Category Archives: economics

One tip for the day…or 5 ;)


How to keep in immune balance plus side of the equation?

1.) sleep 8 hours a night

2.) eat veggies !!! I recommend Mnandi cook book if you have excuses like : I can’t afford or it doesnt taste nice or fill me 🙂

3.) water -mense -water -none of us drink enough plain water -sip it throughout the day and you will be amanzi amazed

4.) exerise -get the blood flowing in a way that makes your heart happy – stay one step ahead of corona by actaully moving 🙂

5.) vit D, Vit c, selenium and zinc – they all boost that immunity -you can access from the sun and your mnandi diet or from tablets 🙂IMG-2580

Glucagon – can save your life if you have type1 diabetes :)


What is a hormone? Essentially a messenger/transmitter. We have many of them. In terms of the glucose metabolism we have insulin and glucagon which do opposite type of functions in the body. Insulin takes glucose into the cell to be used for aerobic cell respiration and glucagon makes glucose available to the body for use in emergency type settings.

This is a simplified version of what they do at cellular level but nonetheless a start to understanding.

If you are a type 1 diabetic, you do not have enough insulin and many times your body seems confused on a glucagon level too.

If you are unconscious from a hypo- a very low sugar (usually a value below 2 mmol/l) and a care-giver or companion injects glucagon it may save your life. At the correct injunction of time glucagon SC/IMI – subcutaneously or Intra-muscularly is life saving.

It is for this reason that a type 1 patient or a patient injecting insulin should have a glucagon pen on their person at all times. In an ideal world.

So, if you fit into this category of patient and you do not have a glucagon pen, make a telephonic, virtual or in the flesh visit to your GP/diabetologist or endocrinologist to get a script so that you have this little gem with you – in the fridge or a cooler preferably.

#glucagonexplained #lifesaving #diabetesglucagon

Corona, covid, go away …


If I had a wish from a genie, I would use it right now.

But I don’t. And for some reason collectively we are resisting what seems to be a truth that we are all battling to reconcile. This thing is here. It’s a terrible virus that has mutated from animal to human and it threatens US at large.

This is not an US and THEM situation it is only an US situation. Humans. Us.

Um, gulp, shit!!!

Against a corona viridae.

And yet, we CAN beat it. We really can. Ask Italy. Who have LOST soooo much.

However, we do need strategies. Now in South Africa we are blessed I believe to have had the experience of the HIV epidemic and the really hard lessons that it taught us. And we are now applying to a new pandemic.

Also we need honesty. More than ever. Not fear-mongering. Honesty and less gas-lighting.

We need community at a time when physically we are distanced. Yet spiritually we have a huge opportunity. For unity. For US. For humanity.

And actually to realise how connected each and everyone of us are. The truth.

Not US and them. Just US. And unless we collectively realise that, I fear worse.

As we hold our breath right now in south africa and some of the countries that have managed miraculously to flatten a curve FOR NOW, we need to realise this is a battle that is going to take a while. Many months, possibly years. And in order to continue to keep a flattish curve we need strategies. On many other fronts : hunger, fear, we need somehow very realistically to take hands, with all of those who are less fortunate.

So back to my genie, actually I may need 3 wishes at least, but failing genies and wishes, what can each one of US actually do? For humanity, for the future? There is sooo much YOU can do, so why not DO it, Like nike said, just DO it. Be part of the solution.genie

Loved the aladin movie (pic above) in it’s magic moments, we need more magic moments and the humblest of humanity are capable.

2020 – a new year for diabetes -perhaps a cure???


I really like the sound of 2020 and we are at the cusp of really exciting things especially for type 1 diabetes and closed loop technology. Eventually.

Yes it has taken quite long to get here partly because it is a really big and honourus challenge going closed loop. But seeing as 2020 has 2 loops that’s double the looping chance of looping becoming more sustainable.

That thought also makes me super happy. Mainly so that patients who previously had to prick fingers 6-10 x a day and inject 4-6 times a day can now really focus on what the rest of us focus on – living life unencumbered.

So let it be the year of accurate CGMS and flawless looping.

Libre flash monitoring – “freeing” you up to live life (technology permitting )


What is flash monitoring ? Well it’s a button you wear on your upper arm (under normal sleeves) and use your phone (many compatible android and iphones) to swipe across the button and voila- a sugar reading. It then records on a graph on your phone.

We have come a long way since 1922 when without insulin type 1 patients essentially died. Crass but the truth sadly. And here we are in 2019 and we do not even have to rely on finger pricks. Yay! Progress and science and so much of happiness all around.

Flash monitoring does have a lag, and that is quite individual. Safe to say the “real time” sugar is ahead ie the flash is behind real time but the trend remains the same – I hope that makes sense. The beauty is being able to see where you have come from and are headed towards. So, if you are heading down you can snack or watch and wait depending on the circumstances : ie food, exercise, illness and same for heading up. And you can flash in 5 minutes to see.

So I very much advise against knee-jerk reaction to the blood sugar on flash monitoring but rather watching and waiting and “learning” from experiences of exercise and cake eating etc. As for adjustments in insulin doses and timing of insulin and what does what. For example stress affects certain people in one way and others in another and the beauty of the flash is that you get to learn what your body does and adjust to that.

In the UK this device is now relatively largely widespread and with great great results of way better control, time in range and very importantly better quality of life for type 1 patients. It is being funded by the NHS at large thanks to the Diabetes warrior doctors who have literally “gone to war” to get this funded.

In south africa we battle “the funders” to do what actually benefits them downstream but happy to say that I do feel that progress is being made in this arena too. Our “war” also slowly slowly being won for the betterment of both funder and patients.

Flash monitoring – glucose readings regularly not requiring finger sticks/pricks – accurate, timeous and life changing – allowing patients to live full lives rather than survive.

#abbottlibreflash a multitasking device that adds value at every level

670G medtronic – a lesson for all diabetic practioners in a very good way :):)


The new 670G medtronic pump is truely a wonderful amazing device.

What suprised me more than anything else is what an absolute pearl of a lesson it is in terms of how insulins work and the daily awful grind and variability of being a type 1.

Honestly congratulations to this development team, you have come up with a genius product. Genius!

It expertly and simply solves for so many of the dilemmas type 1’s face daily. And in a safe and perfect way.

Truely a product that answers so many of the questions that we have up to now not solved.

Thank you thank you thank you.

THe MARD was my biggest happiness on the sensor – 8.7- wow-Yay!

So many reasons that in my opinion as many type1 patients should get onto this technology in terms of cost saving in the long run for med aid schemes and longevity with quality for patients both old and young.

I nominate it for product of the year.

Problems it solves for :

1.) daily variability (automatic adjustments according to blood glucose)

2.) hypoglycemia – on a downward trend of sugar readings it keeps decreasing insulin as to prevent a low and then eventually suspending insulin so as to prevent the low from happnening, as soon as the sugar trends up it resumes insulin and keeps adjusting

3.) high sugars – on an upward trend it increases insulin (up to a preset SAFE) level with alarms and alerts so as to prevent the high sugar

4.) variability immediately improves as does TIME IN RANGE

5.) multiple layered safety catches in case of problems

Type 1 diabetes is a tough life sentence and pump/cgm is the key to a little more freedom 🙂

 

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 🙂

Accuracy data from ADA 2019 hot off the press praising CGMs’s at large 🙂

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

dexcom

“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 type 1 is no one’s fault, don’t be ignorant


Daily I hear very interesting “lies” about diabetes. I heard a classic last week. Someone’s mom who had had a stroke was told her mom has the kind of diabetes that CAN NOT be controlled. God’s truth!!!

Another common lie is that this is a disease “you do to yourself” i.e. you behave/eat in a certain way and your “punishment” is diabetes. Well I am afraid that is NOT TRUE.

Especially in type 1 diabetes. This scourge has been with us for a long time. However up until the 1920’s there was no “cure” or “treatment” so to speak i.e. you generally died from it. And the consequence being the “genes” or genetic inheritance died with that. Since the 1920 s we have had insulin and now one can live very “normally” yes ~I said normally with type 1 diabetes. Yes it involves checking sugars and injecting insulin but other than that you can eat mostly what you would like to and get on with life as you would like to.

So to the diabetes that can not be cured I say : Lord have mercy. There is so much lack of knowledge especially in public sector about diabetes. That added to the corruption. Ie meters, strips, insulin being sold on the black market meant for the poorest of the poor free as part of a the dismal service being provided is a scourge.

Any form of diabetes can be treated and controlled. Is it easy ? No but is it do-able even for the poorest of the poor. YES!!!

There is so much corruption in this country and it always affects the poor more. Let’s at grass roots level tackle this with the power of words, peace, and the truth. Join us to contribute to both awareness and funds for shap shap doing this very task daily excellently : roarin 20s party 27 oct 2018 …see Facebook drleethegp and shap shap

Silent heart attack


What is a silent heart attack. An acute myocardial infarct where the patient feels no pain whatsoever. Diabetics are very prone to this. Particularly poorly controlled diabetics. If the average sugar is consistently above 10 mmol/l then the nerves to the various organs actually stop working. Which means in essence you don’t feel pain like you should.

The problem with not feeling the pain is that you don’t realise what is happening. So generally the patient presents later. Sometimes with confusion (acute), sometimes with electrolyte disturbances or unfortunately death.

Control of sugar is key.

A1c – three month average of the glucose must be performed in diabetics at least every 6 months and attended to if too high.

Controlled sugars prevent heart attacks. Controlled blood pressure prevents them too 😉

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