If you or a loved one have been diagnosed with diabetes, take note. If you haven’t been, the take-home message is get checked.
And if you are new to diabetes, here are some extremely important pointers for where to turn to get the information you need.
This insidious disease often has few or very mild symptoms, but if undiagnosed and untreated, its complications can cost you a limb, or your eyesight.
Diabetic nurse educator, Sister Karen Pike, gave the Bulletin some expert information, unique to her position and years of experience.
This has been her field and her world since 2004, and she loves it. Her patients range in age from 18 months, to 85 years.
First off, she says: Diabetes is treatable. But make no mistake, it’s also progressive, and there is no cure. Treatment is made up ideally of a multi-disciplinary team which includes a podiatrist for help with foot care, a biokineticist to find the best form of exercise for you individually, an ophthalmologist to keep your vision clear, a dietitian to advise you on correct nutritional choices, a GP to provide scripts, a specialist endocrinologist, a pharmacist who knows your diagnosis and will not give you meds with sugar or coritsol in them – and a diabetic nurse educator to share with you the wealth of information you are going to need.
And you will inevitably need a hospital plan or medical aid.
That is Sister Pike, being purely practical. Diabetes costs. And it bothers her immensely that money makes the difference between care and quality of care in many instances.
For those who have tried to source information themselves and ended up in a fit of frustration and fury, pause, breathe and take a walk. Then look up your closest diabetic nurse educator. Here you will find resolution with all the conflicting things you are reading and being told by well-meaning, but ill-informed others.
Diabetes needs a pretty individual plan, says Sister Pike. Yes, there are over-arching principles for diabetics which you will find everywhere: exercise is non-negotiable but as Sister Pike says, for goodness sake find something you enjoy doing. For one person it will be swimming, another a parkrun, another gym.
“But there are exercises you can even do, in your chair, that are age or mobility appropriate. Nutrition is essential, but even this is not as simple as it may appear. “Most people don’t really know where their carbs come from,” Sister Pike says. “They only know the basics of rice and potatoes.”
She has created a chart to show people where they will find fructose or what fruits convert to the most sugar, when to eat what and what is better not to eat at all.
She adds that on a popular chart showing food portions and balancing, that it states diabetic products are not recommended. “There are two reasons for this. If they take the sugar out, the fat content goes up; and they are generally very pricey.”
She says before the Banting diet became popular, she and her colleagues were already suggesting low carb, more protein meals. “I really feel that a counsellor should be part of the team, because many people become terribly depressed with the diagnosis.
“That diagnosis should be given some grieving time as people come to terms with it all. Its very personality or circumstance dependent. A-type personalities simply get out their notebooks and ask all the questions, and get on with doing it all by the book. Not everyone can respond like that,” she says.
Family support is crucial, not only for all people newly diagnosed with diabetes, but especially for the elderly or infirm, especially if they have early signs of dementia and their insulin has to be especially carefully managed.
Sister Pike’s declaration that the disease – being progressive – means that even Type 2 diabetics end up using insulin injections was a shock. But she was very quick to (soothingly) point out that today, the injections are thinner, and the insulins available are incredibly well tailored to all sorts of people – different insulins for sedentary, elderly people than for fit healthy active folk.
She is very clear that the fear of insulin is worse than the insulin, and that often it is sold as a last resort and many people go into denial about their necessity to take it. “It is to be taken seriously and well monitored, but it is not a handicap. You can climb Kilimanjaro, do the Comrades or Two Oceans: you just have to plan carefully,” she said.
For those who are militant about checking their glucose levels and amending behaviour and diet who still see wild fluctuations in their readings, Sister Pike explains that factors such as infection in the body or stress can play havoc with the readings. The flight or flight response we have during stress will raise blood glucose levels without a doubt, she said.
Which is why general good health is important to maintain.
Diabetics are told to take good care of their feet, Sister Pike says fungal infections are part of the problem; any infection will increase the body’s reaction and your glucose levels will increase. The great variety of medications available are a boon to people today, and she says there are any combination of medications and insulin that can help. “The aim is to drop your blood glucose levels before any damage happens to your organs. Most people have so few symptoms that by the time they are diagnosed they have been diabetic for three to five years already.”
One important message for parents of children with Type 1 diabetes is not to feel guilty, Sister Pike says. “Type 1 is an auto-immune reaction, you have done nothing wrong.”
She explains that Type 2 is about lifestyle management and has two over-riding causes: obesity, or a family history of diabetes. Treatment is
vital, she says, but help is also on hand.