VOLUME 10 NUMBER 1 • MARCH 2013
35
SA JOURNAL OF DIABETES & VASCULAR DISEASE
PATIENTS AS PARTNERS
SUMMING UP
Educating patients about their diabetes is a continuous and ongoing
process. People generally worry less about aspects of their health if they
know what to expect, how to deal with it and when to ask questions. If
people with diabetes understand why they put on weight with insulin they
can be proactive and take preventive action. Likewise, understanding the
effect of exercise on blood glucose levels is important for anyone with
diabetes, not just for those using insulin.
Driving with diabetes has legal implications, and it is essential that peo-
ple realise the dangers and know how to keep safe on the roads. Illness is
a nuisance at the best of times and is a bigger nuisance when combined
with diabetes, especially if patients are unaware of what to expect and how
to deal with the unexpectedly high blood glucose levels that can result.
Practice nurses are well placed to support and help patients through these
aspects of their care. Continuous education and reinforcing important mes-
sages means patients learn to self-care effectively, promoting their well-
being, reducing the incidence of complications and keeping them safe.
•
Shaw K. Safe driving with diabetes: risks, reality and responsibilities.
•
Practical Diabetes International
Sept 2008 vol 25 no7.
Dept of Transport, For Medical Practitioners. At a glance guide to the cur-
•
rent medical standards of fitness to drive. Drivers Medical Group. DVLA.
Swansea. Sept 2008
aspx
MacKinnon
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M. Diabetes Care in General Practice
.
A Practical Guide to
Integrated Care
. Fourth ed. London: Class, 2002.
Sonksen P, Fox C, Judd S.
•
Diabetes at your Fingertips
. Fifth ed. London:
Class 2003.
Barnett AH.
•
Insulin Made Easy
. Revised ed. London: Medical Education
Partnership, 2004.
Krentz AJ, Bailey CJ. Type 2
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Diabetes in Practice
. London: RSM, 2001.
Williams G, Pickup JC. Handbook of Diabetes. Third ed. Oxford: Blackwell
•
2004.
Waugh A, Grant A.
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Ross and Wilson Anatomy and Physiology in Health
and Illness
. Ninth ed. London: Churchill Livingstone 2001.
•
MORE INFORMATION
DIABETES NEWS
C
hanging dietary habits and consequent
nutritional deficiencies are having a
significant impact on the health status of
individuals living with chronic heart failure
(CHF) in Soweto. These were the findings of
a study published in January 2013.
1
The earlier Heart of Soweto study was
undertaken to document the increase in
cardiovascular disease among recently
urbanised Africans in Soweto. Further to this,
nutritionist Sandra Pretorius of the Soweto
Cardiovascular Research Unit, University of
theWitwatersrand, Johannesburg, undertook
that study specifically to assess the nutritional
aspect of this worrying phenomenon.
2
Her conclusion was that patients suffering
from CHF in Soweto might be in the early
stages of the ‘nutrition transition’ and that
while they continue to eat some of the more
‘traditional’ carbohydrate foods, their food
choices are increasingly being affected by
urbanisation. Where the traditional rural
Diabetes news
Changing dietary habits and associated nutritional deficiencies impact
on urban African patients living with heart failure in Soweto
diet is low in fat and high in unrefined
carbohydrates, vegetables and fruit, urban
diets are being supplemented by highly
refined carbohydrate sources, with individuals
now consuming only around one piece of
fruit and one vegetable serving per day.
‘Urbanisation has brought increased
access to a wider range of food choices, but
many of these are the wrong choices’, she
told the
SAJDVD
in a recent interview. ‘Fast
foods and convenience foods, which usually
have high fat, trans fats and salt content,
are not only easily available but also more
affordable, so people are consuming more
of them. An increasingly sedentary lifestyle
exacerbates the problem.’
Pretorius feels strongly that it’s not
enough simply to document these trends.
Steps need to be taken to arrest them.
Specific dietary recommendations, which
are culturally sensitive and economically
viable for the prevention and management
of CHF in this population group, as well as
targeted intervention programmes, need
to be developed and implemented. She is
currently working on making these a reality.
Her concerns go beyond CHF, however,
to embrace diseases of lifestyle in general
and the risk factors for these. The findings
are sobering. In a survey of 1 311 patients
attending primary health clinics in Soweto,
Stewart
et al
. found a high prevalence of
obesity; 42–47% in women and 11% in
men. There was a similarly high prevalence
of hypertension of approximately 33%.
2
Pretorius, together with Prof Karen Sliwa
and the Soweto Cardiovascular Research
team, has been instrumental in organising
awareness days in Soweto to make the
public more conscious of the dangers
associated with obesity and hypertension.
‘There is still a lot of ignorance among the
public, especially when it comes to obesity,’
she says.
