Cover Story Living with Diabetes
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Cover Story Living with diabeteS Get Connected. Get Living. Don’t let your life be ruled by diabetes. Use the power of your smartphone* and the web to manage your diabetes so that you can get on with the job of living your life. 5SBOTGFSZPVSblood glucose results wirelessly to the mobile app. (FUmobile and online reports of your blood glucose patterns. Calculate how much insulin to take at mealtimes with the clinically proven Accu-Chek Bolus Advisor.¹ Share your diabetes data online with your healthcare professional. Automatically send test results to loved ones. To see which smartphones are compatible with the Accu-Chek Connect system, scan this barcode or go to www.accu-chek.co.za/dmapp Get your A ccu-Chek P erforma Conne Experience what’s possible. ct Meter from leading ph armacies For more information contact your Healthcare Professional Reference 1 Ziegler R, Cavan DA, Cranston I, et al. Use of an Insulin Bolus Advisor Improves Glycemic Control in Multiple Daily Insulin Injection (MDI) Therapy Patients With Suboptimal Glycemic Control: First results from the ABACUS trial. Diabetes Care. 2013;36:3613-3619. To fi nd out more, visit www.accu-chekconnect.co.za or call 080-Diabetes (Dial 080-34-22-38-37) toll free. Ref: ACUST 140718 Editor Diabetes Lifestyle... Michael Brown - CDE Houghton Real People, Real Stories, Real Answers Sub-Editor Rosemary Flynn Advertising Enquiries Angela Bell EDITOR’S 082 451-0193 [email protected] NOTE Editorial Advisors Prof Larry Distiller It seems, as you get older, that the days, weeks and years flash by at an ever-increasing Dr David Segal rate. 2014 has reinforced this trend in my life! So much done, yet so much more remains... Dr Stan Landau In diabetes care, this is and will continue to be our mantra. How do I know this? Every Vanessa Brown official statistic, scientifically-based ‘guesstimate’ and anecdotal report shows that we are in the middle of a diabetes pandemic. Graphs of the prevalence (number of people with) Gerda Janse van Rensburg and incidence (number of new cases) of diabetes are hitting the steep upswing of an Andrew Heilbrunn exponential climb heavenwards. 2013 International Diabetes Federation (IDF) estimates put the world population of people with diabetes at 382 million. This figure is set to rise by Hester Davel 55 % to 592 million people by 2035. Unfortunately, Africa will bear the biggest brunt of this Paul Baker problem with a 109 % rise in prevalence of diabetes in the same period. That was 2013... What will the 2014 estimates due soon tell us? Michelle Daniels If you have diabetes you may ‘get’ this problem. But, why should anyone else care? Some good reasons include: Project Manager Peter Black - Chief Executive Officer CDE • Diabetes can affect you or someone close to you - No population or age group is spared. • In sub-Saharan Africa, 62 % of people with diabetes remain undiagnosed, yet at risk from life-threatening complications of uncontrolled diabetes. This is because type 2 diabetes (affecting 90-95 % of people with diabetes) may be asymptomatic for years, Published for the Centre for Diabetes even decades before diagnosis or the appearance of diabetes-alerting complications. and Endocrinology by • Both type 1 and type 2 diabetes are serious. Both can affect children. • Every 10 seconds someone dies from diabetes-related causes. Homestead Publishing (Pty) Ltd • Late diagnosis or poor management of diabetes can result in disabling and life- P O Box 1261 Rivonia 2128 threatening complications affecting your eyes, heart, kidneys and feet. • Diabetes care is costly. Unchecked, the epidemic has the potential to cripple and Telephone: 011 787-9366 overwhelm our already stretched healthcare system. Fax : 088 011 787-9366 A major problem we face globally is a general lack of activism and political involvement in [email protected] many people who have diabetes. It’s time to change this. You have a compelling and urgent story to tell – this problem will affect all . Go out and tell it! Design and layout This issue of Diabetes Lifestyle, includes ’back to basics’, psychological, lifestyle and Adéle Gouws community-based features. We continue with a second article looking at the important, but often overlooked problem of diabetes-related hearing loss, tinnitus and vertigo. It deals with Output Reproductions the management of these problems and restoring the joy of hearing. Two new additions to the menu include the funny things that may happen in diabetes and a crossword puzzle to help you negotiate some key principles of diabetes care. In keeping with this year’s IDF World Printing Diabetes Day (14 November) theme, we focus on healthy nutrition. Business Print Our Cover Story features SA musician extraordinaire, Nathan Ro, who is not only talented, but far from one-dimensional. Amongst other talents, he is professionally involved in two completely different and successful bands, the ‘neon-rock’ Lonehill Estate and the suave and Centre for Diabetes and Endocrinology sophisticated Swing City . He also writes a good story and highlights most persuasively his 011 712-6000 joy in life even with diabetes. If you need a role model, look no further! He says “I can highly recommend being part of a band if you are musically inclined”. As a very part-time, non www.cdecentre.co.za professional musician who also plays in a couple of bands, I agree wholeheartedly! Playing guitar, bass or mandolin in a band that has found each other is amazing! It is one of my ‘happy places’ in life. Should you be as talented and grounded as Nathan is, this could be a Copyright great career option to contemplate. And, diabetes has no place in the decision! Material published in Diabetes Lifestyle Yours in diabetes care including all artwork, may not be copied, Michael Brown reproduced or published without the Editor permission of the Publishers. [email protected] 1 INSIDE COMMENTARY • Ahhh, ‘Quality’… What does that mean again? Peter Black 4 • Paul’s side of the fence – joBerg2c - Ride the Beloved Country Paul Baker 24 LIVING WITH DIABETES • Healthy Eating and Diabetes Michelle Daniels 14 • Back to Basics – Self Home Blood Glucose Monitoring for those on insulin Prof Larry Distiller 28 • Injecting Insulin – For some, a pain in the... Rosemary Flynn 32 COVER STORY 6 • “I heard that!” The management of diabetes-related hearing loss, Dia“BEAT”es... it's just a wakeup call! tinnitus and vertigo Tarryn Sparg 36 Nathan Ro • Youth With Diabetes Goes Camping Hester Davel 42 CONTRIBUTORS Paul Baker Peter Black Sheena Campling Community Columnist Chief Executive Officer, CDE Youth Leader for YWD Rosemary Flynn Janet Lopes Nathan Ro Clinical Psychologist, CDE, Houghton 2 DISCLAIMER Views expressed in editorial are not necessarily those of the CDE, the Publishers, or Editors. While every effort is made to ensure the accuracy of the CROSSWORD content of this journal, the CDE, the Publishers, and Editors do not accept • Healthy eating and diabetes 21 responsibility for omissions or errors or their consequences. Any general advice contained within cannot and is not intended to be a substitute for PUT A SMILE ON YOUR DIAL 35 professional medical advice, diagnosis or treatment and is not purporting to be the • The Danger of Jumping to Conclusions Janet Lopes practice of medicine. Never disregard • ‘Sweet’ Pick-Up Lines Sheena Campling professional medical advice, or delay in seeking it, because of something you have read here, or rely on this information in place of seeking professional medical HEALTHY CHOICES advice. Always discuss any new information with your Diabetes Team • Cooking from the heart - Introduced by Michelle Daniels 40 before acting on any aspect of it. Use of the information contained within this publication is thus with the understanding DID YOU KNOW? 50 that it is at the readers own risk. Acceptance of advertising does not imply that the products and services advertised are recommended by the CDE, the Editors ACCREDITED CDE SERVICE PROVIDER CLASSIFIEDS 52 or Publishers. Michelle Daniels Hester Davel Prof Larry Distiller Registered Dietician, CDE Houghton Diabetes Nurse Educator, CDE Specialist Physician / Endocrinologist, CDE, Houghton Tarryn Sparg Audiologist 3 COMMENTARY Ahhh, ‘Quality’… What does that mean again? Peter Black, Chief Executive Officer, CDE f asked, most of us would say that we fully understand Different conditions, including diabetes, can and should be the concept of quality. Do we really? We know that the considered separately when evaluating whether quality concept of quality implies a state of excellence, of exists in its management. Recently, an actuarial firm, allied Isomething being better than something else is. But, if we to an industry body that examines quality in the medical were asked to define the concept of quality, we would all scheme environment, published their results. These show probably come up with quite different answers. that most people with diabetes are not receiving the One business website states, “Quality is about meeting expected quality of care. the needs and expectations of customers” . Henry Ford said, “Quality means doing it right when • Less than half of patients have an HbA1c test no-one is looking” . performed. This test forms a vital part in best practice What does it mean when we talk about quality in health for good diabetes management! care? The healthcare industry has grappled with this • Less than 40 % of patients have their cholesterol levels question for a long time. checked regularly and less than half are on effective cholesterol lowering medication The World Health Organisation (WHO) recognises six • Only 20 % have their eyes proactively screened for dimensions of healthcare quality, with requirements that damage due to diabetes health care should be: • Only 2 % have their feet screened for risk and checked • Effective – it should work and should be evidence-based by a podiatrist.