood glucose levels.
“The amount of carbohydrates eaten at each meal and snacks will depend on what insulin the child is using.”
IDF president Professor Nam Cho said a lack of knowledge about diabetes meant that spotting the warning signs was a problem.
“Diabetes can easily be missed or mistaken for a different condition and this leaves people vulnerable to serious consequences.
“For many, particularly in developing countries, type 1 diabetes is still a death sentence. Many with type 2 diabetes are diagnosed too late when complications are already present.”
Appavoo said a rise in diabetes, particularly in young people, could be due to an increase in unhealthy diets and sedentary lifestyles.
Oosthuizen said it was possible for diabetics to live a normal life. “By taking each day as it comes, you learn something new that can be used to improve your control and become adept at managing your condition.”