SA JOURNAL OF DIABETES & VASCULAR DISEASE
VOLUME 8 NUMBER 4 • NOVEMBER 2011
169
‘Walking the walk’ to a greater
understanding of diabetes
D
iabetes nurse educator (DNE) Christine
Swart believes in ‘walking the walk’ to
a deeper understanding and control of
diabetes alongside her patients, every step of the
way. She is uniquely placed to do this. An insulin-
dependent diabetic herself for more than 20 years,
she’s living proof that it’s possible to have diabetes
and still lead a normal, healthy life. ‘I believe that
ultimately diabetics are people just like everyone
else with the same general concerns and challenges.
Managing their diabetes is just one additional aspect
of their lives and not something that defines them’,
she says.
Based at Netcare Kuils River Hospital in the north-
ern suburbs of Cape Town, Christine works with
three physicians and four gynaecologists, providing
diabetes education to all patients admitted to the
hospital’s various wards. The population she serves
is diverse, ranging from the wealthy to the disadvan-
taged, but she is committed to giving a good-quality
service to all and to working around any constraints
related to funding. In addition she runs a monthly
support group that addresses topics identified by
the patients themselves. ‘Once a year, this takes the
form of a dinner at an outside venue – usually with
a dietician present. It provides a good opportunity to
advise on correct eating choices’, she says.
A registered nurse with a background in primary
care and community health nursing, Christine first
became involved in diabetes when she worked at
Netcare Park Lane Clinic in Johannesburg, counsel-
ling pregnant women with gestational diabetes. On
her return to Cape Town, she became aware of how
many diabetics received inadequate counselling and
the prescriptive, unempathetic way they were often
treated. She has been a DNE since 1997 and in her
current position since 2002.
‘Most people don’t really understand what hap-
pens in the body when you have diabetes’, she says.
‘There are many myths and misconceptions that
need to be addressed. When a patient comes to me
for the first time, I start by assessing how much they
know and understand, and sift out the correct infor-
mation from the nonsense. I then give them a basic
course in physiology, using models and pictures of
the body so that they become familiar with the vari-
ous organs and their location. I also have a model
hamburger that I dissect in front of them as I explain
how eating it affects a diabetic versus how it affects
someone without the condition. I tell them how that
extra glucose affects the various organs and the po-
tential damage it can do.’
Christine emphasises that it’s important to keep
things simple and avoid information overload. To this
end, she often educates incrementally in ‘manage-
able portions’ over successive patient visits and
uses tests to assess that patients understand what
they’ve been told. ‘I make them aware that the dis-
ease will progress and that the pancreas will secrete
less insulin over time. This does mean that they will
probably need to change their therapy in the years
ahead.’
Once patients understand the condition, the next
step is to educate them around its treatment. This
also takes time, especially when it comes to insu-
lin therapy, which Christine feels requires at least a
90-minute to two-hour conversation. In addition, all
patient conversations are individualised and ‘tailor-
Diabetes Personality
S Afr J Diabetes Vasc Dis
2011:
8
:
169–170.
‘Most people don’t really understand what
happens in the body when you have diabetes’
