Category Archives: diabetes

NHI and what is to come…because it IS coming!


The NHI will certainly be coming whether or not it is yet another train smash as we have experienced with every state run institution or not. Will it be a better south africa ? That remains to be seen.

What is unequivocal is that it is coming and it WILL be implemented. Does that make me want to run away. Yes, yes and yes. Am I going to ? No, no and no. I have personal reasons for staying but I do believe that we also need better health care for the majority and NHI may well aid in a small way to some kind of “fairness” when in the past there has been gaping holes of “unfairness”.

I would like to start a new movement of positivity and seeing the opportunities in south africa.

Face it, there is no perfect place in the world. People are the problem. And they are everywhere. However there are also unique wonderful people who are everywhere.

Also in this place we call home with wide aching gaps there are opportunities for both financial prosperity as well as kindness prosperity – which is all we go to the grave with.

So will NHI be a challenge. Yes it will. Does it mean the end of health care for the wealthy or relatively wealthy (bear in mind there are folk who survive out here each month on R1000 a month). No, I hope not. Is there opportunity to assess this situation and find a new way regarding the epic challenges that face us like diabetes, hypertension and the complications thereof ? Yes. I believe necessity is the mother of invention and as health care practioners it is yet another to re-evaluate and use our God given brains to come up with a palatable solution.

Kindness is one of the few things we take with us. And death is a certain guarantee.

So let’s start there and move outward as the ripples on the sea when a stone skips over the surface. South african’s are adaptable at large and we are able to see and do the positive, come with me.

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Continous monitoring and it’s influence on control – a huge wonderful impact


If I could pick only one thing for all my type1s and type 2 s on insulin to have in their armamentarium of goodies it would be access to continous monitoring for sooo many reasons.

1.) they learn from it and figure out which foods spike them

2.) they learn what drops them and how quickly and how to rectify this, ie how long the rescue takes to kick in so to speak

3.) they are able to see that if they inject insulin correctly at the correct time that it actually controls the sugar

4.) they can see what a “missed” dose does to the sugar

and I could honestly go on to 100 things …

REcently prices have literally plumetted on these devices making them more and more accessible.

THe next question to ask is : ? accuracy.

It is imperative that the device have the lowest MARD possible.

All this means is that the reading you see on the device is actually a TRUE reading.

Sluce. Kapish. Simple

Accurate is everyting .

So pick up something in your armementarium today for YOUR control ๐Ÿ™‚

Accuracy data from ADA 2019 hot off the press praising CGMs’s at large ๐Ÿ™‚

The data backs up the average clinician’s gut feel that seeing is the answer.

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The battles we face daily …diabetes and the funders :) yeeha!


So we all know we are currently experiencing an epidemic that is about to “tidal wave” africa in terms of diabetes. And we know that world wide despite logarythmic increases over at least the last 10 years there is no stopping the tide. We love food and no exercise too much.

So we also know that the more this happens the less health wealth and happiness for society and the more sick folk get the more it costs the medical aids – so then with tears in my eyes and a brain between my ears why is it that we have a daily fight with funders to do what is right for patients and saves them hugely downstream costs ?????

To me it’s a no-brainer. I dont know.

I have been accused of being a dilly woman and yes I am a woman doctor – that does not bode well to start in the patriachy. And yes my dress sense is a bit quirky. And yes my mouth she speaks way too easily for the patriachy once again. BUT, really all I want is the best for my patients short term, long term, longevity with quality wise which adds up to a societal knock on downstream. So whilst quirky all I am actually fighting for is the greater good ????

The funders and generally brushed with a giant sweep of a brush at large seem to slowly be waking up to the multiple facts staring them down like a gun barrel as this is a very large challenge to them to. How does one solve these dilemmas as still stay top 5 profitable in south africa ??;) ๐Ÿ˜‰ ๐Ÿ˜‰ ah em …

Just saying, there are better ways to tackle this tsunami…

I met an amazing academic yet pracitical medical advisor the other day, and my suggestion is that other medical aids follow suite – yes have your acturial scientists who make you the top JSE company when a med aid is supposed to be a med aid not a top achiever, but combine it with some sense so that you can stay there cos right now your tactic aint going to work for you on the long game.

 

Diabetes and you and me …


When you overload a cart the horses take strain. Much the same with the human body. Each cell requires a few things : amino acids, glucose molecules, and a whole host of other complicated yet simple molecules.

Each cell in the body essentially respirates, breathes in so to speak glucose and oxygen and breathes out ATP and CO2 in order to function, much like the lungs and the opposite of what trees do.

Simple yet complex.

If you overload the system with glucose molecules they will simply be stored as fat for a rainy day and also overwhelm and flood the system with stickiness.

That is what diabetes is in the type 2 sense of the word, flooding the system and causing a sticky mess.

Type 1 however is an initial lack of the key that takes the glucose into the cell and forcing the cell to respirate anaerobically which leads to death without the rescue molecule insulin.

Starving in a sea of plenty is type 1.

Drowning in a sticky mess is type 2.

The ebb and flow of the cell works in harmony if the correct diet is maintained and goes horribly out of whack with an overload or under-dose of glucose molecule flow to the cell.

 

Type 2 Diabetes – what is that?


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Are you fatigued and have blurry vision ? Have ย you had your sugars checked.

You may be one of the many people who are living with an undiagnosed illness that is causing a train wreck in your blood vessels at large from head to toe.

It’s easy, simple and could be life saving.

One finger prick could save your life. The truth of the matter is that at least 1/3 of patients have had diabetes for 10 years BEFORE it is diagnosed. Have yourself tested today.

“hybrid” Closing the loop …how divine :)


If you have an intact pancreas you already have a closed loop. That is to say you eat food and your pancreas automatically releases the perfect amount of insulin to “match” the carbohydrate you have just eaten so that the glucose molecule can travel easily into the cell, all cells require glucose for metabolism.

However if you are reading this and you are a type 1 diabetic you do not have B cells that are functioning and this is great news for you – a closed loop. It is in essence : an artificial intelligent pancreas.

It is here and for that we rejoice. It is not the full monty but at this stage each step is a win and this is a big big win. The algorithms get more and more accurate and detailed as time and data increase.

From march 2019 the alogrythms to close the loop will be available to all and anyone in the world.

For more info : 0832898351 Romae for a booking

It’s here and that is awesome. It’s hybrid and it’s not at its full potential as yet however it it more than we have had up to now and for that we rejoice.

Diabetes and CDE and Discovery 2019


This year from around next week, the various options excluding keycare of discovery will join the CDE family. Why this is exciting is that CDE has always provided comprehensive holistic care to diabetic patients and by managing a disease like this in a team approach it is simply put better managed.

What that means “downstream” so to speak is less cost to med aid, better health to patient. Greater longevity with more quality.

We are super excited at this development and though teething problems will certainly occur the benefits will outweigh the initial stumbles.

THe swtich over for diabetics on discovery is automatic you don’t have to do anything. Ok so top 2 plans nil to do, other plans register on health ID it seems with your GP/doctor. ๐Ÿ™‚

Multi-disciplinary team approach to all diseases is a good way forward.

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