Diabetes in the family - It's all for one, and one for all

ADSA (Association for Dietetics in South Africa) spokesperson, Liana Grobbelaar, who works at the Centre for Diabetes & Endocrinology, points out that knowing what to eat, and how much to eat is one of the most challenging parts of managing the treatment plan of a family member. “Getting the whole family on board makes it easier for the person with diabetes to stay healthy,” she says. “It breaks the isolation that comes with being the sole member whose plate looks different, for one thing. But there's another positive effect - everyone else can get healthier, too.”

The reason for this, Liana points out, is that there is actually no ‘diabetic diet’. Instead, the person living with diabetes and their family, find themselves on a journey of understanding the impact of different foods on blood glucose levels and health. “Healthy eating should be for everyone, with or without diabetes,” says Liana. “It’s actually an ideal opportunity to take positive steps to adopting a healthy family lifestyle. You can transform the negative into positive by educating your whole family to help them understand the importance of making the necessary changes, healthy choices and to be more supportive.”

Psychologist, Rosemary Flynn also emphasises the importance of family-wide support. “The way each member of the family responds to the necessary changes influences how well the person with diabetes will accept and manage their condition,” she says. “If they feel criticised and devalued because of their condition, they can feel alienated and resentful. If they feel empathy and support from the family, they will have the encouragement to embrace their treatment management in an effective way.”

Knowledge is power

Understanding diabetes, its symptoms, treatment and lifestyle impacts is key for the whole family. All people with diabetes should be offered a referral for individualised nutritional education provided by a registered dietitian with experience in diabetes management. Registered dietitians are uniquely skilled in equipping people living with diabetes with the knowledge to better understand the impact of food choices on blood glucose levels and overall health, which can lead to improvements in quality of life. A registered dietitian will take into account factors like culture, religion, age, other health conditions, medications and your finances, food preferences and family dynamics which will influence the approach that will work best for you and your family.

Practical tips for families with a loved one with diabetes include:

Choose healthier carbohydrates - All carbohydrates tend to raise blood glucose levels, but some carbohydrate sources provide nutrients important for health. Focus on high fibre carbohydrate sources such as vegetables, fruits, whole grains, unsweetened dairy products and legumes such as chickpeas, beans, peas and lentils instead of refined carbohydrates with added sugar, fat and salt. From a blood glucose perspective, the portion size of these foods is critical.

Eat a rainbow of vegetables and fruit - Vegetables, particularly non-starchy vegetables, contain much bulk relative to the amount of energy they provide. They also contain phytonutrients or plant chemicals that play many vital roles in the body including behaving as antioxidants (repairing the body from daily damage) and stimulating a good immune system response. Although fruits also contain these properties, they do contain natural sugars which can affect your blood glucose management, so, don’t eat fruit to excess.

Swop out red fatty and processed meat with healthier alternatives – Replace red, fatty and processed meat with protein-rich legumes such as beans and lentils, as well as eggs, fish and poultry.

Choose heart healthy fats - Fats are an essential component of one’s daily food intake. But, the type and quality of the fats you consume is vital. Eat foods rich in long chain omega-3 fatty acids or anti-inflammatory fats found in naturally fatty-fleshed fish like mackerel, pilchards, sardines, salmon, trout and herring, at least twice a week. Reduce your intake of saturated fats such as animal fats, coconut and palm kernel oils. Rather choose mono-unsaturated fats like olive or canola oils, avocado, olives and nuts. Remember that fats are a concentrated source of energy and should only be used in small amounts.

Treat any new foods as an experiment - test your blood glucose before and after trying out something new to understand the effect of your food choices on blood glucose levels.