#Allin4health #health4all #Minding your wellbeing #Diabetes awareness

Dr TW Ngwenya Changamire


This week on the Sunday Express, the fundamental question for the readers to ponder is: I am diabetic, how can I achieve optimum control of my condition

So here is the answer. Blood glucose levels need to be controlled and to remain consistently within the recommended ranges to prevent development of complications. In our previous article “How Diabetes affects our body,” we listed out how Diabetes causes injury to various vital organs.

It does this by damaging the small blood vessels that supply blood to these organs. Diabetes self-management can appear to be overwhelming in the beginning. Where do I even start? You may ask.

Here are some tips to help you get started. I have listed below the steps that you may take to achieve optimum glucose control.


Step 1 Stay informed


Keep yourself up to date with information about Diabetes and the lifestyle that a Diabetic patient should comply with and strive for.

Read as much literature on Diabetes and browse reliable websites like the World Health Organisation, Centre for Disease Control and the local health ministry websites to get up to date information on Diabetes. An individual can only achieve control of Diabetes if they have good sound knowledge of what Diabetes is, how it affects the body and the complications thereof if it is not well controlled.

Get tips on how best you can control it. This will enable you to make conscious informed decisions about your diet options, lifestyle and activities.

Learning about how and when to monitor your blood sugar, how to detect early signs of complications, and learning tips of how to care for yourself as a Diabetic patient will also help to prevent frequent illness and frequent hospital visits. Management of diabetes starts with you. Only you have the power to control it.


Step 2 Monitoring

It is important for you to routinely check your blood sugar level. This may be done by you or it can be checked at the local clinics, doctor’s rooms or pharmacies at intervals advised by your health practitioner.

We prefer that patients invest in getting their own blood glucose reading machine (glucometer). This way, they are able to frequently check their glucose levels and document in a diabetic diary.

This diary need not to be expensive or fancy.

A simple notebook will suffice. Before you begin to monitor your blood sugar it is important to have an understanding of what the recommended blood sugar targets are for a diabetic patient.

Normal blood sugar levels for early morning readings before a meal are referred to as Fasting blood sugar and this reading must be below 7mmol.

A reading that is taken anytime during the day after having a meal is referred to as Random blood sugar and this must not go above 11.1mmol.

So if your Fasting blood sugar (FBS) is above 7mmol or your Random blood sugar (RBS) is above 11.1mmol you are not well controlled.

All patients must be able to check their blood sugar level and they should also be able to interpret the meaning of the result and again if the readings are not optimum you should be able to come up with a diet and exercise plan that suits you but guided by the dietician and health professional.

This will help you to achieve optimum blood sugar levels. As part of your monitoring your doctor also monitors how well your blood sugar is controlled by taking a blood test named HBA1C. This gives an indication of how your blood sugar has been over the past 2 to 3 months.

The target is a reading that is less than 6.5%. So if your HBA1c is above 6.5% it also means you are not well controlled and the high circulating blood sugar may have started to cause damage to small blood vessels supplying vital organs.


Step 3 Ensure that you take your medication

It is important to ensure that medication is taken daily as advised. Always ask if you are unsure of how to take your medication. Always have a blood sugar monitoring diary. Remember to monitor frequently at least once a day.

Alternate at checking RBS and FBS levels. Also check your sugar level when you have symptoms of weakness, dizziness, sweating and tiredness.

This will enable the treating clinician to adjust your medication accordingly. If the blood sugar readings that you have taken and documented at home are consistently high, treatment doses may be adjusted up or some drugs may be added to your chronic prescription.

The doctor will use the HBA1C value in conjunction with your readings to make a decision on how to alter your treatment.

On the other hand, if the blood sugar readings are consistently low then the clinician will decrease doses of some medication or may withdraw some drugs from your chronic prescription.

Notify your clinician if you experience any symptoms of low blood sugar and any side effects to the medication issued.

Your clinician will work up a suitable alternative for you, because our aim is for patients to be comfortable with their medication because this reduces risk of non-adherence to treatment.


Step 4 Eat healthy

Diabetics must be referred to a Dietician for them to get reliable dietary information. The goal is to have you capable of controlling your blood sugar levels by eating well.

But what do we mean when we say you must eat well? Eating well means having to plan your weekly meals, grocery shopping, healthy meal options when eating out and reading food labels to understand how much carbohydrates you are taking.

Carbohydrates commonly referred to as carbs are broken down after digestion into glucose or blood sugar. So it is these “carbs” that are directly related to blood sugar. The more carbs you eat the higher your blood sugar is going to be.

There are different types of “carbs”. Sugars, Starches and Fibre. Sugars and starches increase your blood sugar but fibre doesn’t.

Most foods have hidden sugars like yoghurt, carbonated drinks and baked goods, be careful and start a new habit of reading food labels to know the amount of carbs the food contains.

Minimise your intake of starches and sugars. Diabetics are encouraged to have a higher proportion of foods rich in fibre like whole grain pasta, whole grain rice, wholegrain bread and oats, nuts and seeds, vegetables, fruits like berries, watermelon and oranges in conjunction with healthy portions of meat, dairy and vegetables.


Step 5 Be Active

When you exercise learn to target a total weekly exercise time of 150 minutes of moderate to intense physical activity.

This may be 30-minute brisk walking sessions, 5 times per week or 20 to 25 minutes of activity every day. Activities may include walking, jogging, skipping, cycling, swimming, dancing or playing sport. Ensure to work all muscle groups. Keep the exercise routine fun.

Exercise makes your body more sensitive to insulin and so your blood sugar levels will improve. Exercise not only improves sugar levels but is also good for cardiovascular health, lowering cholesterol and blood pressure and most importantly mental health.


Contact All In 4 Health for General Medical Consultation, health screening, medical check-up, health education and promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619








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