Category Archives: ease of use

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.

 

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Your sugars and your holidays


holidaysHow does one approach glucose control during the holidays?

Holidays are generally a time where we relax and let our hair down a bit more than at other times. Included in this are dietary relaxations like consuming more refined sugar than normal as well as alcohol in slightly greater amounts and strengths, depending on your preference and age. Also for some it may include more than normal outdoor activity and exercise.

All of these have repercussions for glucose levels.

So, obviously each person has an entirely unique set of circumstances as well as metabolism but roughly speaking here are some basic holiday guidelines.

If you are a type 1 and injecting insulins and testing :

1.) Consider testing your sugar more often if you are exercising more and possibly feeling hypo.

2.) Consider adjusting your insulin dose at meals with more carbs and simple carbs than you are used to (perhaps go through your dietician and doctor re this).

3.) Understand that if you drink a lot and sleep in the next morning this is dangerous and alcohol will at first raise your sugars and then after about 10-12 hours drop your sugars, so watch out for a “missed” hypo and make sure you tag a mate to check on you at least.

4.) If you are snacking and the carb count is more than 10-15 g of carbs you may need to bolus for this kind of snack in order to keep your sugars stable but it really depends on a number of factors other than just this.

5.) the weather plays a bigger role than you think, some people will go either high or low depending on very hot or very cold conditions so try to understand your body and rather pre-empt the rise or fall or at least be vigilant and test more often.

6.) consider wearing a type of medic alert bracelet in case of unconsciousness – it may save your life.

For type 2 diabetics on oral agents only or have additional insulin injections

1.) Most importantly holidays can mean massive weight gain, and this is very bad and hard to get rid of in the long run. Pre-empt this by seeing a dietician who could give you guidelines on how to cheat without too much weight gain. Also see it as a challenge to maintain your weight rather than a punishment and reward yourself with things other than the wrong food on the holidays. Set incentives and be kind to yourself with spoilers that blow your hair back and don’t put weight on.

2.) Make sure that you have enough medication and testing strips for the time that you are away as well as some back-up diabetes supplies.

3.) Know what carbs are and how they affect your sugars and plan accordingly.

4.) Know the carb content of the alcohol you are drinking and factor it into the daily calculation of insulin (if injecting) as well as the total effect of the alcohol and your activities (physical) or not.

5.) Try to see the holiday as an opportunity for increased movement -exercise in many different forms and find one that works for you, start the routine on holiday.

6.) Experiment with different healthy food and take mental note of how you feel and what it does to your sugars.

We all need a break, a re-set and a proper unwind. So most of all give yourself the mental  “space” and time you need to do just this. Planning for your holiday around your diabetes will aid in enjoying this time more and taking stress out of certain situations.

There are always healthcare professionals on duty, know the nearest casualty location and telephone numbers as well as ambulance and other emergency numbers before leaving home.

Libre flash monitoring


The patient driven and marketed libre has arrived in south africa.

R990 for a reader once off which is a meter for both glucose and ketones.

R990 for a sensor that lasts 2 weeks and so i.e. cost per month if worn every day is R990 x2

You scan your button and get a reading every 5 minutes. The device has functions like worked out a1c (3 month average) as well as about 100 more. See the website.

https://www.freestylelibre.co.uk/libre

You need to fill in a form, pay the amount and it gets couriered to you.

Contact me for forms

26 hilton avenue 033 343 1826

😉libre.jpg

Innate


http://innatehilton.wix.com/innate

Holistic integrative medicine

Pump for me or not for me?


Report back : We had a marvellous discussion about pumps on wednesday evening. Highly enjoyable and informative, even our pump patient learnt something.

JOIn us today : On wednesday night 530 pm in Hilton Pietermaritzburg we will be holding an informal hour discussion about pumps -insulin pump therapy. What is pump therapy ? Who “qualifies”? What is the benefit. Is it for everyone who injects insulin?

Feel free to join us for free for an hour to explore the “pump market” in south africa and get first hand feedback from “pump” patients 😉

Surgery as a patient


The hardest 2 things I have ever had to do is deliver 2 babies. Yes I did do it naturally and perhaps at the age of 37 and 39 I should have listened to the wise advice of so many colleagues and had 2 planned caesars. I wanted the very best for the two angels that I had waited so many years for and I believed going through the birth canal was that. What I did not realise is what it would take out of and from me.

Delivering a child naturally comes with a lot of waiting (patience has never been my forte). It then involves an “older” body “co-operating” with the birth process. If that had all happened “naturally” I guess it may have been different. My body needed help and in the second birth it needed an ocean of a medication called oxytocin (syntocinon). This very large dose into my system helped my 39 year old uterus contract in order to deliver one 3.5 kg baby.

I will keep you in a bit of suspense, like a bit of a thriller novel.

I have just (last friday) had surgery – 4 years after my precious second child’s birth. It was an operation to effectively remove my uterus. This organ that has caused a fair amount of poor quality of life. The surgeon was extremely happy with his operation (they usually are) and presented me with a photo of the wretched organ and great news that it had gone swimmingly.

Wind back 4 years. I had just delivered a baby at around 3 am in the morning. The team were tired. God knows they had had me in chunks. No nursing staff are ever delighted to “nurse” a lady doctor – goes against many grains. I was lying in a lot of blood and had already started to bleed. I was in a fair amount of pain considering I had already delivered a child. The pain escalated, the nausea escalated, the bleeding escalated. I called for help so to speak and was told to shut up and sleep (in my own blood) they had really had enough of me for one night. I tried again. I phoned a friend – no one was up at 4 am. I tried my husband – his phone was off – he was trying to sleep after a hell of a night. I phoned the neighbour and asked him to wake my husband and come to the hospital.

AT one point I left my body and watched mayhem from above.

I woke up – well “arrived” back in my body about 2 days later having been taken to theatre, resuscitated, transfused etc. They never did figure out what was causing my pain 4 years ago. I started on a long journey of recovery mentally, physically and emotionally.

The surgeon showed me (this last saturday)

what happened – my uterus had ruptured and well lets just say the human body is an amazing thing.

I do certainly wish that it had been discovered 4 years ago for a few reasons. The very first and most important being my marriage which suffered greatly for the rupture. The second being the suffering that could so easily have been avoided. I can actually deal with a fair amount (though I do believe my pain threshold is useless), but my wish would be for another women to not have to go through the journey I have travelled. The third being the faith I have lost in my own “kind”. Never did I think it possible to be treated the way I was that night or on 3 occasions where all I really wanted was an apology from the midwife and all staff closed rank and called me something close to a lunatic and just bloody well get over this and move on.

Well I can now. Move on.

I can also say that a hysterectomy is a relative walk in the park. Almost a non-event. Yes I had pain post-op and yes I required the strong stuff. But 2 days later I was not on anything for pain and today I feel like I could run a marathon (I won’t for all those urging me to rest).

Life is an interesting journey and some of the suffering actually helps create focus and for that I am grateful. The most awesome part is just beginning – a journey with Dave and my two girls.

Guardian connect – a step in the right direction


Ok so south africa’s latest CGM is here and available. We have a few on the market and this is the newest addition.

It currently “talks” to iPhone and from next year will also “speak” to android phones.

The great great benefit of this device is that the sensors are relatively “cheap” and the device is simply a sensor contraption that attaches to the body and then “speaks” to the iPhone. From that iPhone to the cloud where a healthcare provider, mom or dad or care-giver can access the “data” – a blood test every 5minutes that is 288 tests per 24 hours !!

The data is reliable with an MARD of 9 and thus insulin can be titrated using the readings.

The cost of the kit is 13k (R13828.20) and the sensors are R1695 for 5 – they last a week each, that’s 399 per sensor.

The benefit of “knowing” your sugar is fairly obvious but is in actual fact revolutionary and life changing for an individual diabetic.

You simply can not compare 6 tests a day to 288. The maths of that in itself is a mindblow.

NOW is a great! time to order one at the end of the year before a brand new year on med aid benefits.

email me if you have questions : drleethegp@gmail.com

Knowing your number is honestly the single most effective way of getting control.