VOLUME 19 NUMBER 2 • November 2022 33 SA JOURNAL OF DIABETES & VASCULAR DISEASE Learning to live with diabetes Diabetes is not just about sugar, every organ is affected LEARNING TO LIVE WITH DIABETES At just three years old, Liezl was diagnosed as diabetic. ‘My mom noticed I was losing weight and drinking lots of water, and I wanted to eat a lot of tomato sauce because I was craving the sweetness. She also says my breath smelled sweet. Now we recognise these as symptoms of uncontrolled diabetes, and diabetic acidosis, a shortage of insulin in the body that prevents blood sugar from getting to the cells to be used as energy,’ says Liezl, now 34 years old. ‘Diabetes is a long-term condition that affects how your body breaks down sugar from the food that you eat. While type 1 diabetes is usually diagnosed in childhood, type 2 diabetes develops over time and is more often diagnosed in adulthood,’ says Joy Steenkamp, a pharmacist at Medipost Pharmacy, South Africa’s first national courier pharmacy. Being diabetic is a full-time job Insulin is a hormone that helps control your body’s blood sugar levels. If your body doesn’t produce enough insulin or cells stop responding to insulin, too much sugar remains in your bloodstream, leading to serious health problems over time, including potentially irreversible damage to the eyes, kidneys and other organ systems. Liezl had to learn to inject herself with insulin at only seven years old. ‘My mother made my teachers aware that I had diabetes and I did my injections in the offices at the school. I always had to have insulin with me, from such a young age. Being a diabetic is a full-time job. It’s a responsibility that comes too soon and the consequences may come when it’s too late,’ she says. ‘Diabetes can be a great journey or a terrible journey, depending on how you see it and how you manage it. Emotionally, it can get really tough. I want to help people understand what it is like to be diabetic and, if you are diabetic, how important it is to look after your health and do everything possible to avoid complications,’ Liezl says. ‘With the medicines available these days, along with regular exercise and a healthy diet as advised by your treating doctor, diabetes can be very well controlled. There are many new oral or injectable medicines, as well as insulin pumps to help diabetics keep their blood sugar levels stable,’ Steenkamp adds. ‘If you are diabetic, it is especially important to be aware of your blood sugar levels and be consistent with managing the condition. No one chooses to be diabetic, and it is often emotionally difficult to come to terms with a diagnosis and to learn how to control your blood sugar.’ Poorly controlled diabetes has lifelong consequences ‘As somebody who has walked this path, I take blood sugar control seriously now. When I was a teenager, there was a time when I felt isolated because of my condition and, like a teenager, I rebelled against my diabetes and didn’t take the care I knew I should with my diet and monitoring my blood sugar to stay within safe levels,’ Liezl says. ‘You think diabetes is just about sugar, but there is so much more to it than that, and every organ in your body is affected when the condition is not properly controlled because it damages your blood vessels. In my case, as a result of the damage caused in my teens, by the age of 20, I had developed kidney failure and impaired vision. I wasn’t managing my diabetes well enough all those years ago, and now I can’t reverse the damage it caused,’ Liezl shares. The ‘sweet spot’ for blood glucose levels ‘Persons living with diabetes should monitor their blood sugar levels closely. Sometimes patients learn to recognise the symptoms when their blood sugar is high, which is known as hyperglycaemia, or too low, known as hypoglycaemia, however there are several ways to accurately test and this should become part of your daily life to manage diabetes,’ Steenkamp advises. The treating healthcare practitioner will recommend specific target blood glucose levels for persons living with diabetes according to an individualised risk–benefit analysis. For most adult patients, it is recommended that blood glucose levels should be between 4 and 7 mmol/l if you have not eaten in several hours, and less than 10 mmol/l within one to two hours of a meal. Joy Steenkamp, Medipost Pharmacy.
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