Many South Africans have diabetes, but a large
number remain undiagnosed. World Diabetes Awareness Day, which
is the 14th November, was created as an effort to
educate the public about this disease and to inform those with
diabetes about the resources available to them.
What is Diabetes:
Diabetes (or sugar sickness) is a condition of
the body, where sugar is not used correctly to provide energy
for living and growing. You develop diabetes when your body
doesn’t produce enough insulin. Without insulin your body cannot
get the energy it needs from your food. Normally, a gland called
the pancreas makes insulin which carries the sugar in the blood
into the cells. In diabetes, the pancreas fails to supply enough
insulin, or the insulin doesn't work properly.
There are two major types of diabetes: Type I,
commonly called juvenile diabetes, and Type II, commonly called
adult on-set diabetes. Both have similar symptoms but very
Type I diabetes, usually diagnosed in
childhood, is a disease whereby the body's own immune system
attacks and kills the cells in the pancreas which produce
insulin, leaving a person's body without insulin, and unable to
regulate its blood sugar levels.
Type II diabetes is a disease that results when
the body's cells become resistant to insulin. In Type II
diabetes, unlike in Type I, insulin is still produced by the
body; it just isn't used correctly.
How would I feel or know if I have Diabetes?
Although there may be no obvious symptoms and
some people have no symptoms, the following are common:
- Always thirsty
- Always tired
- Frequent urination
- Unexplained weight loss
- Changes of vision (blurry)
- Slow healing cuts and bruises
- Numbness in hands and feet
These are all results of the body's inability to
transport sugar (energy) from the bloodstream to the body cells.
Who is at risk?
Anyone, anywhere, at any age can get diabetes.
Being overweight and having a family history of diabetes
increase the risk.
How is diabetes treated?
Depending on the type and severity of the
- with diet plus exercise,
- or diet, exercise and medication.
Medication may be insulin or tablets, or both.
The good news is that having diabetes does not
mean the end of a normal healthy life. You need to accept that
you have the condition and then learn how to manage it.
Management and control of blood sugar is very
important as it prevents or reduces the risk of developing the
complications of the disease. The abnormally high blood sugar
levels (hyperglycemia), can cause kidney, eye, heart, blood
vessel, and other diseases. Without proper management it can
lead to heart and kidney disease, blindness and amputation
The Role of Food:
A healthy diet is the foundation for good blood
sugar control in any type of diabetes. Whether you are being
treated with insulin or tablets, you still need to follow a
The so-called "diabetic diet" is not in fact a
diet, but rather a healthy eating plan which can, and should be
followed by the whole family.
Keeping to a healthy food intake not only
controls blood glucose levels (and so delays the onset of
diabetic complications) but also helps to maintain body weight
and prevent heart disease.
Ten important points to remember:
Eat regular meals (breakfast, lunch and
supper), which contain different kinds of foods. Your diet
doesn’t have to be boring by only including boiled foods –
use herbs & spices, try different ways of cooking and
different kinds of foods.
- Make starchy foods the basis of your meals.
- Eat less fat.
- Chicken, fish, lean meat, and low fat dairy foods could
be eaten daily.
- Eat more fibre such as vegetables & fruit with skin and
- Eat dry or tinned beans, peas, lentils and soya (pulses)
at least twice a week.
- Be active and control your weight.
- Eat less salt and salty foods.
- Drink as much safe water as you can throughout the day
- If you drink alcohol, drink sensibly.
- Make Strachy Foods the Basis of your meals
There are two types of carbohydrate:
- Starchy foods
- Sweet foods
The best starchy foods to choose are those high in fibre as
they are digested slowly making it easier for your body to
control your blood glucose. Try to choose high fibre foods more
often e.g. high bran cereals, porridge, brown or wholegrain
bread, rice, dried or baked beans, samp and beans, potatoes,
roti made with brown or wholegrain flour, phutu, lentils, oats
and mealie meal, vegetables and fruit with skin.
- Include a starchy food with each meal
- Starches by themselves do not make you gain weight or
worsen your diabetes especially those rich in fibre.
- However, be careful of having large amounts of starches
in one meal (e.g. potato curry and rice).
Sweet foods are quickly taken up by your body and cause
blood glucose to rise very quickly. The best food choices of
sweetened foods are those which have lots of fibre in them such
as bran muffins.
However, if you are going to eat sweet foods, try to eat them
seldomly and in small amounts, then have them with a high fibre
meal rather than alone. E.g. plain cake following a meal rather
than as a snack.
Use less fat and salt
Too many high fat foods can result in weight
gain and make your diabetes more difficult to control. They can
also increase your risk of heart disease. Fats are in your food
Visible fat (fats you can see) such as:
Cooking oil, dripping, ghee, butter, margarine, fat on meat,
skin on chicken.
Hidden fat (fats you cannot see) such as:
Full cream milk/ maas, coffee creamer, full cream yoghurt,
ice-cream, potato crisps, hot chips, pastry, sweets, chocolate
and cream filled biscuits, chocolate, samoosas, sweetmeats,
bhajias, pies, rich sauces, meat and meat products (wors,
burgers, polony, processed meats, fried foods such as chicken,
eggs and fish).
Having too much salt in the diet is linked with high blood
pressure. Salt is commonly used to add flavour to foods and can
come in the form of table salt, soup and gravy powders, stock
cubes and seasoning. Many people use too much of these foods
when they are cooking.
To use less salt but still keep a great taste make use of
herbs, curry powder, ginger, garlic, onions, peppers and
tomatoes. Some foods are also high in salt such as biltong,
snoek, pickled fish, salted nuts, salted popcorn and chips.
These foods can still be part of a healthy diet if they are
eaten in small amounts and not too often.
Eat plenty of fruit and vegetables everyday
- All types of fruit and vegetables are good for you and
can be eaten in a healthy diet (preferably with their skin
- Try to eat a variety of fruit and vegetables every day.
- 3 pieces of fresh fruit can be eaten every day (each the
size of a tennis ball). Spread fruit intake throughout the
day in different meals/ snacks.
- Frozen vegetables are as good as fresh vegetables.
- Add extra vegetables to recipes such as stews, curries
or pasta dishes.
- Do not overcook your vegetables otherwise the vitamins
will be lost.
- Fruit tinned in syrup, dried fruits and dried fruit roll
may be eaten in small amounts as part of a high fibre meal.
The motto is to " strive for five" – 3 vegetables and 2
fruits a day. This can be managed by for example having a banana
as a snack, salad and an apple with your lunch and 2 vegetables
with your supper.
Eat Beans, Lentils, Peas and Soya Regularly
- Eat dry or tinned beans, lentils, peas and soya
regularly (at least once a week) as they are high in protein
and fibre and low in fat.
- Replace or stretch meat dishes with beans, lentils, peas
- Cut down on the cooking time needed for dried beans,
lentils and peas by soaking them in water overnight.
Chicken, Fish, Lean Meat and Low Fat
Milk/Maas could be eaten daily
- Lean meat/ skinless chicken/ fresh or tinned fish/ egg
(max. 4 per week) and low fat milk/ maas may be eaten every
- Cut off the fat you can see on the meat and take the
skin off the chicken before cooking.
- Eat fish at least once a week, either tinned in tomatoes
or water, or fresh/ frozen (plain) fish if available. Try
not to have fried fish or fish tinned in oil.
Cooking Methods and the best food choices
- If you need to have a snack choose raw vegetables,
fruit, or high fibre biscuits. Try not to have high fat
snacks such those mentioned in the hidden fat section.
- Choose other methods of cooking like baking, steaming,
microwaving, grilling, stewing, braaing or boiling instead
of frying food.
- Use less oil for cooking by measuring out the oil needed
for a stew or curry. Use 1 teaspoon of oil per person in the
family. E.g. curry/ stew for 6 people will need 6 teaspoons
- Use skimmed/fat free/ diet or low fat milk/ maas plain
or fruit yoghurt, low fat cheese.
- Use tub margarine instead of brick margarine. Spread
less margarine on your bread (you should still be able to
see the bread).
- When making sandwiches you may use a fat reduced
mayonnaise or salad cream instead or margarine
What can I drink?
- Hot and cold drinks
- Water is the best drink for health. Don’t wait until you
are thirsty. Drink at least 6-8 cups of water a day.
- "Diet" or "sugar free" drinks are good choices for the
whole family and may be drunk in moderation.
- Fresh fruit juice and sweetened juice are good when then
are diluted with water as otherwise they are a very
concentrated form of sugar.
- Sugar free tea and coffee may be whitened with fresh low
fat milk or low fat milk powder as these are a better choice
than coffee whiteners.
- If you drink alcohol, do so in moderation i.e. try to
have at least 2 days free of alcohol per week. If you have
been advised not to drink by your doctor then it should be
- All alcohol is high in calories and some drinks are high
in sugar e.g. sweet sherry. Use sugar free or diet mixers
with spirits e.g. diet lemonade & whiskey.
- Try not to drink more than the following amounts per
day: 2 small cans or 1 pint ordinary beer, lager or cider or
2 glasses of dry wine or 2 glasses dry sherry or 2 spirit
- Avoid sweet wine, sweet sherry, liqueurs, homemade beer
- Alcohol lowers blood glucose, which can become
dangerously low. Always have alcohol with a meal and your
usual snack afterwards. Never drink on an empty stomach.
A guide to healthy snacks
It may be important for some people to have a snack at
mid-morning and at bedtime. Try to choose a high fibre snack
-the following are some examples:
Best snack choices
- Fresh fruit
- Wholegrain cereal with low fat milk
- Brown or wholegrain bread with thinly spread peanut
- High fibre biscuits
- A bran muffin
- Low fat yoghurt
Not so good snack choices
- Meat pies, sausage rolls, fried samoosas
- Potato crisps and hot chips
- Chocolate/ cream biscuits/ chocolate bars/ ice-cream
- Sponge cake, sweet pastries/ cream cakes/ sweetmeats
Tips for healthy shopping
- Check labels on foods, which say "reduced sugar" or "no
added sugar" – as glucose, fructose, sucrose and dextrose
all mean sugar. Choose foods where sugar is not listed in
the first 3 ingredients.
- Use skimmed/ fat free/ diet or low fat milk/ maas, fruit
& plain yoghurt and low fat cheese as they contain less fat.
- Eat high fat take-aways or fast food such as deep fried
chicken, burgers, chips, and pizza seldomly.
It is important to do some form of exercise 3-4 times per
week for 10-20 minutes. This may take the form of :
- Walking up and down a flight of stairs instead of taking
- Walking to the shops instead of taking a car/taxi/bus or
getting off a bus/ taxi a couple of stops early.
- 50 –100 skips with a skipping rope.