When one family member is diagnosed with diabetes, it can be extremely difficult to help them switch to a new, healthier diet. Many factors need to be considered and questions answered. Can you afford to make the nutritional changes? What kind of food should they be avoiding? Do I have to change my diet too?

According to the Borgen Project, diabetes is one of the three leading causes of death in South Africa, the other two being tuberculosis and cerebrovascular diseases. 

Socioeconomic disparities and other factors contribute to the prevalence of diabetes in South Africa, where proper healthcare is inaccessible in poorer communities. 

More than one million citizens in South Africa do not know if they are diabetic. 

Living with diabetes

There are many ill-side effects for those living with diabetes. Diabetics must consistently track their blood sugar levels to ensure they don’t go into a diabetic coma. 

Additionally, diabetics are two to three times likelier to experience cardiovascular problems, like heart attacks or strokes. Diabetes can also cause an individual’s kidneys to stop working.

Among the South African population, there is a major lack of awareness of the disease and access to proper healthcare.

Dr Joel Dave is the Head of the Endocrinology Division at Groote Schuur Hospital and the University of Cape Town.  He explained a few things that we should know about diabetes.

When a family member is diagnosed with diabetes, what happens to their body?  

There is a multitude of symptoms and complications of diabetes. Common symptoms at diagnosis include frequent urinating of large volumes, especially at night, increased thirst, increased drinking, blurred vision, fatigue and dizziness.  

Good control possible

At diagnosis, 50% of people living with type 2 diabetes are already likely to have a complication such as nerve damage in their feet, eye damage or damage to their kidneys.  All of the symptoms and complications can resolve and be prevented by good control of diabetes.

What kind of changes do they have to make in terms of their diet (do they have to cut out certain foods or add certain foods)? 

The most important thing to cut out of the diet is anything containing sugar.  They will also need to limit their intake of carbohydrates.  

How do these nutritional and lifestyle changes make managing diabetes easier for the individual and family as a whole?  

Lifestyle changes and particularly diet are essential components of diabetes management.  Often good control of diabetes could be obtained just with strict lifestyle changes.  There is also some data that suggests that these stringent changes include remission of type 2 diabetes in some people. 

What kind of exercises are they allowed to do?  

This is a difficult question to answer in general because there is a wide spectrum of people living with various types of diabetes and with various comorbidities such as hypertension, ischemic heart disease and diabetic retinopathy.  

In essence, almost all people living with diabetes should do some form of exercise, guided by their treating clinicians.

Will family members who change their eating habits make it easier for the individual who is diagnosed to change theirs? 

Definitely, support is essential for people living with diabetes, and if the whole household is able to eat similarly, it will make it much easier for the person living with diabetes.

Do family members who are not diagnosed with diabetes have to follow the same diet as the family member who is?  

If one was honest, the type of diet that a person living with diabetes is required to adhere to should actually be followed by EVERYONE. 

Review your lifestyle

Obesity and chronic diseases of lifestyle are at an all-time high, so it is important for everyone to review their lifestyle choices and to make the type of changes that would promote achieving a normal body mass index and prevention of chronic disease.

What can a family, who can’t afford to make big nutritional changes, do to support the family member who has been diagnosed with diabetes?  

This is an excellent question that is very difficult to answer.  Food insecurity is a major problem in our country, and the types of food that offer the best chance of achieving good health are expensive.  

We certainly do need some form of social grant system and/or community empowerment to grow vegetables or fruit that can be used to make healthy meals.  

All families should review their spending and to rather divert it to purchasing foods that would promote good health rather than other items, for example, cigarettes, alcohol, fast food, sugar-containing carbonated drinks and high glycaemic index carbohydrates.     

Handy tips for those living with diabetes

Registered dietitian and member of Sweet Life Diabetes Community, Pitsi Dilepi, also shared a few tips that people who have been diagnosed with diabetes can use.

What tip(s) would you give someone who wants to stick to their diet and keep their blood sugar under control? 

TEEL is a simple way to manage your diabetes. The T is for Take your medication, E is for Eat healthy food, E is for Exercise, a little every day, and L is for Lose weight if you need to.

If you’re living with Type 2 diabetes, you might not be taking medication – in that case, you only have to remember EEL: Eat healthily, exercise a little every day, and lose weight if you need to.

Other people with Type 2 will be taking tablets – usually metformin. And then others will be on insulin injections. If you’re taking metformin, you might have noticed that it gives you an upset tummy – diarrhoea is a common side effect.

For Type 1 diabetics, the most helpful tip we have is to rotate your injection sites. Inject into a new spot every day. You might not know it, but if you inject into the same area over and over, it can lead to something called lipohypertrophy – lumps and bumps under the skin. 

If you inject into these spots, your insulin doesn’t get absorbed properly, and you could be losing as much as 25% of your dose.

If all you do is increase the amount of vegetables you eat at lunch and dinner – nothing else! – you will already be doing your diabetes management a big favour.

Think green and get physical

Choose from salads, broccoli, spinach, cucumber, cabbage, peas and green beans,  gem squash and courgettes. 

Some vegetables aren’t green but still fit into this category because they don’t have any carbs or starch in them – veggies like tomatoes, carrots, pumpkin, mushrooms, peppers, cauliflower and onions. 

Avoid potatoes, sweet potatoes or butternut because they are all carbs or starch.

Exercise is like a superpower for diabetes. It can help you lose weight if you need to. It can also help your body use insulin better and make you feel better, happier and more energetic.

Losing weight beneficial

If you’re overweight, losing weight is the No 1 thing you can do to help control your blood sugar. 

It lets the insulin released by your body work much better, it lowers insulin resistance, it’s good for your cholesterol, and it’s good for your blood pressure.

What kinds of food should diabetics eat more of? What kinds should they eat less of?

Foods that diabetics should eat more of include wholewheat bread, seeded rolls, wholewheat pita,  pasta/noodles or wraps, brown or basmati rice, fresh fruit, lean cold meats, grilled chicken, mini meatballs, legumes like beans or lentils, fish like tuna, sardines or pilchards, cottage cheese and boiled eggs.

They should also consider still or sparkling water, tea or coffee, vegetable juice, low-fat milk and sugar-free fizzy drinks.

Foods that diabetics should avoid include deep-fried foods (like samoosas, spring rolls or vetkoek), sausage rolls and pies, croissants, muffins or other pastries. 

Diabetics should also keep in mind that portions are important. – Health-e News