"There is no shame in living with diabetes" - personal account by Duane Boucher, Head of IS Department

Read time: 8 mins

As a person living with Type 2 Diabetes, I want to raise awareness about my condition amongst colleagues and students at the University of Fort Hare.  By sharing the information in this article about diabetes, I hope you will either get yourself tested for diabetes if you suspect you may be at risk, or offer support to your family, partner and friends who have the disease.  There is no shame in living diabetes.

The International Diabetes Federation (IDF) estimates that roughly 12.8% of South Africa’s adult population or 4,581,200 adults are living with diabetes.  The number of diabetes cases has doubled from a previous 5.4% of the adult population in 2017.  In South Africa, diabetes deaths are second only to Tuberculosis.  But by 2040, diabetes is expected to be the leading cause of death in the country.  Improving awareness on diabetes is essential to avoid future medical complications for individuals, and the anticipated financial health burden on the state.

November has been identified as Diabetes Awareness Month and 14 November 2020 is International Diabetes Day.  The IDF uses a blue circle to represent diabetes and challenges everyone who has diabetes or knows someone with diabetes to wear blue on Saturday, 14 November, to show their awareness.

What is Diabetes?

Diabetes is a non-communicable disease that occurs when you have too much sugar (glucose) in your body.  The glucose is produced from the food you eat and enters your bloodstream.  Your body needs glucose for energy but cannot use it if it stays in your blood.  An organ in your body called the pancreas makes insulin to help the glucose get into your cells to give you energy.  Insulin is the “key” that opens the door to a cell in your body so that it can receive the glucose. If your pancreas cannot produce insulin, then you are diagnosed as a person with Type 1 diabetes.  If your pancreas can produce insulin but is not doing so correctly, then you are diagnosed as a person with Type 2 diabetes.

How would I know if I have diabetes?

The IDF estimates that 1 in 11 adults globally are living with diabetes and many more individuals are undiagnosed, as they do not undergo regular health checks.  Not knowing that you are living with diabetes can lead to unnecessary damage to your body’s organs and nervous system, as they rely on the blood flowing through your body to function correctly.

Uncontrolled diabetes leads to the following significant complications:

  • Neuropathy – your nerves become damaged from poor blood circulation, which can result in numbness and eventual amputations of your feet.
  • Blindness – your eyes are made up of an intricate network of tiny blood vessels, and excess glucose in your blood will damage these delicate nerves in your eyes.
  • Kidney (Renal) failure – if you have excess glucose in your blood it will result in damage to the nerves in the kidney, your body’s filtration organ, which will lead to the need for regular dialysis treatments to filter your blood and body of toxins.  My mother was a Type 2 diabetic for 18 years and endured weekly dialysis sessions for four years until she passed away in ICU in October 2007.
  • Heart attacks – your heart, the body’s pumping station for your blood is under strain from pumping the “heavy” glucose blood through your body, which results in high blood pressure (hypertension) and high cholesterol.

People newly diagnosed with diabetes often think they are going to die.  This happens mostly when they are made aware of the complications of the disease, but a person with diabetes can live a long life.  For example, my grandmother, who managed her diabetes well, died in her sleep just shy of 91 in January 2020, after being diagnosed with diabetes in her late 60s. 

So how do you even know that you are at risk of diabetes?  There are four simple questions you could ask yourself as a starting point.  If you answer “yes” to two or more of these questions, then you should get yourself tested for diabetes:

  • Does anyone in your family suffer from diabetes?
  • Are you over the age of 40 years?
  • Are you overweight?
  • Do you exercise regularly?

Being younger than 40 years does not mean that you may not have diabetes.  Type 1 Diabetes diagnosis occurs from birth, as a teenager, or young adult. Increasingly high instances of Type 2 Diabetes are also occurring in young adults due to poor eating habits or a high carb diet, lack of exercise, and being overweight.

Knowing that you are at risk of maybe getting diabetes, known as Pre-Diabetes, is essential as it is your body sending out a call for help that your intervention is necessary.  At present, there is no cure for diabetes and you will have diabetes for the remainder of your life.  There is no miracle cure posted on a lamppost somewhere. Still, Type 2 Diabetes can be reversed or put into “remission” with medication and by following a healthier lifestyle.  However, every day will be a day in vigilance for the rest of one’s life.

WARNING SIGNS THAT YOU MAY BE SUFFERING FROM DIABETES COULD INCLUDE:

  • A constant feeling of being thirsty;
  • A constant feeling of fatigue or lack of energy;
  • A decline in your eyesight or blurred vision;
  • Losing weight even when you are eating;
  • Genital itching and impotence;
  • A constant need to urinate; and,
  • Injuries (cuts, sores) to your body or bruises that don’t heal.

However, the only way to confirm that you have diabetes is to get yourself tested.  Three types of tests exist to check and monitor your diabetes risk.  These are usually administered in this order:

  1. A simple blood prick test using a handheld blood glucose tester, which you can administer yourself, at a local pharmacy, at a clinic, or your doctor.  A constant reading >8 mml could be a sign of pre-Diabetes, and further tests may be necessary to confirm a diagnosis.
  2. To confirm if you have diabetes, you will have a glucose fasting test, which will be administered at a testing lab or a clinic.  You will have blood drawn, get asked to drink a glucose drink, and have your blood checked two hours later to see if your pancreas extracted the glucose from your blood.  Your doctor will advise you of the results from the test.
  3. If you are diagnosed with diabetes, then your doctor will monitor your diabetes management by doing an HbA1c test, which will tell your doctor how much glucose has been in your blood over the past three months.  The test is only done at a minimum every three months, as your red blood cells in your body get replaced every two to three months.

What do I need to do if I’m diabetic?

Once diagnosed, your doctor will start you on a course of medication to ensure that you have enough insulin in your body to open the “door” to your cells for the glucose in your blood.  For people with type 1 diabetes, this will involve insulin injections. For Type 2 diabetics, it will involve oral medications, but can also include insulin injections if the pancreas is badly compromised. 

To manage your diabetes, you will need to:

  • Monitor your blood sugar levels daily.  Do regular blood prick tests using a handheld blood glucose tester.  These can be purchased from a local pharmacy, or available at some government clinics.  Your doctor or diabetes educator (nurse) will advise you of an acceptable range for the readings.
  • Take your medication.  If you are taking Metformin, then you will need to take additional supplements (magnesium and Vitamin B12) to counteract some of the effects of the medication.
  • Follow a healthy diet.  It would help if you found a diet that works for you to reduce your glucose readings and weight as needed.  You can source a diet plan from a dietician, a clinic, or you can follow a popular low carb eating plan such as the Banting Green List.  The goal of a healthy diet is to reduce the amount of glucose entering your body, which as you recall comes from food.  Managing your food intake as a diabetic person will be a lifelong challenge.
  • Exercise daily.  A diabetic person needs to complete at least 30 minutes of cardio-related exercise a day, as this improves the blood flow and distributes your medication through your body.  Your fitness level determines the exercise you undertake.  Just going for a daily walk can be very beneficial.

 Merely taking your medication and not changing your diet and undertaking some form of exercise will not help to manage your disease.  It will result in increased doses of medication and complications later.

Finding support as a diabetic

A person with diabetes will not find support for their disease until they acknowledge and own the implications of the disease.  I was diagnosed with Type 2 Diabetes on the 23rd of March 2020.

Being afraid to tell your family, partner and friends that you have diabetes and living in denial will only hasten you towards the complications mentioned above.  Taking your medication, monitoring your disease with daily blood pricks, changing your eating habits and lifestyle will initially be a challenge. Still, it will get easier as you learn more and more about your diabetes.  In this respect, joining a physical, online or WhatsApp support group can be a valuable learning resource.  The diabetic community is very supportive of one another in helping to learn to manage the disease.

The information for this article is sourced from the websites of the International Diabetes Federation; Diabetes South Africa; Diabetes Education Society of South Africa; Health e-News; and my own lived experience of the disease, as well as the impact of the disease on my late mother, father and late maternal grandmother.