What you need to know about managing diabetes in the family

Diabetes can be managed by medication combined with healthy eating, exercise and monitoring your blood sugar. Registered dietitian and Association for Dietetics in South Africa (ADSA) spokesperson, Neo Mongoegi says, “You need to understand the symptoms of high blood sugars, which is hyperglycaemia, and the symptoms of low blood sugars, which is hypoglycaemia. You also need to understand the impact that food has on blood sugar levels. This awareness enables you to identify any symptoms and then manage them.” Neo is the Head of the Dietetics department at Chris Hani Baragwanath Hospital. She explains, “It is important to know that diabetes is a manageable condition and not a death sentence. However, it is a progressive disease and has to be managed properly through a lifestyle change and compliance to medication. This lifestyle change is essential, and it involves the whole family, not just the person who has been diagnosed. We know that compliance with your healthier lifestyle and new medication routine is improved when the whole family adopts healthy eating and exercise habits.”

Type 2 diabetes disproportionately affects people living in lower income communities where making the necessary lifestyle changes can be challenging due to harder access to healthcare services and diabetes education. Sometimes, access to fresh fruit and vegetables is less easy, and in neighbourhoods with high crime and less recreational space it can be more challenging to develop sustainable exercise habits. No matter the challenges you face, it is important to know that solutions can still be found. This is the advice from another registered dietitian and ADSA spokesperson, Carla Boshoff who works in low income rural communities. She says, “Some small lifestyle changes can be made immediately. Don’t start with what you don’t have, but with what you do have available. Start adding less sugar to foods and drinks, and work towards avoiding it completely. Swop sugary cold drinks for water. Stop adding unnecessary fats or spreads to food and start eating a smaller portion of the carbohydrates that form part of your current daily diet. Start harvesting seeds from available vegetables like tomatoes, pumpkins and peppers, and start planting. Invest in planting spinach, whether you have a garden, an old bucket or old car tyres, so that you always have access to green leafy vegetables. Many people discover that they love food gardening and that there’s great satisfaction in growing your own healthy food. Ask your neighbours and friends to share the costs of seeds with you, and you can all start planting. Join others in community food gardening so that you can share resources, trade vegetables and even sell some for extra income.”

These are Carla’s top 6 tips for people affected by diabetes who live in low-income communities:

• Enjoy a variety of fresh, wholesome food and ensure a variety of vegetables form part of your everyday meal plan
  
• Ensure that you enjoy a healthy breakfast and never skip a meal which is very important when taking medication for diabetes
  
• Choose foods and drinks with little or no sugar. Drink lots of clean, safe water
  
• Work with what you have and focus on portion control. A healthy diet doesn’t need to be expensive and even the smallest changes such as adhering to portion sizes can make a difference. If there is a dietitian or nutrition expert in your area, consult with them for an eating plan that suits you and your family
  
• Follow up at your local clinic to have your blood sugar levels monitored and take your medication as prescribed
  
• Invite your friends or loved ones to join you in exercise to make it more enjoyable and take a brisk walk at least two or three times a week. Get gardening - this is not only good exercise by working physically in the garden; it contributes to food production, improves food security; helps you eat a variety of fresh and wholesome food every day. Food gardening is also encouragement, and setting a good example for your children and the children of the community. Perhaps you can also get involved in local food gardening projects at your hospital, clinic or school – and if there is no such project, then start one!

Raising awareness of diabetes is not only important to help people living with diabetes and their families, but also to help prevent diabetes in your community. November is Diabetes Month in South Africa, and World Diabetes Day is on 14 November 2020. Neo concludes, “There are dietitians at most hospitals and local clinics that can assist you. If the doctor does not refer you to a dietitian, you can still refer yourself to the dietitian at your local clinic or nearest public hospital. If you are struggling with accepting your diagnosis, there are also social workers at local health facilities for counselling after diagnosis.”

You can also find a dietitian in your area by visiting https://www.adsa.org.za/find-a-registered-dietitian.