Category Archives: dancing with obstacles

Diabetes and the holidays …


So I have blogged about this before, but they are upon us now.

What should you be doing/not doing or doing differently during the holidays.

We all know that glucose control is one way in the week and quite a different way on the weekend and holidays. This is partly because we are human and life is well just not always easy and letting your hair down usually goes with a bit of alcohol (if you are old enough) and a bit of cheating (dare I say it).

So all things considered, where does this leave you with your diabetes?

Consider it. Be mindful of it. Carb count it. Accurately.

With the holidays come a little bit of time – that we don’t usually have. Choose to exercise – must be something you love. Be creative. Horse ride or bike ride or dance!

Factor the exercise in. IF you are not sure how to do this, consult someone. Even if you are on holiday – trust me most of us (health care folk) are at work : dieticians, GP’s, nurse educators etc.

Don’t just go ape on yourself. It’s so much harder to get back the lost ground.

Enjoy yourself but be fair about it. Restraint is required.

Give yourself a Christmas present of being present more often. This will carry through to the new year and be a wonderful asset.

Top sites that I feel are invaluable : http://www.fatsecret.co.za – south african ,excellent for carb counting and so much more!, pinterest has awesome pictograms of diabetes.

Feel free to share your best app, resource with me.

Merry Christmas.

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Diabetes non-month -we can still make folk aware ;)


Hello. Today is the first of December. November (diabetes month) officially over. “Ca dover”.

Diabetes is a growing problem. Most people do NOT choose it. More so type 1 – spontaneous destruction of all beta cells of the pancreas making you insulin dependent (like alcohol dependant only a little different (this is a little joke so don’t get too upset about this statement if you are prone to getting upset).

Type 2  can be lifestyle induced but that does not mean you should judge the person. Or that anyone has given you the power to do that. Or the right.

Insulin only comes in the injectable form. Yes that means you have to inject anywhere from one to 6 x a day. Then you also have to test your sugar – another “prick” required.

So don’t be a prick to diabetics as having dealt with so many already they can’t tolerate you too. And for that matter the moms and dads of diabetic children also fall into the category of not needing any more pricks in their lives – they are hard enough. Grow some empathy. Please? Even if just for the festive season.

So, in december, the festive season. Not everyone in this life is as blessed as you : health and wealth and mental health wise. If you only do this this festive season let it be that you are kind. To all around you. Truly kind not the falsely kind of kind.

Born in the wrong country


So sometimes I feel that really deep deep down in my soul I am actually a mixture of spanish, italian and a few kinds of south american.

I love to dance. Even in the light. Even in the night when no-one else is. Even in the sun shining day. Even in the hay. I just love it. I love the beat. I love music with a beat. I love music with a soul, and I love a community that embraces that as do the afore-mentioned.

As south africans and (I am told as men) dancing is something learnt whilst drunk and can only be performed in such a state and the window is quite narrow as once too many drinks are on board the physical act of standing is even hard.

So I am native to another country and my soul beats that drum.

It would be so great though if as south africans (at least) we could embrace the person who is dancing instead of rejecting, dissing and naming and shaming them.

Just a thought.

Different is not bad and it should not be intimidating. It certainly should not ever invoke nastiness.

As a nation (at least the privileged part thereof) we tend to be quite critical as well as sharp with our words. We tend to be a little arrogant and set in certain ways we call our own. There is nothing wrong with our own ways but by the same token there is also nothing wrong with another way ?

Myths around diabetes


November is diabetes month – awareness around what it is and treatment etc. There is actually quite a lot of strange information that circulates, “fake-news” so to speak regarding diabetes at large.

So let’s dispel some myths.

1.) Diabetes is caused by poor diet : firstly type 1 has nothing to do with diet and is bad luck essentially. It seems to be an auto-immune disease and essentially destroys the b cells of the pancreas creating an absolute lack of insulin.

Type 2 diabetes is a lifestyle related as well as genetic disease and even more complex in nature.

Insulin resistance is a condition more and more prevalent due to lifestyle as well as stress – a big factor. More about this another time.

2.) IF you eat properly you will get better : well firstly type 1 diabetes, without insulin – you die, children in the era before 1921 died. Only since 1921 and Banting and Best’s discovery do type 1 ‘s survive with normal life expectancies.

Concerning type 2 diet is critical and important (as it is with type 1) carbs are key and obviously healthy eating and exercising are key but eating 100% correctly will unfortunately not bring back b cells that have died.

3.) Type 1 diabetics should never eat carbs : whilst one should be mindful of the type and quantity of carb and dose the insulin accordingly it is by no means advised that type 1’s exclude all carbs. This is a tricky one and best discussed in consultation with a dietician.

 

Mental health, impossible tasks and other musings


Why is it that when we are ill either physically or mentally and it comes to support for the person it is hard to find. In fact a very common reaction is for people by and large is to withdraw. Leaving an already vulnerable person more vulnerable and more likely to become sicker. Why do we do this as a society?

It seems we are quite cruel.

Much like being a type 1 diabetic. Once diagnosed your life depends on testing sugars and injecting insulin. People are wary, they hide, they run they disappear from your life entirely. Schools refuse to admit children with it. Kids don’t want to have them at their party. And why ?

Yes it’s different. Yes it’s a disease that requires things that some humans are uncomfortable with. But, can you not dig a little deep and conquer that fear, reach out and be a friendly face, hand , eye?

We are actually all connected and our reactions have repercussions. We have choices to make daily.

I challenge you today to not run and hide. To be present, even when it is uncomfortable. To be present. Really there. In the flesh and the mind. Present. That’s all. To be there.

Pushing past impossible is something that is actually possible.

And you know that we all – collectively benefit from that.

And the world at large can be a better place.

 

Diabetes and governments


Why is this not a more pressing issue? The diabesity epidemic threatens to ruin the whole world and yet so much of silence?

The log curve that shows no even inkling of abating rises like a tsunami and we are all “thula-msindo” – zulu for not saying a word.

Urgent action is required, yes I said action. Urgent.

Alternatively we can go with the tsunami of medical costs that are unsustainable, ill populations, knock effect to the economy due to loss of income, knock on due to high costs (medical) etc etc. It is a disaster and yet we look on.

Wake-up oh sleeper!

Now is the time to do something, its fast becoming too late.

 

Tidal wave required


Ok so life is interesting in south africa. I would like the kind of money that Manyi  has, 450 million? was it. I would use it to “fund” my patients needs.

Diabetics, type 1’s in particular have many needs. Most of these are not taken care of by their medical aids and despite the fact that patients pay a LOT of money for the privilege of being on one.

Type 1’s require tight control of glucose above a certain range and below a certain range and everything including the weather impacts on blood sugar. Thus continuous monitoring is a tool that can make a very very big difference in a patient’s life – it can also make such a difference that the medical aid is spared costs of admissions for highs and lows, for amputation, renal dialysis, heart attacks as well as costs attached to being blind.

However medical aids at large do not seem the slightest bit interested in saving themselves money.

Far rather milk the patient for all they are worth and at the same time provide the minimum service and complain about any request made by the health care provider who has studied long and hard and has a passion to save the medical aid costs.

Yes I am angry, perhaps at this time of day I am even h”angry”.

I am tired of begging, pleading for minimum standards of care.

I am tired that overseas things get “accepted” years before they do in south africa. Are we really 3 rd world? Despite having the “Manyi’s” ???

We require a tidal wave of protest in the form of intelligent debate with the stakeholders that matter in the realm of diabetes. I am just so tired of fighting.

Please from far and wide across  this beautiful country we call home join me, join the debate, write to your medical aid. Email me : drleethegp@gmail.com.

Please.

Continous monitoring is available in 4 forms in south africa : dexcom G5 and G4, libre flash abbott, medtronic standalone CGM and most new to the scene : ever sense.

Coming in at the lower end is the abbott flash R990 once off and R990 every 2 weeks. Dexcom is a cost upfront more than about 25k and then monthly around 4 k, medtronic around 15 and 2k per month and ever sense brand new so not too sure but in the ball park for the last 2 mentioned.

What is boils down to is MARD and quite frankly this is the bottom line with CGM is accuracy. The lower the MARD the more accurate. There are really only 2 in the market that a great on MARD : dexcom G5 and ever sense, however for the cost the libre is actually a very good value for money.

The other thing that helps me as a practitioner is a trend and all of the devices are good for this.

What we need is for the medical aids to realise that CGM is a tool they their patients can NOT afford to be without! FOR THEIR own sakes – the medical aid’s sakes.

Please tsunami arrive and let’s flood the medical aids with the truth.

Alternatively could the guptas or the Manyi’s or maybe Grace Mugage give me 450 million to spend on my very deserving patients.

Thanks ;).